Improving Communication About Pain and Opioids

The overall goal of this protocol is to pilot test a clinician training intervention that uses standardized patients (trained actors playing patient roles) as instructors who impart communication skills to primary care clinicians. This project will conduct a pilot clinical trial of the intervention developed by the primary investigator in order to evaluate intervention feasibility and generate data to plan a subsequent fully-powered, multisite trial. Primary care clinicians will be randomized to receive either the intervention or control; 48 patients (2 per clinician) will then be recorded during clinic visits with study clinicians and will provide data on post-visit perceptions and health outcomes. Study hypotheses are that visits with clinicians who receive the intervention (versus control) will be associated with more frequent use of targeted communication skills, lower probability of high-risk opioid prescribing, higher patient-reported agreement with treatment plan, and lower pain interference 2 months later.

Inclusion Criteria: Internal Medicine or Family Medicine residents at UC Davis: * completed ≥1 year of training * see primary care patients in the Ambulatory Care Center (ACC) building. Clinicians will be recruited through clinic huddles, emails, and presentations at meetings. UC Davis Patients: * 18-80 years old * taking opioids (≥1 opioid dose per day) prescribed by their primary care physician for \>90 days to treat chronic musculoskeletal pain * have an appointment scheduled with a participating clinician at which they report they are likely to discuss pain management Exclusion Criteria: * active cancer * hospice * do not speak English * prisoners * pregnant women * unable to consent