Medical Board Leaders Interview Guide

Attachment I. Medical Board Leader Interview Guide

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Exp. Date: xx-xx-xxxx

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Hello, I’m (NAME) from Abt Global. Thank you for taking the time to speak with me.

As a reminder, in 2022 the Centers for Disease Control and Prevention (CDC) released the Clinical Practice Guideline for Prescribing Opioids for Pain, which provided up to date evidence regarding pain management approaches and emphasizes the need for prescribers to be focused on patient-centered care, shared decision making between patients and clinicians, equitable care for those in pain, and flexibility for clinicians in patient care. For shorthand, we call it the 2022 CDC Clinical Practice Guideline throughout this interview.

General Dynamics Information Technology (GDIT) and Abt Global are conducting a research study for the CDC to better understand the adoption, implementation, and outcomes of the 2022 CDC Clinical Practice Guideline on evidence-based care for pain management.

This interview aims to better understand your experiences as a medical board leader with implementing pain management policies and guidelines, and the effects of these policies and guidelines on patient outcomes. This study is funded by the CDC.

Before we begin, I want to read a few points about this interview:

• Participation in this interview is voluntary.

• You will receive a $100 virtual gift card for participating in this interview.

Your answers will not be connected to any information that could individually identify you, such as your name in any internal CDC reports or publicly-facing publications. With your permission, the name of your organization will be included in the acknowledgements in any report or publication; however, we will not attribute our findings to you or your organization explicitly.

• You can decline to answer any question, without affecting your continued participation in the interview or your relationship with the CDC. There is a small risk of loss of privacy. We have many procedures in place to reduce this risk.

• This interview will last approximately 60 minutes.

We also would like to record the interview, so we do not miss anything. The recording will not be shared with anyone outside Abt Global, GDIT or CDC. We will use this recording to make de-identified transcripts of the recordings, which will be shared with GDIT and CDC. This recording will be deleted once our notes from the interview have been completed. 

Do any of you have any questions before we get started?

Do I have your consent to participate in this interview? Yes _____ No _____

May we record this interview? Yes _____ No _____

RESPONDENT’S ROLE

1. Let’s start by describing your role at your medical board.

2. What role does your medical board serve in setting, administering, recommending, or implementing policies/regulations related to pain management, opioid prescribing and management, or medications for opioid use disorder (MOUD)?
   
   
   

3. What has been your role with regard to monitoring or enforcing these policies or regulations with clinicians?

AWARENESS

SAY: I’m going to ask a few questions about YOUR level of awareness of the 2022 CDC Clinical Practice Guideline and your thoughts on how aware clinicians and practices are of the Guideline.

4. In 2022, the CDC released its 2022 Clinical Practice Guideline for Prescribing Opioids for Pain. How did you learn of the 2022 CDC Clinical Practice Guideline?

5. What is your general sense of the 2022 CDC Clinical Practice Guideline and its recommendations?

6. It’s been about two years since the 2022 CDC Clinical Practice Guideline (November 2022) was released, what’s your sense of the level of awareness of the Guideline in your medical board? What is your impression of awareness among other medical boards?

7. How do you think the release and roll out of the 2022 CDC Clinical Practice Guideline was for medical boards? What about for clinicians on a national level?
   
   
   

IMPLEMENTATION

SAY: I’m now going to ask a few questions about medical boards’ role in adopting or implementing the 2022 CDC Clinical Practice Guideline recommendations.

8. Did your medical board update or revise any policies, regulations, mandates or positions related to pain management, opioid prescribing, or opioid use disorder since November 2022? Was this a result of the release of the 2022 CDC Clinical Practice Guideline?

• If no changes have been made or are planned, why do you think that is?
  
  
  

PROBES

• How well did your board’s policies or regulations already align with the 2022 CDC Clinical Practice Guideline?

• Were CDC guideline recommendations incongruous with your board’s policies, regulations or positions? If so, please describe.

• Were the CDC guideline recommendations outside your board’s scope or role?

9. What (else) has your medical board done to adopt or implement the 2022 CDC Clinical Practice Guideline recommendations?
   
   
   

PROBES:

• Any communications? Email blasts?

• Any changes in actions you take regarding clinicians’ opioid prescribing practices, for example?

• Any changes in regulatory mandates for clinical practice related to pain and/or opioids?

• When were these changes implemented with regard to when the Guideline was released?

FROM THE FIELD

SAY: Now I’m going to ask a few questions about what you’ve seen or heard from the field regarding adopting and implementing the 2022 CDC Clinical Practice Guideline with clinicians or in practices/health systems.

10. Do you know of any specific dissemination efforts that happened or are going on related to the 2022 CDC Clinical Practice Guideline?
    
    
    

11. It’s been about two years since the 2022 CDC Clinical Practice Guideline has been in place. What is your sense of how the Guideline – or specific recommendations – are being used by clinicians, practices or health systems?

PROBES:

• Were many of the recommendations already a standard of practice? If so, which recommendations?

• Were the recommendations a big shift or light lift for clinicians? If so, how?

• What about for practices or health systems – was it a big shift? If so, how?

12. More generally, and not necessarily specific to your medical board, what have you seen or heard in the field about the 2022 CDC Clinical Practice Guideline?
    
    
    

BARRIERS & FACILITATORS

SAY: Now I’m going to ask a few questions about any challenges or successes related to the uptake of the 2022 CDC Clinical Practice Guideline with clinicians and in practices.

13. What went well or is going well related to the adoption or implementation of the 2022 CDC Clinical Practice Guideline in medical boards’ policies, regulations, mandates or positions?
    PROBES:

• What are you hearing?

• Specific examples…
  
  
  

14. What went well or is going well related to the adoption or implementation of the 2022 CDC Clinical Practice Guideline in clinicians’ practices?

15. What has not gone well in adoption or implementation of the 2022 CDC Clinical Practice Guideline?

16. Since the 2022 CDC Clinical Practice Guideline was rolled out November 2022, in what ways has it positively or negatively impacted clinicians’ care of patients with pain or taking opioids?

17. Part of the 2022 CDC Clinical Practice Guideline’s aim was to re-emphasize the need for individualized, patient-centered care, shared decision making between patients and clinicians, equitable care for those in pain, and flexibility for clinician’s clinical decisions. Do you think the recommendations in the 2022 CDC Clinical Practice Guideline facilitate accomplishing these goals?

FOLLOW-UPS: Do the recommendations in the 2022 CDC Clinical Practice Guideline…

• Promote patient-centered care? In what ways?

• Encourage shared decision making between patients and clinicians? In what ways?

• Improve equitable care for those in pain? In what ways?

• Address inequities between patients, or in patient care more generally? In what ways?

• Allow for needed flexibility for clinicians as they care for patients in pain? In what ways?

• Are there specific recommendations that do NOT achieve these goals?

18. What are some changes you have seen (positive or negative; intended or unintended) in clinical practice since the release of the 2022 CDC Clinical Practice Guideline that you weren't expecting?

RECOMMENDATIONS OR LESSONS LEARNED

19. Before we conclude today’s interview, is there anything else that you would like to share?

20. You may remember that earlier I indicated that with your permission, the name of your organization can be included in the acknowledgements in any report or publication; however, we will not attribute our findings to you or your organization explicitly. Would you be willing to have us include the name of your organization in the acknowledgements in reports or publications?

    • If yes: What is the full, formal name of your organization.

21. Are there any questions before we wrap up? [Address questions]