MICIS: 2019 Education Topics

(1) Individual Academic Detailing Sessions & (2) Education Topics

(1) ACADEMIC DETAILING
Academic detailing is peer-to-peer educational outreach which is designed to improve prescribing practices.  It is useful for improving quality of care and identifying priorities for change.

Prescribers (MD, DO, PA, NP) and Medical Directors may request an individual Academic Detailing session at their practice location.  This direct learning session will be lead by Elisabeth Fowlie Mock, MD, MPH, an experienced clinician, teacher and leader in the opioid crisis and an Academic Detailer with MICIS since 2011.  There is no charge for this session.

This service is directed to two groups of prescribers: those who have complex patients with chronic pain on opioids and those who are considering providing buprenorphine treatment for opioid use disorder.  Sessions can be scheduled for any time of day, cover one hour of content, and multiple sessions for providers in the same or nearby practices can be scheduled on the same day.  Participants will be able to prioritize their learning needs and customize the learning session.

  • Treating Complex Patients with Chronic Pain who are Prescribed Opioids
    • Review opioid prescribing guidelines.
    • Assess alternative treatments for acute and chronic pain.
    • Review opioid prescribing practice transformation strategies.
    • Anticipate prescribing naloxone for all patients and families at risk.
  • Overview of Office-Based Buprenorphine Prescribing
    • Appropriately recognize and diagnose opioid use disorder (OUD).
    • Compare risks, benefits and alternatives of/to buprenorphine treatment.
    • Constantly consider harm reduction.

Contact MICIS to schedule an Academic Detailing session.

(2) Education Topics

OPIOID TOPICS: Four modules are available in 2019.

Three of the modules – 2019 Clinical Opioid Update, 2019 Legal and Regulatory Opioid Update, and Co-Prescribing Benzodiazepines & Opioids – can be combined for a 3-hour presentation.

2019 CLINICAL OPIOID UPDATE  slides

Learning Objectives:  

  • Review the latest research related to opioid and pain prescribing practices
  • Constantly consider harm reduction.
  • Discuss opioid use disorder and treatments.


Take home messages:

  • Opioid prescribing has decreased but is still triple the level of 1999.
  • Evidence is mounting that opioids do not improve outcomes for chronic pain.
  • Focus on non-drug and non-opioid therapies for acute and chronic pain.
  • Prescribe naloxone.
  • Know the Medication Assisted Treatment (MAT) resources in your community.

 

2019 OPIOID LEGAL AND REGULATORY UPDATE  slides

Learning Objectives:  

  • Review impact of Chapter 488 in Maine
  • Discuss opioid laws, rules and initiatives of the new administration
  • Study Chapter 21 requirements & logical implementation
  • Investigate methods to further transform local and regional prescribing

 

CO-PRESCRIBING BENZODIAZEPINES AND OPIOIDS: THE BLACK BOX OF INCREASED OVERDOSE RISK  slides
(presented since October 2018)
handout

Learning Objectives:

  • Review the trends in benzodiazepine prescribing
  • Evaluate risks of co-prescribing benzodiazepines and opioids
  • Consider taper plans
  • Recall importance of risk reduction


Take home messages:

  • Benzodiazepines are neither safe nor effective for long-term use.
  • Risk of death increases 4-10x when benzodiazepines and opioids co-prescribed.
  • “Z-Drugs,” gabapentin/pregabalin and carisoprodol are also risky to co-prescribe with opioids.
  • Enlist Behavioral Health support and start benzodiazepine tapers.
  • Prescribe naloxone to all patients currently co-prescribed benzodiazepines and opioids.

 

OPIOID USE DISORDER & MEDICATION ASSISTED RECOVERY: CARING FOR OUR COMMUNITIES  slides    references
(presented since May 2018)
handout

Learning Objectives:

  • Appropriately recognize, diagnose and discuss opioid use disorder (OUD).
  • Compare pharmacologic treatments used in Medication Assisted Recovery (MAR).
  • Develop a strategy for treating acute pain for patients with OUD.
  • Constantly consider harm reduction.

 

Take home messages:

  • The words you use to describe OUD and an individual with OUD are powerful.
  • Recovery is possible and more likely when using medications combined with counseling.
  • OUD medications reduce illicit opioid use, reduce overdose deaths, decrease crime and retain people in treatment/counseling.
  • Treat acute pain with multiple modalities for all patients, including those in recovery.
  • Recommend naloxone prescriptions for all patients in recovery.

 

GENERAL MEDICINE TOPIC

Managing Depression in Older Patients  (Note: this presentation is not opioid-related.)

Learning Objectives:

  • Review health outcomes for patients with depression in later life.
  • Screen older patients for depression and suicidality.
  • Evaluate and implement treatment options.

Contact MICIS to schedule a presentation.

AMA Designation Statement
The Maine Medical Education Trust designates these live activities for a maximum of 1 AMA PRA Category 1 Credit(s)TM.  Physicians should only claim credit commensurate with the extend of their participation in the activity.

Joint Providership
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medicine (ACCME) through the joint providership of the Maine Medical Education Trust and the Maine Independent Clinical Information Service (MICIS).  The Maine Medical Education Trust is accredited by the Maine Medical Association Committee on Continuing Medical Education and Accreditation to provide continuing medical education for physicians.