A Cross-sectional Survey Using Clinical Vignettes to Examine Overdose Risk Assessment and Willingness to Prescribe Naloxone
The number of opioid-related overdose deaths has increased concurrently with rising rates of opioid use nationally.1 Clinical encounters offer an opportunity to provide high-risk patients with targeted interventions,2 yet clinicians routinely miss the opportunity to deliver risk reduction counseling and naloxone to appropriate patients3 due, in part, to knowledge gaps.4, 5
To better identify physician education targets, we examined how internal medicine trainees’ beliefs influence willingness to prescribe naloxone, how residents assess risk of opioid-related overdose, and concordance between risk assessment and naloxone prescription.
The study occurred at an academic medical center in Baltimore, MD, with high rates of opioid use and overdose. IRB deemed our study exempt. We surveyed internal medicine residents and collected information on beliefs and behaviors based on seven clinical vignettes. Each vignette provided patient-specific information including age,...
KEY WORDSclinical vignette medical education-systems based practice substance abuse vulnerable populations
This work was delivered as a presentation in November 2016 at the Association for Medical Education and Research in Substance Abuse Meeting.
This work was supported by Johns Hopkins University Scholars’ Fund. Dr. Wilson was supported by HRSA LEAH (T71MC08054) and NIH (T32HD052459-07). Dr. Matson was supported by NIDA K01DA035387.
Compliance with Ethical Standards
Conflict of Interest
The authors do not have conflicts of interest to disclose.
- 4.Binswanger IA, Koester S, Mueller SR, Gardner EM, Goddard K, Glanz JM. Overdose Education and Naloxone for Patients Prescribed Opioids in Primary Care: A Qualitative Study of Primary Care Staff. J Gen Intern Med. 2015;30(12):1837–1844. doi: https://doi.org/10.1007/s11606-015-3394-3.CrossRefPubMedPubMedCentralGoogle Scholar