scholarly journals The impact of project ECHO on physician preparedness to treat opioid use disorder: a systematic review

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Hunter M. Puckett ◽  
Jenny S. Bossaller ◽  
Lincoln R. Sheets
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Professionals ◽  
Underserved Populations ◽  
Medical Condition ◽  
The United States ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Project Echo ◽  
The Impact

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.

scholarly journals Opioid Use and Its Relationship to Cardiovascular Disease and Brain Health: A Presidential Advisory From the American Heart Association

Circulation ◽  
2021 ◽  
Author(s):  
Sheryl L. Chow ◽  
Comilla Sasson ◽  
Ivor J. Benjamin ◽  
Robert M. Califf ◽  
Wilson M. Compton ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Health Care ◽  
Health Care Professionals ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
The United States ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Brain Health

The misuse of opioids continues to be epidemic, resulting in dependency and a recent upsurge in drug overdoses that have contributed to a significant decrease in life expectancy in the United States. Moreover, recent data suggest that commonly used opioids for the management of pain may produce undesirable pharmacological actions and interfere with critical medications commonly used in cardiovascular disease and stroke; however, the impact on outcomes remains controversial. The American Heart Association developed an advisory statement for health care professionals and researchers in the setting of cardiovascular and brain health to synthesize the current literature, to provide approaches for identifying patients with opioid use disorder, and to address pain management and overdose. A literature and internet search spanning from January 1, 2012, to February 15, 2021, and limited to epidemiology studies, reviews, consensus statements, and guidelines in human subjects was conducted. Suggestions and considerations listed in this document are based primarily on published evidence from this review whenever possible, as well as expert opinion. Several federal and institutional consensus documents and clinical resources are currently available to both patients and clinicians; however, none have specifically addressed cardiovascular disease and brain health. Although strategic tools and therapeutic approaches for recognition of opioid use disorder and safe opioid use are available for health care professionals who manage patients with cardiovascular disease and stroke, high-quality evidence does not currently exist. Therefore, there is an urgent need for more research to identify the most effective approaches to improve care for these patients.

scholarly journals A Systematic Review of Usability Challenges and Testing in Mobile Health

2015 ◽  
Vol 5 (2) ◽  
pp. 1 ◽  
Author(s):  
Tareq Ali Al-Saadi ◽  
Tamer Mohammed Aljarrah ◽  
Anahed Mudheher Alhashemi ◽  
Azham Hussain
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Mobile Health ◽  
Mobile Communications ◽  
Digital Libraries ◽  
Health Care Professionals ◽  
Usability Testing ◽  
Smart Phones ◽  
Portable Devices ◽  
The Impact

Nowadays, the combining of advanced mobile communications and mobile account now in portable devices named "smart phones" has becomes more great uses. Among of these include health care professionals. Few studies in the challenge, blurred reality challenge facing the patient and developer alike in the usability of mobile health. Therefore, this paper aims to analyze the usability challenges in mobile health and usability testing. The systematic review was using for collecting the prior studies that relation with our study. This study concentrates on the three digital libraries Google scholar, ACM and IEEE, as well as, the researcher selected the studies between 2007 and 2015. The results from this systematic were selected 11 studies of 106 based on the inclusions criteria. In more details, the usability challenges found that 27% offered User Interface, 22% tasks and screen size, 16% insert media and 13% network. On the other hand, usability use found that, 46% of the selected studies the usability use of formal type of 45% informal and 9% mixed formal and informal. Sum up, the use of smart phones is getting more on health care and day out. Medical applications make smart phones useful tools in the practice of evidence-based medicine at the point of care, in addition to its use in mobile clinical communications. This study will making a contribution to the researchers to extract over the impact of the challenges on usability testing and the types of usability in mobile health.

Interventions to Decrease Use in Prehospital and Emergency Care Settings Among Super-Utilizers in the United States: A Systematic Review

2019 ◽  
Vol 77 (2) ◽  
pp. 99-111 ◽  
Author(s):  
Samantha Iovan ◽  
Paula M. Lantz ◽  
Katie Allan ◽  
Mahshid Abir
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Acute Care ◽  
Emergency Care ◽  
Grey Literature ◽  
The United States ◽  
Care Utilization ◽  
Regression To The Mean ◽  
High Quality ◽  
The Impact

Interest in high users of acute care continues to grow as health care organizations look to deliver cost-effective and high-quality care to patients. Since “super-utilizers” of acute care are responsible for disproportionately high health care spending, many programs and interventions have been implemented to reduce medical care use and costs in this population. This article presents a systematic review of the peer-reviewed and grey literature on evaluations of interventions to decrease prehospital and emergency care use among U.S. super-utilizers. Forty-six distinct evaluations were included in the review. The most commonly evaluated intervention was case management. Although a number of interventions reported reductions in prehospital and emergency care utilization and costs, methodological and study design weaknesses—especially regression to the mean—were widespread and call into question reported positive findings. More high-quality research is needed to accurately assess the impact of interventions to reduce prehospital and emergency care use in the super-utilizer population.

Pharmacist’s Role in Dispensing Opioids for Acute and Chronic Pain

2011 ◽  
Vol 25 (5) ◽  
pp. 497-502 ◽  
Author(s):  
Karen F. Marlowe ◽  
Richard Geiler
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Pain Management ◽  
Health Care Providers ◽  
Family Relationships ◽  
Health Care Professionals ◽  
The United States ◽  
Care Providers ◽  
Economic Productivity ◽  
The Impact

Pain continues to be a serious health care concern in the United States. Patients with chronic pain experience the impact of the disease throughout their lives including their social interactions, family relationships, and in many cases economic productivity. Multiple surveys have found that many pharmacists hold misconceptions regarding opioids, pain disease states, and their understandings of current regulations. Multiple barriers affect the ability of pharmacists to deliver care to patients' prescribed opioid therapy. Inadequate communication between health care professionals and patients is one of the hurdles, which prevents quality care. Increased communication between health care providers including access to health information is one step, which is crucial to improving provision of pharmacotherapy. Finally, the quality of educational opportunities relative to opioids and pain management specifically for pharmacists needs to be increased, and consideration needs to be given for making appropriate pain management education mandatory.

scholarly journals Federally Qualified Health Centers Can Expand Rural Access to Buprenorphine for Opioid Use Disorder in Arizona

2021 ◽  
Vol 14 ◽  
pp. 117863292110375
Author(s):  
Benjamin R Brady ◽  
Rachel Gildersleeve ◽  
Bryna D Koch ◽  
Doug E Campos-Outcalt ◽  
Daniel J Derksen
Keyword(s):  
Rural Areas ◽  
Underserved Populations ◽  
Opioid Use Disorder ◽  
Health Centers ◽  
Opioid Use ◽  
Federally Qualified Health Centers ◽  
Treatment Access ◽  
Opioid Treatment ◽  
Rural Access ◽  
The Impact

Medication for Opioid Use Disorder (MOUD) is recommended, but not always accessible to those who desire treatment. This study assessed the impact of expanding access to buprenorphine through federally qualified health centers (FQHCs) in Arizona. We calculated mean drive-times to Arizona opioid treatment (OTP) locations, office-based opioid treatment (OBOT) locations, and FQHCs clinics using January 2020 location data. FQHCs were designated as OBOT or non-OBOT clinics to explore opportunities to expand treatment access to non-OBOT clinics (potential OBOTs) to further reduce drive-times for rural and underserved populations. We found that OTPs had the largest mean drive times (16.4 minutes), followed by OBOTs (7.1 minutes) and potential OBOTs (6.1 minutes). Drive times were shortest in urban block groups for all treatment types and the largest differences existed between OTPs and OBOTs (50.6 minutes) in small rural and in isolated rural areas. OBOTs are essential points of care for opioid use disorder treatment. They reduce drive times by over 50% across all urban and rural areas. Expanding buprenorphine through rural potential OBOT sites may further reduce drive times to treatment and address a critical need among underserved populations.

Addressing Bias and Stigma in the Language We Use With Persons With Opioid Use Disorder: A Narrative Review

2021 ◽  
pp. 107839032110501
Author(s):  
Karen Werder ◽  
Alexa Curtis ◽  
Stephanie Reynolds ◽  
Jason Satterfield
Keyword(s):  
Health Care ◽  
Treatment Outcomes ◽  
Health Care Professionals ◽  
Treatment Method ◽  
Opioid Use Disorder ◽  
Narrative Review ◽  
Intentional Stance ◽  
Review Of The Literature ◽  
Opioid Use ◽  
Education Practice

BACKGROUND: Despite an increase in access to medications for opioid use disorder, less than 20% of individuals with opioid use disorder (OUD) receive treatment. Stigmatizing language has been identified as a potential trigger for explicit and implicit biases that may adversely affect treatment enrollment and quality of care for persons with OUD. AIMS: To conduct a narrative review of the literature on stigmatizing language and OUD, examine how treatment outcomes are affected, and present strategies to reduce bias and promote OUD treatment. METHOD: A narrative review of the literature between 2010 and 2019 was conducted using CINAHL, PubMed, and PsycINFO. Key search terms were opioid use disorder (or substance use disorder), stigma, and language. Fifty-two articles were screened for inclusion, and 17 articles were included in this review. RESULTS: The articles reviewed provide consensus that stigmatizing language toward persons with OUD fosters explicit and implicit bias and impedes engagement in treatment. Four themes emerged: (1) stigma and language, (2) stigma and language used by health care professionals, (3) stigma and language used by the general public, and (4) stigma and language used by people with OUD. CONCLUSIONS: Stigmatizing language is dehumanizing and plays a pivotal role in bias and discrimination that may contribute to unsatisfactory treatment outcomes among persons with OUD. Health care professionals, nursing in particular, must assume an intentional stance against stigma perpetuated toward persons with OUD through advocacy in education, practice, policy, and the media.

Revisiting the Fetal Assault Law in Tennessee: Implications and the Way Forward

2021 ◽  
pp. 152715442198999
Author(s):  
Caroline K. Darlington ◽  
Peggy A. Compton ◽  
Sadie P. Hutson
Keyword(s):  
United States ◽  
Health Care ◽  
Drug Use ◽  
Health Care Providers ◽  
Well Being ◽  
The United States ◽  
Care Providers ◽  
Opioid Use ◽  
The Impact ◽  
In Pregnancy

The rising prevalence of opioid use disorder (OUD) among those living in the United States has demanded a collaborative response from health care and policy spheres. Addressing OUD among pregnant women is especially difficult, given the controversies surrounding the medical and ethical balance between meeting maternal versus fetal/newborn needs. Most medical organizations discourage the criminalization of drug use in pregnancy due to the adverse public health outcomes of such an approach. Despite this recommendation, many states continue to use punitive law to address drug use in pregnancy. In 2014, the Fetal Assault Law in Tennessee (TN) became the first law in the United States to directly allow women to be prosecuted for drug use in pregnancy. Since its expiration in 2016, this law has been re-introduced several times to the TN legislature in support of permanent implementation. This article outlines the impact of the initial Fetal Assault Law on maternal/newborn health in TN and provides alternative immediate, short-term, and long-term health policy strategies through which health care providers and legislators can better advocate for the well-being of both mothers with OUD and their infants.

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