The AAFP sent a letter to the NIH in support of a draft National Pain Strategy created by the Interagency Pain Research Coordinating Committee. The AAFP said it agrees with the report that physicians need additional education and training to improve treatment of patients experiencing pain. However, the Academy noted it remains opposed to any effort to limit patient access to physician-prescribed pharmaceuticals or to require continuing medical education as a condition for prescribing any medication.
The NIH Pathways to Prevention Workshop final report published in Annals of Internal Medicine called for additional research to aid physicians who prescribe opioid drugs to patients with chronic pain. Another recent study in the New England Journal of Medicine found efforts to control abuse of the medications have shown some success. The AAFP's Robert Rich, M.D., said there are few evidence-based guidelines to help physicians but several initiatives are ongoing to update pain management and treatment guidelines.
The AAFP's third list of recommendations in the Choosing Wisely campaign covers routine prostate cancer screening, physical exams prior to prescribing contraceptives, antibiotics for ear infections, voiding cystourethrogram for febrile urinary tract infections and scoliosis screening for adolescents. More than 50 groups have identified more than 160 tests and procedures physicians should question, but the AAFP, which released its list during its 2013 Scientific Assembly, is the only one to issue recommendations in all three phases of the program. "These Choosing Wisely lists can help our members identify treatments and procedures that may be unnecessary or duplicative," said AAFP President-elect Reid Blackwelder, M.D.
An FDA letter to physicians asks them to take advantage of training, funded by drug manufacturers, on the appropriate use of extended-release/long-acting opioids. AAFP's manager of CME standards and outcomes Kathy Marian said the Academy is using grant money to develop CME programs that comply with goals set by the FDA and should have those programs available this summer.
Significant improvement was seen from 1999 to 2009 in providing underused care, but only limited reductions were made in the use of inappropriate care, suggesting it has not been a focus of quality improvement efforts, according to a report in JAMA Internal Medicine. The authors recommended using practice guidelines and performance measures to ensure appropriate care and said the AAFP-supported Choosing Wisely campaign was one example of physician collaboration that promotes quality, cost-effective care.