TY - JOUR
T1 - Launching an innovative educational model addressing substance use disorders and dental pain management (Project ECHO® in dentistry)
AU - Kohli, Richie
AU - Replogle, Karan
AU - Gough-Goldman, Andrea
AU - Taylor, Barry
AU - Maughan, Brandon
AU - Sehgal, Harjit Singh
AU - Herink, Megan C.
AU - Hemmings, Rosemarie
AU - Mahoney, Sean
AU - McDonnell, Margaret Mc Lain
AU - McLemore, Kenneth
AU - Schwarz, Eli
N1 - Funding Information:
The small population size of this project limits the generalizability of the results and limits our ability to analyze the effects of confounders and differences in participant characteristics on overall outcomes. Also, since the recruitment was done through mass e-mails through various list serves and with overlap of members in the lists, we were not able to calculate the true response rate. Only a small self-selected group of dentists registered for this program, who must have had a particular interest in the topic beforehand. There was also an attrition issue with more attendees participating in the first sessions and gradually decreasing towards session 6. For the planning of future programs, we will capture additional qualitative data from participants to consider modifying content or session structure to reduce attrition. Further, sustainability of Project ECHO relies heavily on grant funding. Additionally, there was no follow-up with the participants to measure the program’s short- and long-term effects on sustained clinical behavior change for appropriate prescribing for pain management. Future ECHO programs could solicit data on clinical behavior change 6 months and 1 year after completion of the program. While the assumption is that a change in provider knowledge and behavior will result in greater patient satisfaction in pain management and provider-patient interaction, there was no patient participation in this study that allowed the measurement of patient-perceived outcomes as a result of changes in provider knowledge, attitudes and practices.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/12
Y1 - 2022/12
N2 - Background: Uninformed opioid prescribing by dentists has contributed to the current opioid crisis. This report describes the development and implementation of an innovative, interactive, multidisciplinary, and participant-centric telementoring program “Pain Management and Substance Use Disorders Dental ECHO (Extension for Community Health Care Outcomes)”. We disseminated information to dentists about appropriate opioid prescribing practices and engaged them with a focus on pain management and substance use disorders. The objective of this study was to assess the effectiveness of this program for self-reported: (1) change in knowledge and confidence related to clinical skills for dental pain management of patients with substance use disorders; (2) change in clinical behavior of dentists for safe opioids prescribing; and (3) change in clinic policies regarding safe opioids prescribing. Methods: An interdisciplinary panel of experts in medicine, pharmacy, social work, and dentistry designed and led the “Pain Management and Substance Use Disorders Dental ECHO” for invited dental care providers and dental students. Six cohorts each consisting of six, 1-h-long sessions were conducted via the Zoom videoconference platform in years 2020 and 2021. Each session included a didactic expert presentation, a participant-presented patient case and discussion. Each participant completed pre- and post-program surveys to assess the program’s influence on participant knowledge, clinical confidence and behavior change. Results: The participants (N = 151) were dentists (n = 109), dental faculty (n = 15), dental residents (n = 6), dental hygienists/assistants (n = 13) and nurses and clinic administrators (n = 8). Self-reported perceived medication knowledge, confidence in identification, treatment and willingness to engage with substance use disorders patients, and reported compliance with Prescription Drug Monitoring Program (PDMP) checks increased significantly from before to after the sessions (p < 0.001). Overall, participants expressed high levels of satisfaction with the content and reported that the sessions provided high benefit. Conclusion: The Project ECHO model is effective in rapidly disseminating evidence-based information. Dentists viewed this model as having a high degree of benefit for the optimal management of dental pain and the recognition and treatment of substance use disorders.
AB - Background: Uninformed opioid prescribing by dentists has contributed to the current opioid crisis. This report describes the development and implementation of an innovative, interactive, multidisciplinary, and participant-centric telementoring program “Pain Management and Substance Use Disorders Dental ECHO (Extension for Community Health Care Outcomes)”. We disseminated information to dentists about appropriate opioid prescribing practices and engaged them with a focus on pain management and substance use disorders. The objective of this study was to assess the effectiveness of this program for self-reported: (1) change in knowledge and confidence related to clinical skills for dental pain management of patients with substance use disorders; (2) change in clinical behavior of dentists for safe opioids prescribing; and (3) change in clinic policies regarding safe opioids prescribing. Methods: An interdisciplinary panel of experts in medicine, pharmacy, social work, and dentistry designed and led the “Pain Management and Substance Use Disorders Dental ECHO” for invited dental care providers and dental students. Six cohorts each consisting of six, 1-h-long sessions were conducted via the Zoom videoconference platform in years 2020 and 2021. Each session included a didactic expert presentation, a participant-presented patient case and discussion. Each participant completed pre- and post-program surveys to assess the program’s influence on participant knowledge, clinical confidence and behavior change. Results: The participants (N = 151) were dentists (n = 109), dental faculty (n = 15), dental residents (n = 6), dental hygienists/assistants (n = 13) and nurses and clinic administrators (n = 8). Self-reported perceived medication knowledge, confidence in identification, treatment and willingness to engage with substance use disorders patients, and reported compliance with Prescription Drug Monitoring Program (PDMP) checks increased significantly from before to after the sessions (p < 0.001). Overall, participants expressed high levels of satisfaction with the content and reported that the sessions provided high benefit. Conclusion: The Project ECHO model is effective in rapidly disseminating evidence-based information. Dentists viewed this model as having a high degree of benefit for the optimal management of dental pain and the recognition and treatment of substance use disorders.
KW - Case-based learning
KW - Dental pain management
KW - Interprofessional education
KW - Opioids
KW - Project ECHO model
KW - Substance use disorder
UR - http://www.scopus.com/inward/record.url?scp=85137897544&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85137897544&partnerID=8YFLogxK
U2 - 10.1186/s12903-022-02417-6
DO - 10.1186/s12903-022-02417-6
M3 - Article
C2 - 36109782
AN - SCOPUS:85137897544
SN - 1472-6831
VL - 22
JO - BMC Oral Health
JF - BMC Oral Health
IS - 1
M1 - 402
ER -