A Mixed-Methods Study of the Effect of Abdominal Binders on Opioid Use and Postoperative Pain After Cesarean Birth

2022 ◽  
Author(s):  
Corie Hoskins ◽  
Amy Dempsey ◽  
Lina Brou
Keyword(s):  
Mixed Methods ◽  
Postoperative Pain ◽  
Mixed Methods Study ◽  
Opioid Use ◽  
Cesarean Birth

scholarly journals The effects of opioid-agonist treatments on HIV risk and social stability: A mixed methods study of women with opioid use disorder in Ukraine

2017 ◽  
Vol 83 ◽  
pp. 36-44 ◽  
Author(s):  
Emily Hoff ◽  
Ruthanne Marcus ◽  
Martha J. Bojko ◽  
Iuliia Makarenko ◽  
Alyona Mazhnaya ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Hiv Risk ◽  
Opioid Use Disorder ◽  
Mixed Methods Study ◽  
Social Stability ◽  
Opioid Use ◽  
Opioid Agonist

Feasibility and acceptability of mindful recovery opioid use care continuum (M-ROCC): A concurrent mixed methods study

2021 ◽  
pp. 108415
Author(s):  
Thomas Fatkin ◽  
Sarah K. Moore ◽  
Kayley Okst ◽  
Timothy Creedon ◽  
Farah Samawi ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Mixed Methods Study ◽  
Opioid Use ◽  
Care Continuum

scholarly journals The Impact of Non-Pharmacological Interventions on Patient Experience, Opioid Use, and Healthcare Utilization in Adult Cardiac Surgery Patients: Protocol for a Mixed Methods Study (Preprint)

2020 ◽  
Author(s):  
Alexander A. Brescia ◽  
Julie R. Piazza ◽  
Jessica N. Jenkins ◽  
Lindsay K. Heering ◽  
Alexander J. Ivacko ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Mixed Methods ◽  
Healthcare Utilization ◽  
Patient Experience ◽  
Mixed Methods Study ◽  
Opioid Use ◽  
Pharmacological Interventions ◽  
The Impact ◽  
Adult Cardiac Surgery

BACKGROUND Despite pharmacological treatments, patients undergoing cardiac surgery experience severe anxiety and pain which adversely impact outcomes. Prior work examining pediatric and non-surgical adult patients has documented the effectiveness of inexpensive non-pharmacological techniques to reduce anxiety and pain, as well as healthcare costs and length of hospitalization. However, the impact of non-pharmacological interventions administered by a dedicated “comfort coach” has not been evaluated in an adult surgical setting. OBJECTIVE The objective of this trial is to assess whether non-pharmacological interventions administered by a trained comfort coach impact patient experience, opioid use, and healthcare utilization compared to usual care in adult cardiac surgery patients. This study has three specific aims: (1) assess the effect of a comfort coach on patient experience, (2) measure differences in inpatient and outpatient opioid use and postoperative healthcare utilization, and (3) qualitatively evaluate the comfort coach intervention. METHODS To address these aims, we will perform a prospective, randomized controlled trial of 154 adult cardiac surgery patients at Michigan Medicine. Opioid-naive patients undergoing first-time, elective cardiac surgery via sternotomy will be randomized to undergo targeted interventions from a comfort coach (intervention) versus usual care (control). The individualized comfort coach interventions will be administered at six points: (1) preoperative outpatient clinic, (2) preoperative care unit on the day of surgery, (3) extubation, (4) chest tube removal, (5) hospital discharge, and (6) at 30-day clinic follow-up. To address aim 1, we will examine the effect of a comfort coach on perioperative anxiety, self-reported pain, functional status, and patient satisfaction through validated surveys administered at (1) preoperative outpatient clinic, (2) discharge, (3) 30-day follow-up, and (4) 90-day follow-up. For aim 2, we will record inpatient opioid use and collect post-discharge opioid use and pain-related outcomes through an 11-item questionnaire administered at 30-day follow-up. Hospital length of stay, readmission, number of days in an extended care facility, emergency room, urgent care, and at an unplanned doctor’s office visit will be recorded as the primary composite endpoint defined as total days spent at home within the first 30 after surgery. For aim 3, we will perform semi-structured interviews with patients in the intervention arm to understand the comfort coach intervention through a thematic analysis. RESULTS This trial, funded by Blue Cross Blue Shield Foundation of Michigan in 2019, is presently enrolling patients with anticipated manuscript submissions Data generated from this mixed methods study will highlight effective non-pharmacological techniques and support a multidisciplinary approach to perioperative care during the adult cardiac surgery patient experience. Findings from this study may serve as the foundation for a subsequent multicenter trial and broader dissemination of these techniques to other types of surgery.from our primary aims targeted for the end of 2020. CONCLUSIONS Data generated from this mixed methods study will highlight effective non-pharmacological techniques and support a multidisciplinary approach to perioperative care during the adult cardiac surgery patient experience. Findings from this study may serve as the foundation for a subsequent multicenter trial and broader dissemination of these techniques to other types of surgery. CLINICALTRIAL ClinicalTrials.gov NCT04051021; https://clinicaltrials.gov/ct2/show/NCT04051021.

scholarly journals Protocol: mixed-methods study of how implementation of US state medical cannabis laws affects treatment of chronic non-cancer pain and adverse opioid outcomes

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Emma E. McGinty ◽  
Kayla N. Tormohlen ◽  
Colleen L. Barry ◽  
Mark C. Bicket ◽  
Lainie Rutkow ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Cancer Pain ◽  
Survey Methods ◽  
Opioid Use Disorder ◽  
Mixed Methods Study ◽  
Opioid Overdose ◽  
Medical Cannabis ◽  
Opioid Use ◽  
Topical Analgesics ◽  
Quantitative Analyses

Abstract Background Thirty-three US states and Washington, D.C., have enacted medical cannabis laws allowing patients with chronic non-cancer pain to use cannabis, when recommended by a physician, to manage their condition. However, clinical guidelines do not recommend cannabis for treatment of chronic non-cancer pain due to limited and mixed evidence of effectiveness. How state medical cannabis laws affect delivery of evidence-based treatment for chronic non-cancer pain is unclear. These laws could lead to substitution of cannabis in place of clinical guideline-discordant opioid prescribing, reducing risk of opioid use disorder and overdose. Conversely, state medical cannabis laws could lead to substitution of cannabis in place of guideline-concordant treatments such as topical analgesics or physical therapy. This protocol describes a mixed-methods study examining the implementation and effects of state medical cannabis laws on treatment of chronic non-cancer pain. A key contribution of the study is the examination of how variation in state medical cannabis laws’ policy implementation rules affects receipt of chronic non-cancer pain treatments. Methods The study uses a concurrent-embedded design. The primary quantitative component of the study employs a difference-in-differences design using a policy trial emulation approach. Quantitative analyses will evaluate state medical cannabis laws’ effects on treatment for chronic non-cancer pain as well as on receipt of treatment for opioid use disorder, opioid overdose, cannabis use disorder, and cannabis poisoning among people with chronic non-cancer pain. Secondary qualitative and survey methods will be used to characterize implementation of state medical cannabis laws through interviews with state leaders and representative surveys of physicians who treat, and patients who experience, chronic non-cancer pain in states with medical cannabis laws. Discussion This study will examine the effects of medical cannabis laws on patients’ receipt of guideline-concordant non-opioid, non-cannabis treatments for chronic non-cancer pain and generate new evidence on the effects of state medical cannabis laws on adverse opioid outcomes. Results will inform the dynamic policy environment in which numerous states consider, enact, and/or amend medical cannabis laws each year.

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