title: Identifying primary care skills and competencies in opioid risk management.
abstract: BACKGROUND
  Primary care physicians (PCPs) treat a high proportion of chronic pain patients but often lack training about how to assess and address issues associated with prescribing opioids when they are an appropriate component of therapy. The result may be that they may avoid treating these patients, which can lead to an undertreatment of pain. The objective of this study was to identify which skills and competencies are most critical for PCPs in order to effectively manage opioid risk in patients treated for chronic pain.
  
  
  METHODS
  We conducted 1-hour interviews with 16 nationally known experts in primary care, pain management, and addiction. Eight were trained as PCPs, and 8 were trained as specialists. Their responses were collated and then presented online to the participants for independent sorting and rating. These data were analyzed using an online concept mapping program, which offers an innovative method of summarizing and prioritizing qualitative data.
  
  
  RESULTS
  Based on this analysis, items were organized into 10 clusters representing the most critical categories of skills (the "best fit" for these data). The cluster that received the highest average statement rating was "How to Manage Pain Patients With Comorbid Conditions." Follow-up analyses indicated that specialists rated this cluster, and 5 others, significantly higher than the PCPs, suggesting that the specialists perceive these competencies as more important in opioid risk management.
  
  
  CONCLUSIONS
  Using a relatively small sample and cost-effective technique (ie, concept mapping), key PCP competencies can be identified for potential inclusion in continuing education and training in opioid risk management.
authors.affiliation: Product Strategy, Inflexxion, Inc., 320 Needham St., Suite 100, Newton, MA 02464, USA. echiauzzi@inflexxion.com
authors.forename: Emil
authors.initials: E
authors.lastname: Chiauzzi
authors.forename: Kimberlee J
authors.initials: KJ
authors.lastname: Trudeau
authors.forename: Kevin
authors.initials: K
authors.lastname: Zacharoff
authors.forename: Kathleen
authors.initials: K
authors.lastname: Bond
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use*; D059350:Chronic Pain / Q000188:drug therapy; D002983:Clinical Competence / Q000592:standards* / Q000706:statistics & numerical data; D004521:Educational Measurement / Q000379:methods; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008511:Medicine / Q000706:statistics & numerical data; D059408:Pain Management; D010821:Physicians, Family / Q000193:education / Q000523:psychology* / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000592:standards*; D017064:Process Assessment, Health Care / Q000592:standards; D012308:Risk Management; D019966:Substance-Related Disorders / Q000188:drug therapy; D011795:Surveys and Questionnaires
chemical_list: D000701:Analgesics, Opioid