Publication Date



Persistent pain impacts the quality of life of millions of adults and is fiscally draining on the American healthcare system. National recognition of the problem is shifting persistent pain management recommendations. Historically, opioids have played a large role in the management of acute and chronic pain, but the current opioid epidemic in the United States creates an urgent need for clinicians to alter their practice to include new recommendations. Additionally, Medicare has approved changes in reimbursement, to enforce new pain management recommendations, that will make it increasingly difficult for patients with ongoing non-cancer pain to receive continuing opioid medication therapy. However, many clinicians feel unprepared to adequately manage patients with persistent pain. A multidisciplinary primary care clinic that had experienced an influx of opioid dependent chronic pain patients initiated a practice change project to increase provider adherence to current pain management guidelines. Clinicians were offered an onsite workshop. Following the educational interventions, the assessed prescription and referral practices were found to have: 1) reduced opioid prescribing, including in combination with benzodiazepines; 2) increased the number of referrals for interdisciplinary care; and 3) greater use of other classifications of drugs to manage patients’ pain. The providers’ change in practice reflected better understanding of the multifaceted aspects of persistent pain.


Chronic pain--Treatment; Primary care (Medicine)

Publication Information

NRS 597 - Practice Improvement Project

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Document Type

Doctoral Project