ArticleHealth education research2025
A short-duration telementoring pain management programme for Medicaid: impact on clinician outcomes.
Article in Health education research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
Previous evaluations of the pain care-related Extension for Community Healthcare Outcomes (ECHO) telementoring programmes found that long-term programmes (16-52 weeks) improve clinician knowledge, self-efficacy, and prescribing practices. We evaluated a 6- to 7-week Pain Management ECHO in Nevada Medicaid clinician networks. We collected pre- and post-knowledge and self-efficacy scores from 15 of 18 unique ECHO participants (83% response rate). We derived opioid prescribing outcomes from 44 894 Medicaid pharmacy claims records from 11 ECHO participants and 10 comparison clinicians. The three outcomes included any opioid (binary), non-opioid pain medication (binary), and opioid dose (continuous). Logistic regressions using difference-in-difference (DID) estimated the ECHO treatment effects. Knowledge scores (75% to 82%) and self-efficacy scores (3.4-4.1) increased after ECHO participation. After ECHO participation, opioid prescribing decreased, and non-opioid prescribing increased; changes in both outcomes were above and beyond changes in the comparison group (any opioid DID treatment effect: -0.6 percentage points; non-opioid pharmacologic: 1.1 percentage points). Incremental changes across three domains of Moore's Framework for continuing medical education provide evidence supporting a short-duration ECHO intervention in partnership with Medicaid managed care. Promulgation of this less resource-intensive approach can sustainably aid clinicians in managing pain experienced by Medicaid beneficiaries.
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