Pathways to Safer Opioid Use: An Interactive, Simulation Based Elearning Lesson to Prevent Opioid Related Adverse Drug Events

Background: According to the Centers for Disease Control and Prevention, each day, 44 people in the United States die from overdose of prescription painkillers. In recent years, there has been a dramatic increase in the acceptance and use of prescription opioids for the treatment of chronic, non-cancer pain, such as back pain. The prescription opioid epidemic is not only a public health concern but also a concern for the US economy. A 2011 study estimated that, in 2006, nonmedical use of prescription painkillers imposed a cost of $53.4 billion on the US economy, including $42 billion in lost productivity, $8.2 billion in increased criminal justice costs, $2.2 billion for drug abuse treatment, and $944 million in medical complications. Health professionals need multiple strategies to ensure safe prescribing of prescription opioids.

Program background: Pathways to Safer Opioid Use (Pathways), produced by the Office of Disease Prevention and Health Promotion and released in April 2015, is an interactive, simulation based training tool. The training uses key principles of health literacy and a team-based approach to promote the safe, and effective use of opioids to manage chronic pain. The training allows the participant to assume the role of 4 playable characters who make decisions, controlled by the participant, about preventing opioid-related adverse drug events. The characters represent a primary care physician, a nurse, a pharmacist and a patient. This type of simulation based learning appeals to adult learners who retain information best when they are engaged in self-directed, active participation. Participants of the Pathways training are allowed the opportunity to make mistakes in a safe environment and learn from the consequences of their mistakes.

Evaluation Methods and Results: In an evaluation querying over 470 health professionals, 80% of participants reported that they planned on implementing something they learned during the online activity in their job and/or practice. The evaluation found that simulation based learning is a popular and effective medium for health professional training. The majority of participants (74%) found that the lesson met their needs and 76% of participants found that the lesson provided useable ideas and/or techniques. In addition, the evaluation captured rich qualitative feedback from participants.

Conclusions: Health care professionals may be more likely to adopt appropriate opioid prescribing strategies if they are engaged in patient centered simulation based learning.

Implications for research and/or practice: The opioid crisis, as well as future public health crises, may be averted using health professional training in a similar simulation based format.