April 28, 2011

'COPE' online education responds to FDA call for safe prescribing of painkillers

UW Health Sciences/UW Medicine

Related article: Course-correcting how doctors treat chronic pain

University of Washington Medical Center has announced the creation of an up-to-date online training tool that will help doctors and other prescribing providers respond to new U.S. Food and Drug Administration (FDA) requirements concerning opioids, commonly known as painkiller medications.

The Centers for Disease Control and Prevention (CDC) and other health, labor and social service agencies nationally and in Washington state have been concerned about the rapidly increasing number of deaths due to accidental opioid overdose. Prescription opioid abuse is now the fastest growing form of drug abuse in the U.S. The FDAs Risk Evaluation and Mitigation Strategy (REMS) for chronic opioid prescribers that was announced last week is devised to educate providers on reducing risks associated with opioid treatment of chronic non-cancer pain. All opioid manufacturers must be fully compliant with the FDAs Risk Evaluation and Mitigation Strategy within 120 days.

COPE (Collaborative Opioid Prescribing Education), the University of Washingtons interactive, educational training tool, is well positioned to meet the FDAs call for an education program for prescribers.  Developed over a period of six years, COPE is designed to help prescribers and patients improve communication when it comes to making decisions about chronic opioid therapy. Often doctors face difficult conversations with patients who have chronic pain. Trust needs to be present, otherwise patients may be less likely to follow medication instructions, or they may take extra doses or combine them inappropriately with other medications or alcohol. They may even seek out multiple prescribers or seek to obtain medications from outside the medical system, practices that increase the risk of both accidental overdose and abuse.

“COPE is unique because it goes beyond typical factual content about opioid pharmacology and effectiveness of opioids for pain to provide training about goal setting and communication skills training,” said Dr. Mark Sullivan, professor of psychiatry and behavioral sciences at the UW School of Medicine. COPE is rooted in the Chronic Care Model, which argues that health care providers and patients need to make treatment decisions collaboratively to achieve positive health outcomes for patients with chronic conditions. “COPE offers videotaped clinical scenarios that provide learning opportunities and can help build trust between doctors and patients so that they are able to have the kind of crucial conversations needed to address chronic pain.”

UW Medicine’s leadership in pain management dates to the early 1960s, when it established the worlds first multidisciplinary pain clinic. Washington is the first state to issue an opioid dosing guideline that may become a model for other states. The state passed a bill, known as ESHB 2876, that will require mandatory education and use of a prescription monitoring program and a clinical tracking tool to be implemented in the state as of July 1, 2011.

“We are in the business of predicting, diagnosing and preventing pain from becoming a disabling disease,” adds Dr. Alex Cahana, UW Medicines director of the Division of Pain Medicine. “Opioids are among the tools used in pain management, but because pain is a complex problem, it demands a complex solution.” Cahana and his colleagues implement a multidisciplinary approach at the flagship Center for Pain Relief based at UWMC. The Center received the American Pain Society Center of Excellence Award in 2010.

Medical specialists are working with the University of Washingtons Center for Commercialization on broad dissemination of the COPE tool.  COPE is the only web-based training proven to be effective in a randomized trial. More information about COPE may be found at: www.COPE-pain.org

According to the Centers for Disease Control and Prevention, unintentional drug overdose is a growing epidemic in the United States and a leading cause of injury death in 17 states.

Additional Resources:

Collaborative Opioid Prescribing Education: Randomized Trial of Web-Based Training for  Residents Concerning Management of Primary Care Patients with Chronic Non-Malignant  Pain,” by Sullivan, Mark D.; Gaster, Barak; Russo, Joan; Bowlby, Lynn; Rocco, Nicole;  Sinex, Noelle; Livovich, Jeffrey; Jasti, Harish; and Arnold, Robert. In Clinical Journal of  Pain, July/August 2010, Vol. 26, No. 6.

About UW Medicine

UW Medicine provides primary and specialty care to patients, trains tomorrows health professionals and biomedical researchers, and advances scientific discovery. The entities of UW Medicine are Harborview Medical Center, UW Medical Center, Northwest Hospital & Medical Center, UW Neighborhood Clinics, UW Physicians, the University of Washington School of Medicine, and Airlift Northwest. UW Medicine is one of three entities that comprise the Seattle Cancer Care Alliance. UW Medicine is the countrys top public institution in National Institutes of Health funding. Its faculty includes 4 Nobel Prize laureates, 33 Institute of Medicine members, and 33 National Academy of Sciences members. Its medical school is regarded as the nations leader in preparing primary-care and rural physicians through its five-state regional education program. Visit www.uwmedicine.org. Follow us on Twitter – UWMedicineNews

About the UW Center for Commercialization

UW researchers in hundreds of labs are making extraordinary discoveries.  As one of Americas leading federally-funded public research universities, UW is producing innovations that have the power to change the way patients and prescribers make decisions about managing pain and creating communication and educational tools needed to have the conversation about pain. The Center for Commercialization (C4C) is committed to getting research outcomes such as these into products, services, therapies, diagnostics, and cures where they can impact millions of people. Since its founding, C4C has helped create more than 240 companies in Washington state and abroad.