scholarly journals 4408 Using a human-centered design process to address challenges of engaging pregnant & parenting women with opioid use disorder

2020 ◽  
Vol 4 (s1) ◽  
pp. 90-91
Author(s):  
Sarah Wiehe ◽  
Dustin Lynch ◽  
Courtney Moore ◽  
Brandon Cockrum ◽  
Bridget Hawryluk ◽  
...  
Keyword(s):  
Lived Experience ◽  
Healthcare System ◽  
Opioid Use Disorder ◽  
Support Network ◽  
Community Resources ◽  
Opioid Use ◽  
Human Centered Design ◽  
Key Stakeholders ◽  
Study Population ◽  
System Bias

OBJECTIVES/GOALS: Using a human-centered approach, IDEO, a nationally-renown human-centered design team, and Research Jam, Indiana CTSI’s patient engagement core, integrated and tailored complimentary programs to address the challenges of engaging mothers with opioid misuse around the time of birth. METHODS/STUDY POPULATION: Gathered data through focus groups, site visits, and one-on-one interviews with key stakeholders: mothers in opioid use recovery, peer recovery coaches, and other people living with or directly affected by opioid use disorder (OUD). RESULTS/ANTICIPATED RESULTS: Themes emerged around stigma (e.g., constant judgment, majority of interactions focused on addiction, addiction comes from bad choices), the healthcare system (e.g., healthcare system bias and stigma, misalignment of services and timing of need, no support for support network), and relating to recovery (very variable but generally ambiguous and uncertain process and outcomes, importance of peer recovery coaches, importance of community resources). Identified themes were used to create insights that informed the underlying concepts of an engagement strategy including support and resources for recovery coaches, and education materials for mothers with OUD. One of human-centered design’s strengths is iteration, and the materials created for this have yet to be tested and refined thoroughly to be meaningful and lasting interventions. DISCUSSION/SIGNIFICANCE OF IMPACT: Considerable insights into the lived experience of those experiencing OUD and those who support these individuals yielded tangible ways to test improved engagement and recruitment of women with OUD at the time of birth.

scholarly journals Community-Led Research Priority Setting for Highly Vulnerable Communities: Adaptation of the Research Prioritization by Affected Communities Protocol

2020 ◽  
Vol 19 ◽  
pp. 160940692095750
Author(s):  
Molly R. Altman ◽  
Jane Kim ◽  
Morgan Busse ◽  
Ira Kantrowitz-Gordon
Keyword(s):  
Lived Experience ◽  
Research Funding ◽  
Research Priorities ◽  
Opioid Use Disorder ◽  
Participatory Process ◽  
Opioid Use ◽  
Research Prioritization ◽  
Vulnerable Communities ◽  
Research Priority ◽  
Implementation And Dissemination

While community engagement can occur at all levels of research development, implementation, and dissemination, there is a great need for participation from those with lived experience in the development of research priorities to be used by stakeholders in research, funding, and policy. The Research Prioritization by Affected Communities (RPAC) protocol has successfully developed community-driven priorities for those at risk for preterm birth, but the 2-day focus group methodology may not be suitable for all vulnerable communities. For the purposes of a larger study supporting pregnant and parenting individuals with opioid use disorder (OUD) in research prioritization, we adapted the RPAC protocol to meet the needs of this highly stigmatized community. This adaptation made it possible for those who may not have been able to attend two separate sessions to successfully engage in this participatory process and produce a completed set of priorities by the end of 1 day. The objective of this article is to validate the adapted protocol for prioritizing research and service delivery needs with vulnerable and stigmatized communities.

scholarly journals Stigma of Opioid Use Disorder and Its Indirect Effects on Student Pharmacists’ Perceptions and Attitudes

Pharmacy ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 144
Author(s):  
Elizabeth A. Hall ◽  
Alina Cernasev ◽  
Umida Nasritdinova ◽  
Michael P. Veve ◽  
Kenneth C. Hohmeier
Keyword(s):  
Community Pharmacy ◽  
Student Perceptions ◽  
Opioid Use Disorder ◽  
Vital Role ◽  
Primary Objective ◽  
Community Resources ◽  
Opioid Use ◽  
Opioid Prescription ◽  
Electronic Survey ◽  
Perceptions And Attitudes

Objectives: Pharmacists play a vital role in serving patients during the ongoing nationwide opioid epidemic, and so it is also critical to educate the next generation of pharmacists on opioids and opioid use disorder (OUD). The primary objective of this study was to quantitatively characterize student perceptions of opioid use and the stigma associated with OUD. Secondary aims were to determine whether differences in perceptions exist based upon the student’s year in the Doctor of Pharmacy program or employment in a community pharmacy. Methods: First-, second-, third-, and fourth-year student pharmacists voluntarily completed an electronic survey regarding perceptions of opioid use and stigma associated with OUD. Results: Of the 9 survey items, students were most uncomfortable referring patients to community resources for addiction support and/or treatment (25.3% comfortable or very comfortable). Students working in a community pharmacy were significantly more comfortable talking to patients attempting to refill opioids early and providing opioid counseling as compared to their peers not working in community pharmacy. Fourth-year students reported a higher level of comfort talking to a patient attempting to refill an opioid prescription early, counseling a patient on an opioid prescription, and providing information about alternatives to opioids. Third-year students responded most favorably to the items regarding how well the curriculum has prepared them to interact with patients taking opioids and those with OUD. Conclusions: These findings reveal that students are comfortable counseling on opioids and discussing alternative options. Differences in perceptions were observed based upon the student’s year in the program and whether or not they were employed in a community pharmacy setting.

scholarly journals High Mortality Among Patients With Opioid Use Disorder in a Large Healthcare System

2017 ◽  
Vol 11 (4) ◽  
pp. 315-319 ◽  
Author(s):  
Yih-Ing Hser ◽  
Larissa J. Mooney ◽  
Andrew J. Saxon ◽  
Karen Miotto ◽  
Douglas S. Bell ◽  
...  
Keyword(s):  
Healthcare System ◽  
High Mortality ◽  
Opioid Use Disorder ◽  
Opioid Use

scholarly journals The Opioid Awareness and Support Team: an innovative example of medical education and community partnership

2021 ◽  
Author(s):  
Matthew B Downer ◽  
Luke W Duffley ◽  
Phil B Hillier ◽  
Kieran D Lacey ◽  
Madison J Lewis ◽  
...  
Keyword(s):  
Lived Experience ◽  
Local Community ◽  
Opioid Use Disorder ◽  
Community Context ◽  
Opioid Use ◽  
Supplemental Education ◽  
Student Knowledge ◽  
Community Partners ◽  
Support Team ◽  
Medical Student Learning

Implication Statement  The Opioid Awareness and Support Team (OAST) at the Memorial University Faculty of Medicine is a novel student-led initiative designed to supplement medical student learning related to opioid use disorder and the opioids crisis. OAST has focused on grounding educational initiatives related to opioid use disorder in the local community context, working with community partners, and bringing in individuals with lived experience. We present initial findings from an Opioid Education Day that suggest student-led supplemental education for medical students can improve student knowledge surrounding opioid use.

scholarly journals Facilitators of and barriers to buprenorphine initiation for people with opioid use disorder in the emergency department: protocol for a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e053207
Author(s):  
Nikki Bozinoff ◽  
Charlene Soobiah ◽  
Terri Rodak ◽  
Christine Bucago ◽  
Katie Kingston ◽  
...  
Keyword(s):  
Emergency Department ◽  
Lived Experience ◽  
Scoping Review ◽  
Opioid Use Disorder ◽  
French Language ◽  
Future Research ◽  
Opioid Use ◽  
Scoping Reviews ◽  
Barriers To Implementation ◽  
Meta Analyses

IntroductionBuprenorphine–naloxone is recommended as a first-line agent for the treatment of opioid use disorder. Although initiation of buprenorphine in the emergency department (ED) is evidence based, barriers to implementation persist. A comprehensive review and critical analysis of both facilitators of and barriers to buprenorphine initiation in ED has yet to be published. Our objectives are (1) to map the implementation of buprenorphine induction pathway literature and synthesise what we know about buprenorphine pathways in EDs and (2) to identify gaps in this literature with respect to barriers and facilitators of implementation.Methods and analysisWe will conduct a scoping review to comprehensively search the literature, map the evidence and identify gaps in knowledge. The review will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols Extension for Scoping Reviews and guidance from the Joanna Briggs Institution for conduct of scoping reviews. We will search Medline, APA, PsycINFO, CINAHL, Embase and IBSS from 1995 to present and the search will be restricted to English and French language publications. Citations will be screened in Covidence by two trained reviewers. Discrepancies will be mediated by consensus. Data will be synthesised using a hybrid, inductive–deductive approach, informed by the Consolidated Framework for Implementation Research as well as critical theory to guide further interpretation.Ethics and disseminationThis review does not require ethics approval. A group of primary knowledge users, including clinicians and people with lived experience, will be involved in the dissemination of findings including publication in peer-reviewed journals. Results will inform future research, current quality improvement efforts in affiliated hospitals, and aide the creation of a more robust ED response to the escalating overdose crisis.

scholarly journals 28. The Paradox of an Integrated MAT OPAT Program

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S137-S137
Author(s):  
Paula Eckardt ◽  
Jessica Reed ◽  
Claudia P Vicencio ◽  
Alberto Augsten
Keyword(s):  
Drug Use ◽  
Behavioral Health ◽  
Healthcare System ◽  
Standard Of Care ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
History Of ◽  
Picc Line ◽  
Iv Drug Use ◽  
To Receive

Abstract Background Patients with substance use disorders (SUD), specifically opioid use disorder (OUD) and injection drug use (IDU) utilize healthcare resources for prolonged inpatient treatment of serious infections stemming from their addictions. For a variety of reasons, physicians treating these patients refuse to send these patients home to receive outpatient parenteral antimicrobial therapy (OPAT), and instead keep the patient in the hospital for several weeks or longer to complete treatment for the injection-related infections. Patients who do not have history of IDU are sent home with a PICC line to receive OPAT once they are no longer acutely ill and therefore no longer meet criteria to remain inpatient, which is the established standard of care. Patients with OUD and IDU are not allowed the same standard of care, and furthermore do not receive adequate, if any, therapy for their primary problem and reason for their serious infection – the addiction. Flow chart of the MAT-OPAT process Methods Medication-assisted treatment (MAT) with buprenorphine-naloxone has been approved for treating adults with opioid use disorder as part of a comprehensive treatment program that also includes counseling and behavioral therapy. Until now in our healthcare system there has been no comprehensive and integrated program to safely discharge patients with OUD and IDU to receive OPAT via a PICC line, while simultaneously treating their addiction. We describe the implementation of a MAT-OPAT program. Please refer to the chart included. Results We present a successful case of a 36-year-old male with a history of endocarditis associated with IV drug use and the intervention of the Healthcare System to link the patient to appropriate Infectious disease, behavioral health and medication adherence treatment for opioid abuse. The patient completed the IV antibiotic therapy and remained enrolled in the behavioral health program with a successful outcome. Conclusion MAT-OPAT implementation in large healthcare system with continuous outpatient support that includes Infectious Disease services, behavioral health and drug abuse rehabilitation therapy can be a successful strategy to minimize readmisión, cost and complications in patients with history of IV drug use and infections that require prolonged intravenous antibiotic therapy. Disclosures All Authors: No reported disclosures

scholarly journals LO68: Kelowna emergency department buprenorphine/naloxone for opioid use disorder: a program evaluation study

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S32-S32
Author(s):  
M. Jones ◽  
B. Bailey ◽  
W. Nevers ◽  
M. Hill ◽  
L. Lappalainen ◽  
...  
Keyword(s):  
Emergency Department ◽  
Program Evaluation ◽  
General Hospital ◽  
Evaluation Study ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Treatment Pathway ◽  
Service Outcomes ◽  
Study Population

Introduction: Emergency department (ED) buprenorphine/naloxone inductions for opioid use disorder are an effective and safe way to initiate addictions care in the ED. Kelowna General Hospital's ED buprenorphine/naloxone (KEDSS) program was implemented in September 2018 in order to respond to a community need for accessible and evidence-based addictions care. The objective of our program evaluation study was to examine the implementation of the first five months of the KEDSS program through evaluating patient characteristics and service outcomes. Methods: The KEDSS treatment pathway consists of a standardized protocol (pre-printed order set) to facilitate buprenorphine/naloxone induction and stabilization in the acute care setting (ED and inpatient wards) at Kelowna General Hospital, a community academic hospital. All patients referred to the outpatient addictions clinic via the order set during September 2018-January 2019 (the first 5 months) were included in the study population. A retrospective descriptive chart review was completed. Outcome measures included population characteristics (sociodemographic information, clinical characteristics) and service outcomes (number of patients initiated, patient follow-up). Descriptive statistics and bivariate analyses using t-tests or Pearson's χ2 statistic, as appropriate, were conducted to compare the ED-initiated group with the inpatient-initiated group. Results: During the first five months of the KEDSS program, a total of 35 patients (26% female, mean age 36.6 years, 54% homeless) were started on the treatment pathway, 16 (46%) in the ED. Compared to the inpatient-initiated group, the ED-initiated group were less likely to have psychiatric comorbidities (ED 1.0 vs. inpatient 1.5, p = 0.002), require methadone or sustained-release oral morphine (ED 13% vs. inpatient 37%, p = 0.048), and have attended follow-up (ED 56% vs. inpatient 84%, p = 0.004). Conclusion: This study provides a preliminary look at a new opioid agonist therapy (OAT) treatment pathway (KEDSS) at Kelowna General Hospital, and provides insight into the population that is accessing the program. We found that the majority of patients who are started on buprenorphine/naloxone in the ED are seen in follow-up at the addictions clinic. Future work will examine ongoing follow-up and OAT adherence rates in the study population to quantify the program's impact on improving access to addictions treatment within this community hospital setting.

L'esperienza clinica con Levometadone nel trattamento del disturbo da uso di oppiacei

MISSION ◽  
2019 ◽  
pp. 54-57
Author(s):  
Marco Riglietta ◽  
Paolo Donadoni ◽  
Grazia Carbone ◽  
Caterina Pisoni ◽  
Franca Colombi ◽  
...  
Keyword(s):  
Adverse Events ◽  
Real Life ◽  
Opioid Use Disorder ◽  
Racemic Mixture ◽  
Opioid Use ◽  
The Real ◽  
New Formulation

In Italy, at the end of the 1970s, methadone hydrochloride was introduced for the treatment of opioid use disorder, in the form of a racemic mixture consisting of levomethadone and dextromethadone.In 2015 Levometadone was introduced, a new formulation marketed in Italy for the treatment of opioid use disorder in 2015.The article aims to bring the experience of an Italian Addiction Centre back to the use of this new formulation in the "real life" analyzing the efficacy, the trend of adverse events and pharmacological iterations in a context in which the treated population often uses besides the opiates, cocaine and alcohol, are burdened by a relevant physical and psychic comorbidity and frequently have a prescribed polypharmacy.

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