Evidence map›Paper›PMID 30382471›Full record

Observational studyJournal of general internal medicine2019

Army and Navy ECHO Pain Telementoring Improves Clinician Opioid Prescribing for Military Patients: an Observational Cohort Study.

Joanna G Katzman, Clifford R Qualls, William A Satterfield, Martin Kistin, Keith Hofmann, Nina Greenberg, Robin Swift, George D Comerci, Rebecca Fowler, Sanjeev Arora

Open access · hybridAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of general internal medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed
4.8field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 43 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Joanna G KatzmanECHO Institute, University of New Mexico, Albuquerque, NM, USA. JKatzman@salud.unm.edu.
Clifford R QuallsDepartment of Statistics, University of New Mexico School of Medicine, Albuquerque, NM, USA.
William A SatterfieldDefense Health Agency, Falls Church, VA, USA.
Martin KistinECHO Institute, University of New Mexico, Albuquerque, NM, USA.
Keith HofmannKennell and Associates, Falls Church, VA, USA.
Nina GreenbergDepartment of Mathematics, University of New Mexico, Albuquerque, NM, USA.
Robin SwiftECHO Institute, University of New Mexico, Albuquerque, NM, USA.
George D ComerciDepartment of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA.
Rebecca FowlerDepartment of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque, NM, USA.
Sanjeev AroraECHO Institute, University of New Mexico, Albuquerque, NM, USA.
University of New Mexico · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOpioid overdose deaths occur in civilian and military populations and are the leading cause of accidental death in the USA.

objectiveTo determine whether ECHO Pain telementoring regarding best practices in pain management and safe opioid prescribing yielded significant declines in opioid prescribing.

designA 4-year observational cohort study at military medical treatment facilities worldwide.

participantsPatients included 54.6% females and 46.4% males whose primary care clinicians (PCCs) opted to participate in ECHO Pain; the comparison group included 39.9% females and 60.1% males whose PCCs opted not to participate in ECHO Pain.

interventionPCCs attended 2-h weekly Chronic Pain and Opioid Management TeleECHO Clinic (ECHO Pain), which included pain and addiction didactics, case-based learning, and evidence-based recommendations. ECHO Pain sessions were offered 46 weeks per year. Attendance ranged from 1 to 3 sessions (47.7%), 4-19 (32.1%, or > 20 (20.2%). MAIN MEASURES: This study assessed whether clinician participation in Army and Navy Chronic Pain and Opioid Management TeleECHO Clinic (ECHO Pain) resulted in decreased prescription rates of opioid analgesics and co-prescribing of opioids and benzodiazepines. Measures included opioid prescriptions, morphine milligram equivalents (MME), and days of opioid and benzodiazepine co-prescribing per patient per year. KEY

resultsPCCs participating in ECHO Pain had greater percent declines than the comparison group in (a) annual opioid prescriptions per patient (- 23% vs. - 9%, P < 0.001), (b) average MME prescribed per patient/year (-28% vs. -7%, p < .02), (c) days of co-prescribed opioid and benzodiazepine per opioid user per year (-53% vs. -1%, p < .001), and (d) the number of opioid users (-20.2% vs. -8%, p < .001). Propensity scoring transformation-adjusted results were consistent with the opioid prescribing and MME results.

conclusionsPatients treated by PCCs who opted to participate in ECHO Pain had greater declines in opioid-related prescriptions than patients whose PCCs opted not to participate.

Indexed as

AdolescentAdultAnalgesics, OpioidClinical CompetenceCohort StudiesDrug PrescriptionsEducation, Medical, ContinuingFemaleHumansMaleMentoringMiddle AgedMilitary MedicineMilitary PersonnelPain MeasurementPhysicians, Primary CareAnalgesics, Opioidbenzodiazepinesclinician educationopioid overdose deathsopioidsproject ECHOtelementoring

Identifiers

PMID30382471
PMCPMC6420488
OpenAlexW2898929926

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.