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Improvement in Residents’ Attitudes Toward Individuals with Substance Use Disorders Following an Online Training Module on Stigma

  • OPIOID PRESCRIBING AND PAIN MANAGEMENT / ORIGINAL ARTICLE
  • Published:
HSS Journal ®

Abstract

Background

Resident physicians have been shown to possess negative attitudes toward individuals with substance use disorders (SUDs), even if the residents believe they have adequate knowledge and skills to care for these patients. Residents’ negative attitudes may have an adverse impact on patient engagement, treatment, and outcomes.

Questions/Purposes

The goal of this study was to examine the impact of an online training module on residents’ attitudes toward people with SUDs. We hypothesized that residents who received the educational intervention would show improved attitudes toward people with alcohol and opioid use disorders.

Methods

A web-based questionnaire, including demographic information and the Medical Condition Regard Scale (MCRS) about individuals with alcohol and opioid use disorders, was sent to internal medicine and psychiatry residents before and 6 months after they took an online training module on stigma toward individuals with SUDs.

Results

A total of 46 residents completed the initial questionnaire and 29 completed the follow-up questionnaire 6 months later. Attitudes toward individuals with SUDs, as reflected by an increase in MCRS scores, were improved 6 months after the online training module.

Conclusion

Residents’ attitudes toward individuals with SUDs improved after taking an online training module. This is encouraging, as studies have shown that attitudes toward individuals with SUDs tend to decline during residency training and negatively affect patient care. Larger studies are needed to determine if such online modules can improve attitudes of other groups of clinicians, result in sustained change over time, and improve patient outcomes.

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References

  1. Adams MW. Comorbidity of mental health and substance misuse problems: a review of workers’ reported attitudes and perceptions. J Psychiatr Ment Health Nurs. 2008;15(2):101–108.

    Article  CAS  PubMed  Google Scholar 

  2. American Association of Medical Colleges. Responding to the opioid epidemic through education, patient care, and research. AAMCNews: Current Key Issues. 2018. Available from https://news.aamc.org/for-the-media/article/medical-schools-address-opioid-epidemic/

  3. Avery J, Zerbo E. Improving psychiatry residents’ attitudes toward individuals diagnosed with substance use disorders. Harv Rev Psychiatry. 2015;23(4):296–300.

    Article  PubMed  Google Scholar 

  4. Avery J, Dixon L, Adler D, et al. Psychiatrists’ attitudes toward individuals with substance use disorders and serious mental illness. J Dual Diagn. 2013;9(4):322–326.

    Article  Google Scholar 

  5. Avery J, Zerbo E, Ross S. Improving psychiatrists’ attitudes towards individuals with psychotic disorders and co-occurring substance use disorders. Acad Psychiatry. 2016;40(3):520–522.

    Article  PubMed  Google Scholar 

  6. Avery J, Han BH, Zerbo E, et al. Changes in psychiatry residents’ attitudes towards individuals with substance use disorders over the course of residency training. Am J Addict. 2017;26(1):75–79.

    Article  PubMed  Google Scholar 

  7. Ballon BC, Skinner W. “Attitude is a little thing that makes a big difference”: reflection techniques for addiction psychiatry training. Acad Psychiatry. 2008;32(3):218–224.

    Article  PubMed  Google Scholar 

  8. Bush B, Shaw S, Cleary P, Delbanco TL, Aronson MD. Screening for alcohol abuse using the cage questionnaire. Am J Med. 1987;82(2):231–235.

    Article  CAS  PubMed  Google Scholar 

  9. Capurso NA, Shorter DI. Changing attitudes in graduate medical education: a commentary on Attitudes Towards Substance Use and Schizophrenia by Avery et al. Am J Addict. 2017;26(1):83–86.

    Article  PubMed  Google Scholar 

  10. Center for Behavioral Health Statistics and Quality. Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16–4984, NSDUH Series H-51). 2016. Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2015/NSDUH-FFR1-2015/NSDUH-FFR1-2015.pdf

  11. Chiu AS, Healy JM, DeWane MP, Longo WE, Yoo PS. Trainees as agents of change in the opioid epidemic: optimizing the opioid prescription practices of surgical residents. J Surg Educ. 2018;75(1):65–71.

    Article  PubMed  Google Scholar 

  12. Christison GW, Haviland MG, Riggs ML. The medical condition regard scale: measuring reactions to diagnoses. Acad Med. 2002;77(3):257–262.

    Article  PubMed  Google Scholar 

  13. D’Onofrio GD, Nadel E, Degutis L, et al. Improving emergency medicine residents’ approach to patients with alcohol problems: a controlled educational trial. Ann Emerg Med. 2002;40(1):50–62.

    Article  PubMed  Google Scholar 

  14. Degenhardt L, Larney S, Kimber J, Farrell M, Hall W. Excess mortality among opioid-using patients treated with oral naltrexone in Australia. Drug Alcohol Rev. 2015;34:90–96.

    Article  PubMed  Google Scholar 

  15. Doherty N, Gottlieb S, McCance-Katz E, Schuchat A, Volkow N. Federal efforts to combat the opioid crisis: a status update on CARA and other initiatives. Testimony to Congressional Senate Committee on Health, Education, Labor & Pensions. 2017. Available from https://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2017/federal-efforts-to-combat-opioid-crisis-status-update-cara-other-initiatives

  16. Fiellin DA, Reid MC, O’Connor PG. Screening for alcohol problems in primary care: a systematic review. Arch Intern Med. 2000;160(13):1977–1989.

    Article  CAS  PubMed  Google Scholar 

  17. Geller G, Levine DM, Mamon JA, et al. Knowledge, attitudes, and reported practices of medical students and house staff regarding the diagnosis and treatment of alcoholism. JA.MA. 1989;262(21):3115–3120.

    Google Scholar 

  18. Gilchrist G, Moskalewicz J, Slezakova S, et al. Staff regard towards working with substance users: a European multi-centre study. Addiction. 2011;106(6):1114–1125.

    Article  PubMed  Google Scholar 

  19. Hser YI, Saxon AJ, Huang D, et al. Treatment retention among patients randomized to buprenorphine/naloxone compared to methadone in a multi-site trial. Addiction. 2014;109:79–87.

    Article  PubMed  Google Scholar 

  20. Lindberg M, Vergara C, Wild-Wesley, et al. Physicians-in-training attitudes toward caring for and working with patients with alcohol and drug abuse diagnoses. South Med J. 2006;99(1):28–35.

    Article  PubMed  Google Scholar 

  21. Maher KH, Nereberg L, Bower KJ. Modifying residents’ professional attitudes about substance abuse treatment and training. Am J Addict. 2001;10(1):40–45.

    Article  Google Scholar 

  22. Miller NS, Sheppard LM, Colenda CC, Magen J. Why physicians are unprepared to treat patients who have alcohol- and drug-related disorders. Acad Med. 2001;76(5):410–418.

    Article  CAS  PubMed  Google Scholar 

  23. National Institute on Drug Abuse. Health consequences of drug misuse. 2017. Available from https://www.drugabuse.gov/related-topics/health-consequences-drug-misuse

  24. Rao H, Mahadevappa H, Pillay P, Sessay M, Abraham A. A study of stigmatized attitudes towards people with mental health problems among health professionals. J Psychiatr Ment Health Nurs. 2009;16(3):279–284.

    Article  CAS  PubMed  Google Scholar 

  25. Renner JA. How to train residents to identify and treat dual diagnosis patients. Biol Psychiatry. 2004;56(10):810–816.

    Article  PubMed  Google Scholar 

  26. Richmond IC, Foster JH. Negative attitudes towards people with co-morbid mental health and substance misuse problems: an investigation of mental health professionals. J Ment Heal. 2003;12(4):393–403.

    Article  Google Scholar 

  27. Van Boekel LC, Brouwers EPM, Van Weeghel J, Garretsen HFL. Stigma among health professionals towards patients with substance use disorders and its consequences for healthcare delivery: systematic review. Drug Alcohol Depend. 2013;131(1–3):23–35.

    Article  PubMed  Google Scholar 

  28. Wakeman SE, Pham-Kanter G, Donelan K. General internists’ attitudes, practices and preparedness related to substance use disorder. J Gen Intern Med. 2016;31(2):S231–S232.

    Google Scholar 

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Correspondence to Jonathan Avery MD.

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Conflict of Interest

Jonathan Avery, MD, Daniel Knoepflmacher, MD, Kristopher A. Kast, MD, Miranda Greiner, MD, MPH, Joseph Avery, JD, and Julie B. Penzner, MD, declare that they have no conflicts of interest. Elizabeth Mauer, MS, reports partial support from a grant from the Clinical and Translational Science Center at Weill Cornell Medicine (UL1-TR000457-06), outside the submitted work.

Human/Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2013.

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Informed consent was waived from all subjects for being included in this study.

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Avery, J., Knoepflmacher, D., Mauer, E. et al. Improvement in Residents’ Attitudes Toward Individuals with Substance Use Disorders Following an Online Training Module on Stigma. HSS Jrnl 15, 31–36 (2019). https://doi.org/10.1007/s11420-018-9643-3

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  • DOI: https://doi.org/10.1007/s11420-018-9643-3

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