Brief report: Training internists in shared decision making about chronic opioid treatment for noncancer pain.
BACKGROUND
The use of chronic opioids for noncancer pain is an increasingly common and difficult problem in primary care.


OBJECTIVE
To test the effects on physicians' self-reported attitudes and behavior of a shared decision-making training for opioid treatment of chronic pain.


METHODS
Randomized-controlled trial.


METHODS
Internal Medicine residents (n=38) and attendings (n=7) were randomized to receive two 1-hour training sessions on a shared decision-making model for opioid treatment for chronic pain (intervention, n=22) or written educational materials (control, n=23).


METHODS
Questionnaires assessing physician satisfaction, physician patient-centeredness, opioid prescribing practices, and completion rates of patient treatment agreements administered 2 months before and 3 months after training.


RESULTS
At follow-up, the intervention group reported significantly greater overall physician satisfaction (P=.002), including subscales on relationship quality (P=.03) and appropriate use of time (P=.02), self-reported completion rates of patient treatment agreements (P=.01), self-reported rates of methadone prescribing (P=.05), and self-reported change in care of patients with chronic pain (P=.01).


CONCLUSIONS
Training primary care physicians in the shared decision-making model improves physician satisfaction in caring for patients with chronic pain and promotes the use of patient treatment agreements. Further research is necessary to determine whether this training improves patient satisfaction and outcomes.
Sullivan
Mark D
MD
Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195-6560, USA. sullimar@u.washington.edu
Leigh
Janis
J
Gaster
Barak
B