Annals of Family Medicine (04/01/23) Balari, Pardis; Zhao, Jane; Inniss, Bayley; et al.
A recent study sought to assess the ECHO Ontario Chronic Pain and Opioid Stewardship continuing medical education program for primary care providers (PCPs) treating patients with chronic pain. The retrospective chart review included the practices of 12 PCPs who attended at least four ECHO sessions between June 2014 and August 2018. For each of the 47 patient charts reviewed, PCPs were asked to select chronic pain patients on whom they had used their ECHO-based education, who had been prescribed opioids during the study period. Fifty-one percent of the patients had two or more pain diagnoses at baseline, most often musculoskeletal pain. Fifty-five percent had comorbid mental health conditions, and 28% reported sleep disorders. Post-ECHO PCP performance showed marginal but non-significant improvements highlighted by greater use of pain and opioid management methods. Noting the "challenging" effort of using chart reviews to assess PCP performance, the researchers suggest that "future work to assess provider performance should include a qualitative component (in-depth interviews or focus groups) in order to complement the quantitative data and provide context for care and management decisions."