scholarly journals Patient Experiences with the Transition to Telephone Counseling during the COVID-19 Pandemic

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 663
Author(s):  
Augustine W. Kang ◽  
Mary Walton ◽  
Ariel Hoadley ◽  
Courtney DelaCuesta ◽  
Linda Hurley ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Interrater Reliability ◽  
Telephone Counseling ◽  
Patient Experiences ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Therapeutic Experience ◽  
Perceived Impact

Background: To identify and document the treatment experiences among patients with opioid use disorder (OUD) in the context of the rapid move from in-person to telephone counseling due to the COVID-19 pandemic. Methods: Participants (n = 237) completed a survey with open-ended questions that included the following domains: (1) satisfaction with telephone counseling, (2) perceived convenience, (3) changes to the therapeutic relationship, (4) perceived impact on substance use recovery, and (5) general feedback. Responses were coded using thematic analysis. Codes were subsequently organized into themes and subthemes (covering 98% of responses). Interrater reliability for coding of participants’ responses ranged from 0.89 to 0.95. Results: Overall, patients reported that telephone counseling improved the therapeutic experience. Specifically, 74% of respondents were coded as providing responses consistently indicating “positive valency”. “Positive valency” responses include: (1) feeling supported, (2) greater comfort and privacy, (3) increased access to counselors, and (4) resolved transportation barriers. Conversely, “negative valency” responses include: (1) impersonal experience and (2) reduced privacy. Conclusions: Telephone counseling presents its own set of challenges that should be investigated further to improve the quality of care and long-term patient outcomes.

scholarly journals Medication for Opioid Use Disorder Service Provision and Telephone Counseling: A Concurrent Mixed-Methods Approach

2021 ◽  
Vol 18 (11) ◽  
pp. 6163
Author(s):  
Rosemarie Martin ◽  
Augustine W. Kang ◽  
Audrey A. DeBritz ◽  
Mary R. Walton ◽  
Ariel Hoadley ◽  
...  
Keyword(s):  
Substance Use ◽  
Mixed Methods ◽  
Telephone Counseling ◽  
Opioid Use Disorder ◽  
Appropriate Technology ◽  
Counseling Services ◽  
Opioid Use ◽  
Qualitative Evidence ◽  
Positive Experiences ◽  
Anxiety Depression

Using quantitative and qualitative evidence, this study triangulates counselors’ perspectives on the use of telemedicine in the context of Opioid Use Disorder (OUD) treatment. A concurrent mixed-methods design examined counselors’ experiences with telephone counseling during the COVID-19 pandemic. N = 42 counselors who provided OUD counseling services completed a close-ended, quantitative survey examining their experiences in addressing clients’ anxiety, depression, anger, substance use, therapeutic relationship, and substance use recovery using telephone counseling. The survey also assessed comfort, convenience, and satisfaction with telephone counseling. Counselors also completed open-ended responses examining satisfaction, convenience, relationship with patients, substance use, and general feedback with telephone counseling. The synthesis of quantitative and qualitative evidence indicated that a majority of counselors had positive experiences with using telephone counseling to provide services to clients undergoing OUD treatment. Convenience, greater access to clients, and flexibility were among the reasons cited for their positive experience. However, counselors also expressed that the telephone counseling was impersonal, and that some clients may have difficulties accessing appropriate technology for telehealth adoption. Findings suggest that further research with counselors is needed to identify the key elements of an effective integration of telephone counseling with traditional in-person treatment approaches in the post-pandemic era.

scholarly journals Prior National Drug Abuse Treatment Clinical Trials Network (CTN) opioid use disorder trials as background and rationale for NIDA CTN-0100 “optimizing retention, duration and discontinuation strategies for opioid use disorder pharmacotherapy (RDD)”

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Matisyahu Shulman ◽  
Roger Weiss ◽  
John Rotrosen ◽  
Patricia Novo ◽  
Elizabeth Costello ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Extended Release ◽  
Primary Outcome ◽  
Opioid Use Disorder ◽  
Drug Abuse Treatment ◽  
Opioid Use ◽  
National Drug ◽  
Retention In Treatment ◽  
Abuse Treatment

AbstractOpioid use disorder continues to be a significant problem in the United States and worldwide. Three medications—methadone, buprenorphine, and extended-release injectable naltrexone,— are efficacious for treating opioid use disorder (OUD). However, the utility of these medications is limited, in part due to poor rates of retention in treatment. In addition, minimum recovery milestones and other factors that influence when and whether individuals can safely discontinue medications are unknown. The National Drug Abuse Treatment Clinical Trials Network (CTN) study “Optimizing Retention, Duration, and Discontinuation Strategies for Opioid Use Disorder Pharmacotherapy” (RDD; CTN-0100) will be among the largest clinical trials on treatment of OUD yet conducted, consisting of two phases, the Retention phase, and the Duration-Discontinuation phase. The Retention phase, open to patients initiating treatment, will test different doses and formulations of buprenorphine (standard dose sublingual, high dose sublingual, or extended-release injection), and a digital therapeutic app delivering contingency management and cognitive behavioral counseling on the primary outcome of retention in treatment. The Discontinuation phase, open to patients in stable remission from OUD and choosing to discontinue medication (including participants from the Retention phase or from the population of patients treated at the clinical site, referred by an outside prescriber or self-referred) will study different tapering strategies for buprenorphine (sublingual taper vs taper with injection buprenorphine), and a digital therapeutic app which provides resources to promote recovery, on the primary outcome of relapse-free discontinuation of medication. This paper describes how the RDD trial derives from two decades of research in the CTN. Initial trials (CTN-0001; CTN-0002; CTN-0003) focused on opioid detoxification, showing buprenorphine-naloxone was effective for detoxification, but that acute detoxification did not appear to be an effective treatment strategy. Trials on comparative effectiveness of medications for opioid use disorder (MOUD) (CTN-0027; CTN-0030; and CTN-0051) highlighted the problem of dropout from treatment and few trials defined retention on MOUD as the primary outcome. Long-term follow-up studies on those patient samples demonstrated the importance of long-term continuation of medication for many patients to sustain remission. Overall, these trials highlight the potential of a stable research infrastructure such as CTN to advance treatment effectiveness through a programmatic succession of large clinical trials.

scholarly journals Methodological quality of systematic reviews referenced in clinical practice guidelines for the treatment of opioid use disorder

PLoS ONE ◽  
2017 ◽  
Vol 12 (8) ◽  
pp. e0181927 ◽  
Author(s):  
Andrew Ross ◽  
Justin Rankin ◽  
Jason Beaman ◽  
Kelly Murray ◽  
Philip Sinnett ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Systematic Reviews ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Methodological Quality ◽  
Opioid Use Disorder ◽  
Opioid Use

Perceived Benefits and Harms of Involuntary Civil Commitment for Opioid Use Disorder

2020 ◽  
Vol 48 (4) ◽  
pp. 718-734
Author(s):  
Elizabeth A. Evans ◽  
Calla Harrington ◽  
Robert Roose ◽  
Susan Lemere ◽  
David Buchanan
Keyword(s):  
Civil Commitment ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Treatment Access ◽  
Evidence Based Treatment ◽  
Ethics Framework ◽  
Vulnerable Patients ◽  
Underserved Patients ◽  
Legal Consequences

Involuntary civil commitment (ICC) to treatment for opioid use disorder (OUD) prevents imminent overdose, but also restricts autonomy and raises other ethical concerns. Using the Kass Public Health Ethics Framework, we identified ICC benefits and harms. Benefits include: protection of vulnerable, underserved patients; reduced legal consequences; resources for families; and “on-demand” treatment access. Harms include: stigmatizing and punitive experiences; heightened family conflict and social isolation; eroded patient self-determination; limited or no provision of OUD medications; and long-term overdose risk. To use ICC ethically, it should be recognized as comprising vulnerable patients worthy of added protections; be a last resort option; utilize consensual, humanizing processes; provide medications and other evidence-based-treatment; integrate with existing healthcare systems; and demonstrate effective outcomes before diffusion. ICC to OUD treatment carries significant potential harms that, if unaddressed, may outweigh its benefits. Findings can inform innovations for ensuring that ICC is used in an ethically responsible way.

scholarly journals Patient and Clinician Perspectives on Adolescent Opioid Use Disorder Treatment During a Pandemic: One Step Back, but Two Forward? (Preprint)

2020 ◽  
Author(s):  
Samuel W Stull ◽  
Erin R McKnight ◽  
Andrea E Bonny
Keyword(s):  
The United States ◽  
Opioid Use Disorder ◽  
Drop Out ◽  
Mobile Technologies ◽  
Opioid Use ◽  
The Face ◽  
One Step ◽  
Clinician Perspectives ◽  
Receive Treatment

UNSTRUCTURED Opioid use disorder (OUD) is one of the most pressing public health problems in the United States and is highly prevalent among adolescents and young adults (AYAs). However, only a small percentage of AYAs with OUD ever receive treatment. Further, among those that do receive treatment, a substantial proportion of patients continue to struggle with OUD, and many prematurely drop out of treatment. These challenges have only been heightened in the face of the COVID-19 pandemic, but greater utilization of telehealth and mobile technologies by OUD patients may help counter these barriers, which ultimately may improve AYA OUD treatment in the postpandemic period. This viewpoint presents the perspective of a person in OUD recovery using online and mobile technology to support his own OUD recovery combined with thoughts from two clinicians supporting AYAs with OUD. Their perspectives may provide insights to help counter COVID-19–related consequences and offer clues to improving AYA OUD treatment in the long term.

scholarly journals Predictors of long‐term opioid use and opioid use disorder among construction workers: Analysis of claims data

2020 ◽  
Vol 64 (1) ◽  
pp. 48-57
Author(s):  
Ann Marie Dale ◽  
Skye Buckner‐Petty ◽  
Bradley A. Evanoff ◽  
Brian F. Gage
Keyword(s):  
Claims Data ◽  
Opioid Use Disorder ◽  
Construction Workers ◽  
Opioid Use ◽  
Analysis Of Claims Data

Volunteers' Experiences Visiting the Cognitively Impaired in Nursing Homes: A Friendly Visiting Program

2007 ◽  
Vol 26 (4) ◽  
pp. 343-356 ◽  
Author(s):  
Thecla Damianakis ◽  
Laura M. Wagner ◽  
Syrelle Bernstein ◽  
Elsa Marziali
Keyword(s):  
Quality Of Life ◽  
Relationship Building ◽  
Nursing Home Care ◽  
Cognitively Impaired ◽  
Perceived Impact ◽  
Volunteer Programs ◽  
The Moment ◽  
The Impact

ABSTRACTTwo challenges facing nursing-home care today are understanding the concept of quality of life as it relates to cognitively impaired residents and finding effective ways to ensure that it is achieved. Canadian director Allan King's documentary, Memory for Max, Claire, Ida and Company, filmed at Baycrest, captures a method for enhancing the quality of life of six cognitively impaired residents. While the film suggests an intervention model implemented by volunteers, there are challenges unique to institution-based programs (i.e., the recruitment and retention of volunteers). One of the challenges is the fear that volunteers may experience when interacting with the cognitively impaired. We conducted a pilot study of a model for training volunteers to provide friendly visiting and evaluated the impact on the participating residents. Observational accounts of volunteer–resident interactions and seven volunteer interviews were analysed and yielded several themes—(a) relationship building, (b) contribution of the environment, (c) preserving personhood, (d) resident-centred presence and the quality of the moment—and several themes related to the volunteers' role and their perceived impact on the residents. Discussed are the implications for volunteer programs in long-term health care settings.

scholarly journals The Role of Quality of Education in Neurocognitive Functioning in a Diverse Sample with Chronic Opioid Use Disorder

2019 ◽  
Vol 34 (7) ◽  
pp. 1269-1269
Author(s):  
J Olsen ◽  
J Arnsten ◽  
T Scott ◽  
F Arias ◽  
C Zhang ◽  
...  
Keyword(s):  
Executive Functioning ◽  
Opioid Use Disorder ◽  
Reading Level ◽  
Quality Of Education ◽  
Opioid Use ◽  
Significant Group ◽  
Wide Range ◽  
Chronic Opioid Use

Abstract Objective Literacy is a proxy for quality of education (QoE) and mediates ethnicity-related differences in neurocognitive (NC) performance in some populations (Manly et al., 2002; Rivera Mindt et al., 2008). However, it is unknown whether this relationship exists in the context of chronic opioid use disorder (OUD). This study examined the role of ethnicity, QoE, opioid use severity, and depression in predicting NC performance in a diverse sample of persons with OUD. Participants and Method This cross-sectional study included 74 adults with OUD (Age M = 40.3 [SD = 10.5]; Education M = 11.3 [2.5]; 24% female; 68% Latinx and 32% Non-Latinx White [NLW]). All participants completed comprehensive NC testing and psychiatric/substance use questionnaires. Variables included ethnicity (Latinx vs. Non-Latinx White), years of education, QoE (Wide Range Achievement Test, Third Edition; WRAT-3 Reading Standard Scores), opioid use severity (high vs. low OAT dose), current depression (Beck Depression Inventory, Second Edition; BDI-II Total Score), and demographically-corrected NC T-scores were computed and used for average domain T-scores (e.g., learning, memory, verbal fluency, executive function). Bivariate and ANCOVA analyses were used to compare ethnic groups. Results There were no significant group differences on opioid use severity or current depression (p’s > .05). However, compared to the NLW group, the Latinx group had lower years of education (M = 10.9 [SD = 1.7] vs. M = 12.2 [SD = 3.5]; t[72)] = 2.1, p < .05), QoE (M = 83.1 [SD = 13.6] vs. M = 94.8 [SD = 9.4]; t[72] = 3.8, p < .001), executive functioning (M = 42.0 [SD = 6.5] vs. M = 45.8 [SD = 8.5]; t[72) = 2.1, p < .05), and learning (M = 32.2 [SD = 8.2] vs. M = 37.8 [SD = 8.7]; t[72)] = 2.7, p < .05), with medium to large effect sizes (Cohen’s d > .50). The overall effect of ethnicity became non-significant for executive functioning after accounting for QoE (F[2,70] = 10.0, p = .002) and years of education (F[2,70)] = 16.8, p < .001). Conclusions The current study found that accounting for years of education and QoE attenuates some differences in NC performance between Latinx and Non-Latinx participants. References Manly, J. J., Jacobs, D. M., Touradji, P., Small, S. A., & Stern, Y. (2002). Reading level attenuates differences in neuropsychological test performance between African American and White elders. Journal of the International Neuropsychological Society, 8(3), 341-348. Mindt, M. R., Arentoft, A., Germano, K. K., D’Aquila, E., Scheiner, D., Pizzirusso, M., ... & Gollan, T. H. (2008). Neuropsychological, cognitive, and theoretical considerations for evaluation of bilingual individuals. Neuropsychology review, 18(3), 255-268.

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