By: Admin_Mike31 May 2012
Law enforcement and military personnel often use computer simulators as training tools.
A new simulator app will help doctors spot drug abusers who are doctor shopping in search of prescription painkillers like OxyContin. The simulator, which was recently described in The New York Times, uses a video game format to help doctors learn how to tell when patients are lying about their medical conditions and pain symptoms.
The U.S. is currently in the grips of an epidemic of prescription drug abuse. Starting in 2009, the annual drug overdose rate has surpassed traffic fatalities. According to the CDC, roughly three quarters of drug deaths are caused by prescription drugs. Health care professionals are under tremendous pressure to differentiate between legitimate patients in need of powerful painkillers and those who are seeking drugs to fuel an addiction.
The simulator is based on research conducted by Dr. Michael F. Fleming of Northwestern University, who conducted interviews with more than 1,000 patients who were taking opioid medications for pain. It uses the same technology that the F.B.I. uses to train agents in interrogation techniques. A doctor who plays the video game is presented with an actor posing as a patient who is seeking a painkiller prescription. The doctor asks questions to determine the patient's sincerity and the actor repeats responses that have been generated by the simulation program.
This new app will help doctors develop the skills needed to assess a patient's motivation in seeking a painkiller. There are currently no objective medical tests that can measure pain, so a doctor must use his or her judgment to distinguish between patients who are experiencing real pain and those who have fallen victim to the highly addictive nature of opioid drugs.
The simulator is in the final stages of pre-release testing. It will be available as a Web-based app that medical schools and health care providers can access for a fee. Each training session is about 15 minutes long and it is expected that a doctor will complete 10 sessions for maximum benefit. The app currently includes hundred of different patient statements that are delivered by actors in tones ranging from friendly to irate. To communicate with patients in the simulator, doctors will be able to choose from about 1,500 questions; multiple choice responses are provided to help the doctor answer the patient's questions. Based on the conversation between doctor and patient, the simulator will judge the doctor's performance and make suggestions for improvement.
This new app will target primary care and family doctors who may not feel qualified to assess patients for prescription drug addiction.
Many physicians are torn between the desire to help patients by alleviating chronic pain and the need to fight prescription drug abuse. Doctors who use the simulator will be trained to ask patients the most effective questions, to judge their responses and to look for nonverbal signs of drug abuse including finger tapping, an inability to maintain eye contact and general anxiety. Besides helping doctors learn how to detect drug abuse, the app is designed to teach them how to build rapport with patients and avoid adopting an accusatory tone.