FDA REMS Pain Management and Opioid Therapy: Persistent Knowledge Gaps Among Primary Care Providers Rockpointe Program Shows Need for More Healthcare Provider Education

The opioid epidemic that has gripped the US for over 20 years has worsened during the ongoing COVID-19 pandemic with the highest number of drug overdose deaths occurring in 2020. This sobering fact emphasizes the need for healthcare providers (HCPs) to be able to provide evidence-based care and be able to recognize their patients who are at risk for opioid addiction.

To help address this educational need, the US FDA provided a blueprint for continuing education for HCPs in the use of opioid analgesics in pain management in 2016 and an update in 2018. The blueprint defines specific aspects of pain management and opioid analgesic use to be addressed in continuing education (CE), e.g. definitions of pain and its mechanisms, components of an effective treatment plan of pain, managing patients on opioid analgesics, opioid addiction. Rockpointe has developed and presented multiple continuing education programs for HCPs based on these FDA blueprints.  Because of the importance of the topic on October 13^th and 14^th  the FDA is hosting a public workshop on Opioid REMS and considering requiring making opioid REMS a mandatory requirement for physicians and what that would take.

The outcomes from two of these blueprint-based programs developed and presented by Rockpointe, a continuing medical education company in Columbia, MD, served as the basis for an article, “Pain Management and Opioid Therapy: Persistent Knowledge Gaps Among Primary Care Providers,” published this week in the Journal of Pain Research. Knowledge gaps identified among the 5,571 HCP learners who participated in the programs correlated directly to specific aspects identified by the FDA blueprint including only 12% recognizing examples of nociceptive pain; less than 50% were knowledgeable of proper extended-release opioid conversion and less than 25% selected an appropriate choice when initiating chronic opioid therapy; only 33% identified useful screening tools for opioid use disorder screening. These findings provide insights into the clinical aspects of opioid therapies with which primary care providers continue to struggle and direction for continued efforts to educate HCPs in evidence-based care to patients who are struggling with opioid addicted or are at-risk for addiction.

In assessing the outcomes of these programs, Rockpointe found consistent and statistically significant improvements in the knowledge gaps identified above among the participants following completion of the CE programs. Moreover, some of the same improvements, e.g. proper extended-release opioid conversion, were noted within the 90-day follow-up data from a subset of participants, suggesting0404 incorporation of the learning into daily practice. These data demonstrate the ability of educational to address knowledge gaps and improve practices among HCPs in the evidence-based use of opioids to treat patients with acute and chronic pain.

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