scholarly journals Management of Pain in Opioid Addicted Patients: An Education Plan for Psychiatric Nurses

2019 ◽  
Vol 4 (2) ◽  
pp. 22
Author(s):  
Janice M. Parker
Keyword(s):  
Nursing Education ◽  
Replacement Therapy ◽  
Behavioral Health ◽  
Acute Pain ◽  
Disease Model ◽  
Healthcare Setting ◽  
Opioid Addiction ◽  
Psychiatric Nurses ◽  
Opioid Replacement Therapy ◽  
The Impact

Background: Identified on an acute care behavioral health unit has been a gap in nursing education and knowledge about opioid addiction and pain management. Nurses are often frustrated that there seems to be no clear way to manage acute pain in individuals suffering with opioid addiction. Because of difficult behavior sometimes displayed in those with opioid addiction, nurses may be prone to attitudes that reflect bias on their part when administering care. The psychiatric nurses need to learn about the disease model of addiction so its premise can be shared with the opioid addicted patients and their families. Purpose: The purpose of this proposal is to create a plan to teach the Behavioral Health nurses about opioid addiction and management of acute pain to help those afflicted with opioid addiction. Plan: The plan for addressing the gap includes education about opioid addiction, the barriers presented by stigma and bias, and the use of opioid replacement therapy to manage acute pain in those with opioid addiction. Patient education will focus on addiction as a disease and the impact of stigma on those with the disease. Implementation: Implementation of the project will include the development of two classes about management of acute pain in opioid addicted patients emphasizing education of the nurse and patient as the prime solution to this dilemma. The classes will stress the need to model conversations with psychiatric physicians to develop strategies to manage acute pain in patients with opioid addiction. Conclusion: Opioid replacement therapy seems to be the only answer for individuals in need of rehabilitation to end their burden of addiction. It should be accessible to any person with addiction to opioids in every healthcare setting.

A novel model to improve access to care for patients with chronic hepatitis C attended in behavioral health facilities

2021 ◽  
Vol 12 (2) ◽  
pp. 74-77
Author(s):  
Ahmed Shady ◽  
Marybeth Santiago ◽  
Holly Totouom Tangho ◽  
Ronnie Swift ◽  
Nora V Bergasa
Keyword(s):  
Quality Of Life ◽  
New York ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Replacement Therapy ◽  
Behavioral Health ◽  
Chronic Hepatitis C ◽  
Hcv Treatment ◽  
Opioid Replacement Therapy

Background: Chronic hepatitis C (C-HCV) is more prevalent in individuals with behavioral health (BH) diagnoses and those on opioid replacement therapy than in other groups. Accordingly, our aim was to evaluate the effect of C-HCV treatment on the quality of life (QOL) of individuals receiving opioid replacement therapy in a newly created C-HCV clinic attached to the methadone clinic in our 338 beds and 355,702 annual outpatient visits community hospital, serving the population of East Harlem, New York City, where it is located. Methods: Adult patients with behavioral health diagnoses were screened for C-HCV upon entry to the hospital and were referred for evaluation and treatment, as appropriate. The effect of treatment of C-HCV on the quality of life (QOL) was assessed by a questionnaire in which a maximum score of 174 is the worst QOL, and a score of zero is the best, at baseline, and at least 12 weeks post treatment. Results: Three hundred and eighty-seven patients with behavioral health diagnoses were screened. One hundred and fifteen of them had confirmed C-HCV. Twenty-one of those patients had attended the BH HCV clinic. Fourteen additional patients were evaluated at a later date. Nineteen patients agreed to participate in the QOL study. Of these, 15 (79%) completed therapy and were cured. A marked improvement in their QOL scores was documented at least 12 weeks after treatment. Conclusion: A model of care that includes C-HCV treatment in BH facilities leads to adherence to therapy and cure, which is associated with improved QOL and should be the standard practice.

Management of surgical patients on opioid replacement therapy: An audit of current practice

2021 ◽  
pp. 175045892110452
Author(s):  
Karla Mayfield ◽  
Leigh White ◽  
Timothy Nolan ◽  
Xavier Conner ◽  
Brendan Dittmer ◽  
...  
Keyword(s):  
Pain Management ◽  
Replacement Therapy ◽  
Acute Pain ◽  
Management Practices ◽  
Perioperative Outcomes ◽  
Complication Rates ◽  
Acute Pain Management ◽  
Number Of Patients ◽  
Episodes Of Care ◽  
Opioid Replacement Therapy

Patients on opioid replacement therapy hospitalised with acute pain represent a clinical challenge and have poorer perioperative outcomes. There is limited evidence relating to acute pain management of this complex cohort. The primary objectives of this retrospective audit was to establish the number of patients who are admitted on opioid replacement therapy with an acute pain condition under surgical services and evaluate the management of these patients to determine consistency of pain management practices. Secondarily, we aimed to evaluate the documentation of opioid replacement therapy in clinical notes to determine adherence to operational protocols and record clinically relevant outcomes including infection or postoperative complication rates. Forty-four episodes of care for buprenorphine patients and 19 episodes of care for methadone patients were included. There was significant variability in inpatient opioid prescribing, including practice of dose modification, and there was high utilisation of additional opioids, although agent choice varied. Multimodal analgesia was utilised, especially following acute pain service review. There was an 11% readmission rate for complications of the initial presentation. Documentation at transitions of care was poor. There is a need for further clinical studies into specific acute pain management strategies, and their effect on clinically relevant outcomes, to guide consistent management practices.

scholarly journals Consideration of Gut Microbiome in Murine Models of Diseases

2021 ◽  
Vol 9 (5) ◽  
pp. 1062
Author(s):  
Chunye Zhang ◽  
Craig L. Franklin ◽  
Aaron C. Ericsson
Keyword(s):  
Animal Models ◽  
Mouse Models ◽  
Biomedical Research ◽  
Gut Microbiome ◽  
Close Association ◽  
Disease Model ◽  
Potential Contributor ◽  
Potential Factors ◽  
Models Of Disease ◽  
The Impact

The gut microbiome (GM), a complex community of bacteria, viruses, protozoa, and fungi located in the gut of humans and animals, plays significant roles in host health and disease. Animal models are widely used to investigate human diseases in biomedical research and the GM within animal models can change due to the impact of many factors, such as the vendor, husbandry, and environment. Notably, variations in GM can contribute to differences in disease model phenotypes, which can result in poor reproducibility in biomedical research. Variation in the gut microbiome can also impact the translatability of animal models. For example, standard lab mice have different pathogen exposure experiences when compared to wild or pet store mice. As humans have antigen experiences that are more similar to the latter, the use of lab mice with more simplified microbiomes may not yield optimally translatable data. Additionally, the literature describes many methods to manipulate the GM and differences between these methods can also result in differing interpretations of outcomes measures. In this review, we focus on the GM as a potential contributor to the poor reproducibility and translatability of mouse models of disease. First, we summarize the important role of GM in host disease and health through different gut–organ axes and the close association between GM and disease susceptibility through colonization resistance, immune response, and metabolic pathways. Then, we focus on the variation in the microbiome in mouse models of disease and address how this variation can potentially impact disease phenotypes and subsequently influence research reproducibility and translatability. We also discuss the variations between genetic substrains as potential factors that cause poor reproducibility via their effects on the microbiome. In addition, we discuss the utility of complex microbiomes in prospective studies and how manipulation of the GM through differing transfer methods can impact model phenotypes. Lastly, we emphasize the need to explore appropriate methods of GM characterization and manipulation.

scholarly journals Enhancing Behavioral Health Competencies for Senior Center Staff: Lessons Learned From Workforce Training Efforts

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 1-1
Author(s):  
Bronwyn Keefe ◽  
Jennifer Tripken
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Behavioral Health ◽  
Lessons Learned ◽  
Organizational Level ◽  
Senior Center ◽  
Senior Centers ◽  
Knowledge And Skills ◽  
Center Staff ◽  
The Impact

Abstract Increases in the numbers of older adults with mental health and substance use concerns compel us to identify best practices in training to address these issues. Senior Centers are an ideal location for behavioral health education programs as they are the go-to place for many older adults. This session will describe a program funded by The Retirement Research Foundation and offered in collaboration with Center for Aging and Disability Education and Research at Boston University and NCOA to increase senior center staff knowledge and skills. Approximately 250 senior center staff in Illinois, Florida, and Wisconsin completed an online certificate in Behavioral Health and Aging. Results show that 100% of respondents felt that the training was useful for their job; 93% felt that they will be a more effective worker as a result of the training; and 97% felt that the information they learned in the training will make a difference with the people they serve. We held key informant interviews to assess the impact of training and participants stated that their knowledge, skills, and behaviors were influenced by the program. At the organizational level, leaders reported new programming related to behavioral health and revised practices and protocols. This presentation will cover: (1) the extent to which training participants mastered the competencies needed for effective practice; (2) knowledge and skills gained from the training program; (3) Senior Centers’ capacity to identify and refer older adults to mental health services; and (4) organizational changes related to behavioral health programming with older adults.

scholarly journals Quality of Life in Opioid Replacement Therapy: A Naturalistic Cross-Sectional Comparison of Methadone/Levomethadone, Buprenorphine, and Diamorphine Patients

2021 ◽  
pp. 1-10
Author(s):  
Stephanie Paula Elisabeth Guillery ◽  
Rainer Hellweg ◽  
Golo Kronenberg ◽  
Ulrich Bohr ◽  
Hagen Kunte ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Replacement Therapy ◽  
Psychological Functioning ◽  
Treatment Options ◽  
Chronically Ill ◽  
Cross Sectional ◽  
Life Improvement ◽  
Methadone Patients ◽  
Opioid Replacement Therapy

<b><i>Background:</i></b> Research on quality of life (QoL) of chronically ill patients provides an opportunity to evaluate the efficacy of long-term treatments. Although it is established that opioid replacement therapy is an effective treatment for opioid-dependent patients, there is little knowledge about physical and psychological functioning of QoL for different treatment options. <b><i>Objectives:</i></b> Altogether, 248 opioid-dependent patients receiving substitution treatment with either methadone/levomethadone (<i>n</i> = 126), diamorphine (<i>n</i> = 85), or buprenorphine (<i>n</i> = 37) were recruited in 6 German therapy centers. <b><i>Methods:</i></b> Sociodemographic data were collected. QoL – physical and psychological functioning – for different substitutes was assessed using the <i>Profile of the Quality of Life in the Chronically Ill</i> (PLC) questionnaire. <b><i>Results:</i></b> Patient groups were similar regarding age and duration of opioid dependence. Employment rate was significantly higher (<i>p</i> &#x3c; 0.005, φ = 0.22) in the buprenorphine group (46%) compared to methadone (18%). Dosage adjustments were more frequent (<i>p</i> &#x3c; 0.001, φ = 0.29) in diamorphine (55%) than in methadone (30%) or buprenorphine (19%) patients. Buprenorphine and diamorphine patients rated their physical functioning substantially higher than methadone patients (<i>p</i> &#x3c; 0.001, η<sup>2</sup> = 0.141). Diamorphine patients reported a higher psychological functioning (<i>p</i> &#x3c; 0.001, η<sup>2</sup> = 0.078) and overall life improvement (<i>p</i> &#x3c; 0.001, η<sup>2</sup> = 0.060) compared to methadone, but not compared to buprenorphine patients (both <i>p</i> &#x3e; 0.25). <b><i>Conclusion:</i></b> Measurement of important QoL aspects indicates significant differences for physical and psychological functioning in patients receiving the substitutes methadone/levomethadone, diamorphine, and buprenorphine. This could be relevant for the differential therapy of opioid addiction.

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