1 / 10

Svetlana V. Doubova Dolores Mino-Leon Hortensia Reyes Morales Sergio Flores-Hernández

Effects of two educational programs aimed at improving the utilization of non- opioid analgesics in family medicine clinics in Mexico. Svetlana V. Doubova Dolores Mino-Leon Hortensia Reyes Morales Sergio Flores-Hernández Ricardo Pérez-Cuevas. Problem Statement:.

minor
Download Presentation

Svetlana V. Doubova Dolores Mino-Leon Hortensia Reyes Morales Sergio Flores-Hernández

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Effects of two educational programs aimed at improving the utilization of non-opioid analgesics in family medicine clinics in Mexico Svetlana V. Doubova Dolores Mino-Leon Hortensia Reyes Morales Sergio Flores-Hernández Ricardo Pérez-Cuevas

  2. Problem Statement: • There is a high frequency of prescription of non-opioid analgesics (NOAs), second only to cardiovascular drugs. • Several studies have reported that medical doctors do not prescribe properly and patients do not use the NOAs appropriately. • This finding is evidenced by overutilization rates of up to 41%and by the frequent appearance of preventable adverse events. -42% of the medical doctors are unaware of the adverse events that NOAs cause. -34% of patients are unsure about the proper method of taking NOAs,despite the fact that these are among the most common self-medicated drugs.

  3. Objectives: • To develop and test two educational programs (interactive and passive) aimed at improving family doctors’ (FDs) prescribing practices and patient’s knowledge and use of NOAs. Methods: • The educational programs were conducted in two family medicine clinics belonging to the Mexican Institute of Social Security in Mexico City. The study was performed in three stages: 1) Baseline evaluation 2) Implementation of educational activities 3) Post-program evaluation.

  4. EDUCATIONAL PROGRAMS PASSIVE (PEP) INTERACTIVE(IEP) FAMILY DOCTORS PATIENTS FAMILY DOCTORS PATIENTS WORKSHOPS, DISCUSSION GROUPS, IN-SERVICE TRAINING VIDEO, LIFLET, INTERACTIVE EDUCATIONAL SESSION CLINICAL GUIDELINE LIFLET 1 MOUNTH 1 OCASION PER PATIENTE 1 OCASION 1 OCASION

  5. Methods: All FDs working at the clinics were invited to participate in the programs, and most (99%) of them accepted the invitation. • There were 58 FDs in the IEP group and 52 FDs in the PEP group. The eligibility criteria for patients were: • age ≥ 50 years, suffered from non-malignant pain syndrome, had received at least one NOA prescription for a period of ≥ 7 days, were under the care of the participating FDs, and were able to answer the questions posed during the interview. • The baseline and post-program evaluations included 300 patients by group.

  6. Methods: The effect of the programs: • on the FDs was measured through the appropriateness of prescriptions of NOA and analyzed using the differences-in-differences estimator (D-in-D) • on patients through changes in self-medication and in their knowledge about the proper use and adverse events by analyzing the inter- and intra-group differences before and after the programs.

  7. Table 1. Characteristics of non-opioid analgesic prescriptions, according to the type of the educational program *p<0.05 between groups A comparison of data from the IEP and PEP groups (i.e., baseline and post-program evaluation data) revealed that prescription of paracetamol increased and NSAIDs decreased in the IEP group (p < 0.05), particularly with regard to prescriptions for elderly patients.

  8. Table 2. Effect of educational programs on the prescription of non-opioid analgesics by family doctors. *The model was adjusted according to baseline evaluation data and seniority of the family doctors. **p < 0.0001 between pre- and post-intervention stages, within groups. †p < 0.0001 between IEP and PEP. In the IEP group, the mean difference in the proportion of appropriately prescribed NOAs between the baseline and post-intervention stages was 17.8% (p < 0.05), whereas the mean difference in the PEP group was 6.0% (p > 0.05).

  9. Table 3. Effect of educational programs on patients’ use of non-opioid analgesics. *Abbreviation: NOA, non-opioid analgesics. * p < 0.05. The percent differences in IEP and PEP patients reporting self-medication were –9.1% and –13.4%, respectively. The percent difference in knowledge of proper NOA administration was 8.5% in both groups, while awareness of adverse events was 39.6% in the IEP group and 9.2% in the PEP group

  10. Key lessons from the study • The IEP aimed at patients and family doctors are superior to PEP in improving family doctors’ prescribing patterns and enhancing patients’ knowledge of NOA-associated adverse events. • Our findings suggest that programs aimed at improving medication use should focus on interactive educational activities. • The IEP had a positive effect on patients’ awareness of NOA-associated adverse events even though the intervention did not improve the ability of patients to identify gastrointestinal adverse events. • The IEP should be improved in this aspect, and novel programs should be developed to specifically educate patients about NOAs gastrointestinal adverse events.

More Related