University of Washington’s interactive online training arms physicians with knowledge to curb prescription drug abuse

Story by Clare LaFond

Talking about chronic pain can be difficult for patients and their medical providers. Talking about managing chronic pain with long-term opioid therapy can prove even more challenging. A University of Washington School of Medicine interactive online education program gives providers the confidence and perspective they need to have these difficult conversations.

drugs---doctoredAimed at curbing the alarming rise of opioid prescription drug abuse, the University of Washington has just launched an enhanced version of its course to help healthcare providers more safely and effectively manage patients’ chronic pain. Known as COPE-REMS (Collaborative Opioid Prescribing Education for Risk Evaluation and Mitigation Strategy), the new course is part of a nationwide educational effort sponsored by the Food and Drug Administration to better equip healthcare practitioners when it comes to prescribing painkiller medications, or opioids, to patients with chronic non-cancer pain.

The COPE-REMS course is targeted to these providers, who often struggle with difficult decisions when it comes to opioid prescribing. The course features patient-prescriber video vignettes on how to handle tough situations, behavioral tools and tips for safe prescribing, and interactive exercises and audiovisual content. Providers learn practical tips for treating chronic pain, including how to:

• Recognize when it’s safe to prescribe opioids to patients—how to start, stop or switch opioid therapies;
• Better manage patients in order to prevent opioid misuse, abuse and accidental death from overdose;
• Communicate effectively when facing difficult patient situations;
• Treat chronic pain without promoting addiction.

“It is critical to fully understand these medications and how they work,” said Dr. Mark Sullivan, a psychiatrist with the UW Medicine Center for Pain Relief, professor in the UW Department of Psychiatry and Behavioral Sciences, and a widely published expert in pain management. “But what is equally as important are the personal communication skills that allow providers to develop trusting relationships with patients who are potentially at risk for bad outcomes of opioid therapy, whether due to high opioid doses or personal histories of substance abuse or mental illness.”

COPE-REMS teaches a collaborative care model for treating patients, thereby broadening the scope of educational content about best practice care of chronic pain. The course provides portable and convenient online training to family practitioners and other primary care providers who prescribe opioids — specifically extended-release and long-acting drugs such as Vicodin and Oxycodone. COPE-REMS expands upon COPE, the only online opioid training that has been proven effective in a randomized control trial. The University of Washington’s Training Xchange has been supporting the UW COPE team by building the online course and assisting with its marketing efforts.

Across the nation, the annual death toll from prescription painkillers continues to escalate, with Washington, Oregon, Colorado and Idaho forming the newest hub for the highest rates of painkiller abuse, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). Two years ago, in reaction to the alarming death rate of more than 16,000 prescription drug overdose deaths per year in the U.S., the FDA issued a Risk Evaluation and Mitigation Strategy (REMS) for long-acting, extended-release painkillers. The FDA REMS requires opioid manufacturers to educate health care providers on ways to reduce risks associated with chronic opioid therapy.

In 2007, Washington became the first state in the U.S. to issue an opioid dosing guideline. In 2011, the state passed legislation on opioid dosing guidelines suggesting a daily dose threshold and the need for referral to pain specialists under certain conditions. WA State law 2876, with its opioid dosing guideline, has now become a model for other states.

UW Medicine’s COPE-REMS course is one of the first of its kind nationally to respond to this training need and to be fully compliant with the REMS. The new COPE-REMS course meets all FDA requirements and is rich with guidance about when it is appropriate to prescribe, to change a dose level, or to discontinue opioid prescribing. Learn more at www.coperems.org