scholarly journals Emergency Physicians Ability to Recognize and Diagnose Opiate Use Disorder: A Qualitative Study

Cureus ◽  
2021 ◽  
Author(s):  
Christine Crain ◽  
Tracy Meyer ◽  
Devon Webster ◽  
Jacqueline Fraser ◽  
Paul Atkinson
Keyword(s):  
Qualitative Study ◽  
Emergency Physicians ◽  
Opiate Use ◽  
Opiate Use Disorder

How and When Do Expert Emergency Physicians Generate and Evaluate Diagnostic Hypotheses? A Qualitative Study Using Head-Mounted Video Cued-Recall Interviews

2014 ◽  
Vol 64 (6) ◽  
pp. 575-585 ◽  
Author(s):  
Thierry Pelaccia ◽  
Jacques Tardif ◽  
Emmanuel Triby ◽  
Christine Ammirati ◽  
Catherine Bertrand ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Cued Recall ◽  
Emergency Physicians

Mu Opioid Receptor Gene (OPRM1) in Patients With Opiate Use Disorder

2020 ◽  
Vol 19 (1) ◽  
pp. 16-21
Author(s):  
Nehal Mostafa ◽  
Maha W. Mobasher ◽  
Heba N. El Baz ◽  
Mohamed A. Khalil
Keyword(s):  
Opioid Receptor ◽  
Receptor Gene ◽  
Mu Opioid Receptor ◽  
Mu Opioid ◽  
Opiate Use ◽  
Opiate Use Disorder

scholarly journals Emergency physicians’ attitudes to implementing ultrasound in Dutch emergency departments after a 2-day training: A qualitative study

2018 ◽  
Vol 25 (5) ◽  
pp. 249-256 ◽  
Author(s):  
Rein Ketelaars ◽  
Esther Van Heumen ◽  
Lambert P Baken ◽  
Marja Witten ◽  
Gert Jan Scheffer ◽  
...  
Keyword(s):  
Emergency Department ◽  
Qualitative Study ◽  
Solid Base ◽  
Emergency Physicians ◽  
Structured Interviews ◽  
Evaluation Program ◽  
Practical Applications ◽  
Assurance System ◽  
Essential Insight ◽  
Level 2

Background: Diagnostic ultrasound is increasingly used by nonradiologists in trauma victims and critically ill patients. In the emergency department, the extended focused assessment with sonography for trauma and Polytrauma Rapid Echo-evaluation Program protocol are often used to assess these patients. Dutch Polytrauma Rapid Echo-evaluation Program-trained Emergency physicians are implementing the use of ultrasound in the emergency department but might encounter barriers to overcome. Objectives: This study aims to explore individual experiences of Dutch emergency physicians. Methods: We performed a qualitative study by conducting semi-structured interviews in Dutch emergency physicians working in a Level 2 emergency department that completed the 2-day Polytrauma Rapid Echo-evaluation Program course at least 1 year before the interviews. Data were analyzed using directed content analysis. Results: Eight emergency physicians employed by eight different hospitals were interviewed. Thirteen categories were identified in the transcribed interviews and these were combined into four general themes: (1) the desire to develop the Emergency Medicine specialty, both nationally and local; (2) incentives to start using ultrasound; (3) exploring practical applications of ultrasound; and (4) barriers faced while implementing emergency physician-performed ultrasound on the emergency department. The interviewees regard the course to be a solid base and are eager to independently perform ultrasound examinations, although challenges are faced. Conclusion: This exploratory study provides essential insight in Dutch emergency physicians implementing ultrasound in their emergency department. It shows that there is a need to develop a quality assurance system and it identified barriers that have to be dealt with.

Levomethadyl Acetate versus Buprenorphine versus Methadone for Opioid Dependence

2018 ◽  
Author(s):  
Robert Ross ◽  
Brian Fuehrlein
Keyword(s):  
Substance Use ◽  
Opioid Dependence ◽  
Clinical Case ◽  
Low Dose ◽  
High Dose ◽  
Opiate Use ◽  
Opiate Use Disorder ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of a landmark study on substance use disorders. Which of the following is most effective for treatment of opioid dependence: levomethadyl acetate, buprenorphine, high-dose methadone, or low-dose methadone? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case. The study demonstrates that buprenorphine, high-dose methadone, and levomethadyl acetate are equally effective in the treatment of opiate use disorder. All three treatments are significantly more effective than low-dose methadone.

scholarly journals Buprenorphine/naloxone maintenance therapy in patients with meperidine use disorder

2017 ◽  
Vol 6 (9) ◽  
pp. 2292
Author(s):  
Ahmet Bulent Yazici ◽  
Alime Burcin Saykan ◽  
Esra Yazici ◽  
Atila Erol
Keyword(s):  
Maintenance Therapy ◽  
Opioid Dependence ◽  
Addiction Treatment ◽  
Partial Agonist ◽  
Treatment Options ◽  
Full Remission ◽  
Opiate Use ◽  
Care Workers ◽  
Opiate Use Disorder ◽  
Long Acting

Meperidine hydrochloride is a synthetic opioid and a weak µ receptor agonist. Meperidine use disorder is mostly iatrogenic and is common in health care workers. In addition, it is prescribed in acute and chronic pain complaints, and has a high potential for creating addiction. Treatment of meperidine use disorder is a challenging issue and there is no standardised treatment for meperidine addiction. Buprenorphine is a μ receptor partial agonist, a long-acting synthetic opioid for the treatment of opioid dependence and has a buprenorphine/naloxone (BN) form combined with naloxone. Buprenorphine maintenance therapy is one of the treatment options performed in opiate use disorder. But there is a paucity of data about treatment of meperidine use disorder. Here, a full remission case report is presented with BN maintenance treatment for a patient with meperidine use disorder diagnosis.

scholarly journals Emergency Physicians’ Perceptions of Critical Appraisal Skills: A Qualitative Study

2021 ◽  
Author(s):  
Sumintra Wood ◽  
Jacqueline Paulis ◽  
Angela Chen
Keyword(s):  
Qualitative Study ◽  
Professional Identity ◽  
Identity Formation ◽  
Critical Appraisal ◽  
Skills Training ◽  
Training Methods ◽  
Emergency Physicians ◽  
Structured Interviews ◽  
Barriers To Learning ◽  
Critical Appraisal Skills

Abstract BackgroundCritical appraisal of medical research is a valuable skill set that emergency physicians must learn in order to become competent clinicians. Despite the need for effective critical appraisal skills training, these skills have remained difficult to teach and assess. This study aimed to explore emergency physicians’ perceptions of the barriers and motivations for learning critical appraisal skills in order to develop more successful critical appraisal training methods for Emergency Medicine (EM) residents.MethodsThis qualitative study involved in-depth semi-structured interviews with emergency physicians interested in education and administration at an urban academic hospital. Transcribed interviews were descriptively coded by three main reviewers. A coding template was developed after coding an initial set of interviews and used to code the remaining transcripts. A thematic analysis of the codes was conducted to create a summary report which was given to the interviewees as part of a member checking process to further solidify themes.ResultsFourteen emergency physicians participated in the study. They described time limitations, perceived difficulty, and disinterest as major barriers to learning critical appraisal, and patient care as well as professional identity goals of being a good educator or researcher as motivations for developing critical appraisal skills.ConclusionThere remain significant challenges to learning critical appraisal skills as well as an increasing need to build these skills during residency. Educational theories and a greater emphasis on professional identity formation during residency can be incorporated to create a more effective approach to teaching critical appraisal skills despite these barriers.

scholarly journals Acute pain management in patients with opiate maintenance treatment in primary care: a qualitative study

2020 ◽  
Author(s):  
morgane guillou landreat ◽  
Melia Baillot ◽  
Le Goff Delphine ◽  
Le Reste Jean Yves
Keyword(s):  
General Practice ◽  
Data Collection ◽  
Thematic Analysis ◽  
Acute Pain ◽  
Maintenance Treatment ◽  
Structured Interviews ◽  
Opiate Use ◽  
Number Of Patients ◽  
Data Collection Technique ◽  
Opiate Use Disorder

Abstract Background: Opiate use disorders are a worldwide disease. In the last 30 years, opiate maintenance treatment prescription changed patients’ and also changed physicians’ practice. General practitioners (GPs) have to deal with patients on OMT who are in acute pain. Both clinically and pharmacologically, the treatment of acute pain in patients with an opiate use disorder and an OMT(opiate maintenance treatment) differs from that given to patients with other conditions. As this situation is complex, it was important to explore whether GPs recognised this problem and whether they managed it effectively.Objective: To investigate how GPs identify and manage situations of acute pain in patients with opiate use disorders and OMT. Methods: semi-structured interviews were used as a data collection technique with a purposive sample of practising GPs. Data collection continued until saturation was reached. Analysis was undertaken using a thematic analysis method. Two independent researchers, working blind and pooling data, carried out the analysis. Results: The maximal variation of the sample and saturation of data were reached with 11 GPs. The thematic analysis resulted in 4 main themes: (1) the importance and difficulties of professional links , (2) the specific clinical reasoning , (3) the importance of the doctor-patient relationship and (4) the particular characteristics of OMT patients. Conclusion: The complexity of pain and opioid dependence represents significant challenges for GPs. It is hard to achieve a balance between pain relief and opiate use disorder treatment. These questions are particularly important in general practice, where the practitioner may feel insufficiently trained, and isolated. Existing protocols do not seem to be in line with general practice. The number of patients on OMT has increased since it was first marketed; GPs will increasingly have to deal with these situations and will have to issue their own recommendations.

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