Mexican Traditional Medicine: Application of a Traditional and Complementary Medicine System to Improve Opioid Use Treatment in Latinos

2020 ◽  
Vol 38 (4) ◽  
pp. 384-399 ◽  
Author(s):  
Tanya R. Sorrell

Background: Initially considered a primarily rural, White issue, opioid use and overdose rates have risen faster for Latinos (52.5%) than for White, non-Hispanics (45.8%) from 2014 to 2016. With an estimated 45% to 65% of Latino immigrant families using Mexican traditional medicine (MTM) practices before seeking Western medical services, these practices could be used as a method to increase access to care and improve outcomes. Practice Model: Although not well known, MTM is founded on a defined set of theoretical tenets that comprise a whole medical system as defined by the National Center for Complementary and Integrative Health. Whole medical systems are characterized as complete systems of theory and practice that develop independently and parallel allopathic medicine. Classifying MTM as a whole medical system to encourage further research and utilization of traditional and complementary medicine (T&CM) practices could help improve health outcomes for Latino patients. Specific T&CM practices that could be used in opioid treatment integration to decrease stigma and increase treatment utilization are then discussed. Conclusion: Incorporating T&CM practices will allow more effective, culturally competent and culturally sensitive health care provision for Latino immigrants in the United States to decrease stigma, improve health care outcomes, and address disparities in opioid use treatment.

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F Magalhaes ◽  
D Santos ◽  
G Martins ◽  
J Barbosa ◽  
M Riquieri ◽  
...  

Abstract Background A qualitative and exploratory study that analyzed the perspective of access to Integrative and Complementary Practices in Health (PICS) by listening users from a selected service of primary care of a municipality. Objective Analyze the access to PICS in a health public service of a municipality in a state of Brazil, from the perspective of users, as well as aimed at understand the needs and desires of health care these users in the search process and use of PICS, identifying facilitators and barriers in this trajectory. Methods The theoretical reference from Frenk on access was used, which systematizes the flow of events at the moment when the health need is perceived until the effectiveness of the care, besides the demand and entrance in the health services and the continuity of the treatment. The data collection was done by participant observation and semi-structured interview with 29 users of the service. The narratives were worked through the analysis of thematic content. Results The results indicated two groups of PICS: complex medical systems and therapeutic resources. There were differences in the organization of the offer with consequent influence on the different forms of access. It was registered the interest for the use of health care in a non-biomedical logic and a re-signification of the health-disease process in PICS users, contributing to the continuity of health production. Conclusions It was concluded that the current models of access analysis do not contemplate the diversities of access to the PICS, and the various possibilities of encounters with these practices allow the identification of the marginality of this care in all cases analyzed. Key messages Integrative and Complementary Health Practices gain national relevance as they contribute to the development of health promoting activities, focus on the individual, prevention and comprehensive care. However, considered a controversial topic in a hegemonically biomedical scenario, the incorporation of these new knowledge and practices in the health field occurs in a marginal way.


2021 ◽  
Vol 30 (3) ◽  
pp. 499-545
Author(s):  
Jinhyouk KIM

Immediately after the liberation, the health care system debate was studied focusing on the orientation of the American and Soviet medical systems, roughly divided into Lee Yong-seol and Choi Eung-seok. However, the existence of people who are not explained in the American and Soviet health care systems’ orientation led to the need to reconsider the existing premise. Therefore, this study identifies the characters that were not explained in the perspective of existing studies, and reevaluates the arguments of Lee Yong-seol and Choi Eung-seok. This paper raises the following questions: First, what is the background of the policy orientation that Lee Yong-seol and Choi Eung-seok had? Second, if there are people who made different arguments from Lee Yong-seol and Choi Eung-seok, what direction did they set and argue? third, how the orientations of Lee Yong-seol and Choi Eung-seok and etc. converge into the answer to the Joint Soviet-American Commission? In response to theses questions, this study confirms the following: first, Lee Yong-seol’s and Choi Eung-seok’s health care policies were established based on realism and empiricism. As a policyholder, Lee Yong-seol emphasized withholding medical state administration and raising the level of medical education and medical systems according to the condition at that time, although the American system was mobilized by Lee as the basis for his judgment and administrative assets. On the other hand, Choi Eung-seok aimed for a Soviet-style systems in health care but this was realistically put on hold. Choi insisted on the establishment of the Medical Service Associations and rural cooperative hospitals that appeared in Japan’s medical socialization movement. In summary, immediately after the liberation, Lee Yong-seol’s and Choi Eung-seok’s policy arguments were based on policies that could be implemented in Korea, and the American system and Soviet system served as criteria for the policy resources. Second, Jeong Gu-chung and Kim Yeon-ju show that the topography of the health care debate immediately after the liberation was not represented only by Lee Yong-seol and Choi Eung-seok. Both Jeong and Kim were consequently led to medical socialization, which was the implementation of a health care system that encompasses social reform, but the context was different. Jeong drew the hierarchy of the health care system, which peaked in the United States, from the perspective of social evolution based on his eugenics, but the representation suitable for Korea was the Soviet model absorbed into his understanding. On the contrary, Kim argued that representations suitable for Korea should be found in Korea. As national medical care, Kim’s idea aimed at a medical state administration that provides equal opportunities for all Koreans. Third, the aspect of convergence to the Joint Soviet-American Commission reply proposal was complicated. Among the policies of Lee Yong-seol, the promotion of missionary medical institutions and the gradual planning of medical institutions converged into the three organizations’ proposal, and Choi Eung-seok’s policy was almost the same as that of the Democracy National Front and the South Korean Labor Party. However, the medical system of Japan, the colonial home country, appears to have been based on Lee Gap-soo, chairman of the Korean Medical Association in the colonial period, and the plan was in line with the use of the union system of the left-wing organizations’ proposal in the south. It was in accordance with a common task to expand health care from colonial conditions to different status.


2020 ◽  
Vol 135 (1_suppl) ◽  
pp. 100S-127S ◽  
Author(s):  
Bahareh Ansari ◽  
Katherine M. Tote ◽  
Eli S. Rosenberg ◽  
Erika G. Martin

Objectives In the United States, rising rates of overdose deaths and recent outbreaks of hepatitis C virus and HIV infection are associated with injection drug use. We updated a 2014 review of systems-level opioid policy interventions by focusing on evidence published during 2014-2018 and new and expanded opioid policies. Methods We searched the MEDLINE database, consistent with the 2014 review. We included articles that provided original empirical evidence on the effects of systems-level interventions on opioid use, overdose, or death; were from the United States or Canada; had a clear comparison group; and were published from January 1, 2014, through July 19, 2018. Two raters screened articles and extracted full-text data for qualitative synthesis of consistent or contradictory findings across studies. Given the rapidly evolving field, the review was supplemented with a search of additional articles through November 17, 2019, to assess consistency of more recent findings. Results The keyword search yielded 535 studies, 66 of which met inclusion criteria. The most studied interventions were prescription drug monitoring programs (PDMPs) (59.1%), and the least studied interventions were clinical guideline changes (7.6%). The most common outcome was opioid use (77.3%). Few articles evaluated combination interventions (18.2%). Study findings included the following: PDMP effectiveness depends on policy design, with robust PDMPs needed for impact; health insurer and pharmacy benefit management strategies, pill-mill laws, pain clinic regulations, and patient/health care provider educational interventions reduced inappropriate prescribing; and marijuana laws led to a decrease in adverse opioid-related outcomes. Naloxone distribution programs were understudied, and evidence of their effectiveness was mixed. In the evidence published after our search’s 4-year window, findings on opioid guidelines and education were consistent and findings for other policies differed. Conclusions Although robust PDMPs and marijuana laws are promising, they do not target all outcomes, and multipronged interventions are needed. Future research should address marijuana laws, harm-reduction interventions, health insurer policies, patient/health care provider education, and the effects of simultaneous interventions on opioid-related outcomes.


2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 235-235 ◽  
Author(s):  
Diana Martins-Welch ◽  
Christian Nouryan ◽  
Myriam Kline ◽  
Sony Modayil

235 Background: According to the CDC, 117 million Americans have one or more chronic health conditions and 31% have used two or more prescription drugs in the past month. Approximately 40% of adults in the United States are using some form of Complementary and Alternative Medicine. Medical marijuana is one such medicine, and to date 29 states have legalized medical marijuana. Methods: A multicenter, anonymous, on-line survey of health care providers was distributed via e-mail within a large health system in the NY Metropolitan area. The survey was distributed in April and May of 2017. The specific aim was to collect information about health care providers’ perspectives on the use of MM in general and for specific medical conditions. Results: The sample (n = 137) consisted of 4% RNs, 10% NPs, 10% fellows, 21% resident physicians, and 52% attending physicians. Average experience was 13 years (range: 0-43), half (53%) were under 40 years old and just over half (56%) were female. Most practitioners recognized a benefit of MM for the treatment of cancer-associated symptoms, few were concerned with side effects and 5% of responders answered that MM was not appropriate at any stage of illness. Responders were “most likely to recommend or refer MM if other therapies were not effective” for cancer (83%), chronic pain (68%), spinal cord injury with spasticity (50%), MS (46%), epilepsy (42%), neuropathy (42%) and Parkinson’s disease (41%). Most providers (77%) believed that MM has the potential to reduce overall opioid use, this was found to be statistically more common in younger providers. The most common conditions that providers reported their patients were requesting MM for were cancer (37%), chronic pain (26%) and neuropathy (10%). The most common concerns about MM use were side effects (16%), addiction (13%), legal consequences (11%), cost (7%) and that other providers would judge MM use (7%). Conclusions: Our survey shows that providers are overwhelmingly in support of MM use in patients with chronic illness, particularly in cancer patients. However providers describe significant and practical concerns about MM utilization. Given the rate at which MM is being legalized throughout the country, it is imperative that there be increased focus on education and clinical studies on MM.


2018 ◽  
pp. 1-10 ◽  
Author(s):  
Jeffrey D. White ◽  
Barry R. O’Keefe ◽  
Jitendra Sharma ◽  
Ghazala Javed ◽  
Vid Nukala ◽  
...  

Therapies originating from traditional medical systems are widely used by patients in both India and the United States. The first India-US Workshop on Traditional Medicine was held in New Delhi, India, on March 3 and 4, 2016, as a collaboration between the Ministry of Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy (AYUSH) of the Government of India, the US National Cancer Institute (NCI), National Institutes of Health, and the Office of Global Affairs, US Department of Health and Human Services. It was attended by Indian and US policymakers, scientists, academics, and medical practitioners from various disciplines. The workshop provided an opportunity to open a dialogue between AYUSH and NCI to identify promising research results and potential topics for Indo-US collaboration. Recommendations that emerged from the workshop underlined the importance of applying rational and scientific approaches for drug development; standardizing traditional medicine products and procedures to ensure reliability and reproducibility; promotion of collaboration between Indian traditional medicine practitioners and researchers and US researchers; greater integration of evidence-based traditional medicine practices with mainstream medical practices in India; and development of training programs between AYUSH and NCI to facilitate crosstraining. Several positive developments took place after the thought-provoking deliberations.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Hunter M. Puckett ◽  
Jenny S. Bossaller ◽  
Lincoln R. Sheets

AbstractOpioid use disorder (OUD) is a medical condition that has evolved into a serious and deadly epidemic in the United States. Both medical and psychological interventions are called for to end this growing epidemic, but too few health care professionals are trained to treat OUD. One proven model of training physicians and cross-disciplinary teams in treating a variety of disorders is exemplified by Project ECHO (Extension for Community Healthcare Outcomes), a collaborative tele-mentoring program in which specialists train health-care workers to treat medical conditions, especially those that affect underserved populations. This systematic review found that Project ECHO has the potential to effectively extend current services to patients suffering from OUD, but that there is also a gap in knowledge regarding this type of training. The articles that we reviewed all presented evidence that Project ECHO improves healthcare provider preparedness to treat OUD, especially in regard to improving knowledge and self-efficacy.


2021 ◽  
pp. 106002802110322
Author(s):  
Luigi Brunetti ◽  
Janaki Vekaria ◽  
Peter E. Lipsky ◽  
Naomi Schlesinger

Background The incidence and health care costs of gout flares have increased in the United States. The increased costs may be a result of a lack of adherence to treatment guidelines and medication knowledge. Identifying causes for this trend is vital to mitigate inappropriate resource use. Objectives The aim was to identify pharmacotherapy use related to gout treatment before, during hospital visit or stay, and on discharge in patients presenting to the emergency department (ED) with gout flares. Secondary end points included opioid use, revisit rates, and associated risk factors. Methods We performed a retrospective cohort study at a community teaching hospital ED. All consecutive patients visiting the ED from January 2016 to July 2019 with a primary diagnosis of gout flare were included. Data were extracted from the electronic medical records. Results The analysis included 214 patients. Anti-inflammatory medication was not prescribed in 33.6% during the hospital visit and 29.6% of patients on discharge. History of opioid use (odds ratio [OR] = 3.3; 95% CI = 1.3-8.6; P = 0.014) and gastroesophageal reflux disease (OR = 3.5; 95% CI = 1.09-10.9; P = 0.035) were associated with opioid prescription on discharge. ED revisits within 90 days for any gout-related or non–gout-related cause were recorded in 16.8% of patients. Conclusion and Relevance Roughly 30% of patients did not receive an anti-inflammatory on discharge, and opioids were frequently overused in gout management in the ED. There is an opportunity for further education of health care providers regarding gout treatment.


2020 ◽  
Author(s):  
Marissa Tan ◽  
Elham Hatef ◽  
Delaram Taghipour ◽  
Kinjel Vyas ◽  
Hadi Kharrazi ◽  
...  

UNSTRUCTURED In an era of accelerated health information technology capability, health care organizations increasingly use digital data to predict outcomes such as emergency department use, hospitalizations, and health care costs. This trend occurs alongside a growing recognition that social and behavioral determinants of health (SBDH) influence health and medical care use. Consequently, health providers and insurers are starting to incorporate new SBDH data sources into a wide range of health care prediction models, although existing models that use SBDH variables have not been shown to improve health care predictions more than models that use exclusively clinical variables. In this viewpoint, we review the rationale behind the push to integrate SBDH data into health care predictive models and explore the technical, strategic, and ethical challenges faced as this process unfolds across the United States. We also offer several recommendations to overcome these challenges to reach the promise of SBDH predictive analytics to improve health and reduce health care disparities.


Sign in / Sign up

Export Citation Format

Share Document