An Assessment of Opioid Prescribing Behaviors in Ontario Family Physicians before and after Participation in ECHO Chronic Pain/Opioid Stewardship

Canada is in the middle of an opioid crisis. The Ontario Ministry of Health and Long-Term Care funded a demonstration project of the first replication of Project ECHO in Canada to tackle the opioid crisis. ECHO Ontario Chronic Pain / Opioid Stewardship started in June 2014. Participants attending ECHO acquire knowledge related to chronic pain management with or without opioids. This study aims to assess opioid prescribing behaviours among family physicians who attended ECHO compared to those who did not. We conducted an observational study with two control groups: a matched cohort and a random sample of 3,000 primary care physicians in Ontario using the Narcotics Monitoring System. We found that none of the groups reduced the number or proportion of patients on opioids. Secondary outcomes showed a reduction in high-dose opioid prescriptions in the ECHO group, but not in the control groups during the same comparable periods.M.Sc