I-COPE ECHO Series Curriculum and Case Discussion Data

Chronic pain, opioid use, and opioid use disorder (OUD) are increasingly common in older adults. Outpatient clinician education may improve outcomes. Our aim was to create and evaluate a novel curriculum for outpatient clinicians on older adult pain management, opioid prescribing, and OUD leveraging Project ECHO®, a model for delivering subspecialized medical knowledge to community outpatient clinicians via videoconferencing.

The series is comprised of 8 hour-long sessions, each with an expert-led interactive lectures= followed by participant-led case discussions. Topics include pain assessment & treatment, considerations in older adults (e.g., cognition, caregiver support), shared decision-making, behavioral health, and OUD diagnosis and treatment.

Sixty-nine clinicians attended the series and completed the pre-series survey; 78% (n=54) completed the post-series survey. Clinicians reported a significant increase in self-efficacy in 12/12 queried competencies and greater frequency of performing 7/10 practice behaviors regarding older adult pain management, opioid prescribing, and OUD management. The most liked curricular components were opportunities to learn with subspecialists and discussions with other community clinicians. Qualitative analysis suggests that clinicians may benefit from education on the Geriatrics 5Ms framework.

This novel curriculum has potential to improve management of older adult chronic pain, opioid prescribing, and OUD in a virtual and scalable format.