Defining the Rural Health Care Professional's Role in the Prevention of Opioid Misuse
August 17th Virtual Think Tank Results
AgriSafe Network conducted a virtual Think Tank on the role that rural healthcare providers could play in the prevention of opioid misuse. The presentation was marked by polling questions that gauged the attendees opinions and perspectives on opioid use amongst rural agriculture communities. These results and other resources can be found on the AgriSafe website.
What words come to mind when thinking of the opioid crisis in rural United States?
"Lower income people addicted only"
"What 'misuse' is"
"Who actually misuses?"
What risk factor do you find most significant as it relates to agricultural opioid misuse?
"Diagnosis issues"
"it doesn't happen to professionals or 'good' people"
Prescribing patterns as it relates to healthcare providers that treat agricultural workers and the prescriptions they typically award, and the occupation-related injuries that agricultural workers are clear priorities to address with opioid misuse.
"Pills aren't as dangerous as heroin"
"Not dangerous if prescribed"
"People don't know what an opioid is"
"Choose to misuse"
"It only happens in urban areas"
"Higher doses ok"
"Misusers are young, uneducated, POC"
What misconceptions about opioids or opioid misuse have you encountered in your field?
"Farmers are tough and won't seek pain relief"
Most answers reflected confusion about terminology, best practices, and myths mainly regarding the populations using opioids. Understanding from where the misinformation stems is crucial to improving prevention and treatment plans.
"Screening patients"
Massage therapy
"Personal contact and in-depth questions"
Cognitive behavioral therapy was voted most underutilized for pain management, with light to moderate exercise placing second. Addressing alternative therapies is an important avenue to explore when available pain medications may not be sufficient to manage pain alone.
"Not prescribe as a holdover till a different season"
Physical Therapy /Occupational Therapy
"Utilize the PDMP resources"
"Follow-up after Rx issues"
91% identified alternative therapies for pain management. 9% identified tools for risk assessment.
"Better decision-making"
In your opinion, in what field does there exist the largest gap of evidence-based guidance?
Cognitive Behavioral Therapy
"Start out at lowest dosage"
"Interview and follow-up"
"Direct questions"
Acupuncture
Light to moderate exercise
How can rural healthcare providers assess for and address risk factors for opioid misuse?
The attendees identified multiple approaches to managing opioid misuse that are feasible for rural healthcare providers and provided direction for future resources.
"Consider alternative therapies if an option"
What is the most underutilized non-drug alternative therapy related to pain management?
"Frequent visits"
5%
"Apply for grants to develop prevention efforts in rural communities"
"Medication management discussions with each opioid prescription presented and inform about resources available"
"Providing links to local resources in Ag community"
Physical and mental stressors within agricultural work are commonly discussed during clinical visits.
"Networking/information sharing"
The majority of attendees disagreed with the above statement. Incorporating discussion about the physical and mental implications of agricultural work during clinical visits can be helpful in identifying risk factors for opioid misuse and addiction and improve the conversation on pain management.
"Educate employees for signs"
"Alternative medication"
"Work to assist providers & health systems"
"Follow safety guidelines and be aware of the symptoms of abuse in others"
"Raise awareness amongst the farm populations to our Ag community"
What are some short term actions steps you hope to take in your work to help prevent opioid misuse?
"Raise awareness amongst the farm populations I serve"
"Have state government buy into and provide resources to address this 'epidemic'"
"Simplified education"
Are there adequate mental health resources for rural health providers to refer their patients to?
In office posters
Rural primary care providers are capable of providing basic mental health services with proper training.
Pamphlets, factsheets, etc.
Pharmacy brochures
Online resources (web, social media, etc.)
What do you think is the most effective patient material for prevention of opioid misuse?
Other
Briefly describe your professional experience with opioids. What words come to mind when thinking of the opioid crisis? What misconceptions about opioids or opioid misuse have you encountered in your field? Please share any additional resources for prescribing opioids. What do you think is the most effective patient material for prevention of opioid misuse? Pamphlets, fact sheets, etc In office posters Pharmacy brochures Online resources (web, social media, etc.) Other What is the most underutilized non-drug alternative therapy related to pain management? Physical therapy/Occupational therapy Acupuncture Light to moderate exercise Cognitive Behavioral Therapy Massage therapy How can rural healthcare providers assess for and address risk factors for opioid misuse? In your opinion, in what field does there exist the largest gap of evidence-based guidance? Opioid prescribing guidelines Emergency response to opioid overdose Tools for risk assessment Alternative therapies for pain management Rural primary care providers are capable of providing basic mental helath services with proper training. Strongly Agree Agree Neutral Disagree Strongly Disagree What risk factor do you find most significant as it relates to agricultural opioid misuse? Nature of work Occupational injuries Age Prescribing patterns Stigma and stereotypes Physical and mental stressors within agricultural work are commonly discussed during clinical visits. Strongly Agree Agree Neutral Disagree Strongly Disagree Are there adequate mental health resources for rural health providers to refer theit patients to? Strongly Agree Agree Neutral Disagree Strongly Disagree What are short term action steps you can take in your work to help prevent opioid misuse?
AgriSafe Think Tank Polling Questions
Copyright@2018
Generous support provided by
AgrISafe Opioid Think Tank
Other Resources on Opioids
CDC Prescribing Guideline Chronic Pain
AgriSafe Resources on Opioids
Moving Forward
Working to identify the gaps in knowledge and resources is crucial to prevent opioid misuse. This Think Tank provided important perspectives from our stakeholders and we appreciate their contributions. From our research and attendee feedback, it remains clear that pain management is at the root of the problem. Informing healthcare providers on how best to address pain as well as elucidating alternatives to pain management is a distinct step AgriSafe can make in confronting the opioid crisis. AgriSafe Action Steps: Improve the AgriSafe Health Risk Assessment to include chronic pain of farmers Advocate for improved surveillance of opioid use/misuse amongst farmers Analyze workers' compensation data to examine prescription opioid patterns amongst farmers compared to general public Continue offering online trainings and webinars about emerging issues related to opioids
Non-opioid alternative therapies
Click on images below for link.
CDC Prescribing Guideline Acute Pain
Talk to Farmers About Their Pain
