Guide for Future Directions for the Addiction and OUD Treatment Ecosystem

Waller, R. Corey; Clark, Kelly James; Woodruff, Alex; Glossa, Jean; Ostrovsky, Andrey

doi:10.31478/202104b

Cited by 4 publications

(4 citation statements)

References 35 publications

(24 reference statements)

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“…We did not validate or measure the reliability of our survey. The small number of survey patients enrolled reflects the problematic nature of these patients in terms of follow-up and medical noncompliance [ 20 ]. The study was conducted at a single institution comprised of two EDs and two free-standing EDs.…”

Section: Discussionmentioning

confidence: 99%

Emergency Department-Based Medication for Opioid Use Disorder Program: Addressing Gaps in Linkages to Care

Seaberg,

McKinnon,

Haselton

et al. 2024

Cureus

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Background Emergency department (ED)-based medication for opioid use disorder (MOUD) has been shown to be effective in providing ease of access and successful treatment rates for patients with opioid use disorder (OUD). This study examined the social determinants of health (SDOH) of patients entering an ED-based MOUD program through individual and focus group surveys. SDOH may impact treatment retention for current and future patients. Methods A survey of all patients entering our MOUD program at two hospital-based EDs and two free-standing EDs was conducted from January to March 2022. Addiction care coordinators (ACCs) used standardized screening tools to enroll patients into the MOUD program, and trained research coordinators used a standardized form, using previously validated survey questions, to examine the role of SDOH. Focused group surveys were also collected. The survey measured patients’ perspectives of the program and solicited feedback on SDOH and program barriers. Results Of the 60 OUD patients inducted into the ED-based MOUD program during our survey period, 19 (32%) participated in an individual or focus group interview. Of these, 16 patients (27%) completed all survey questions. The mean age was 42 years old, 94% identified as Caucasian, and 65% were males. Over 94% of subjects found the ACCs helpful in providing follow-up care. Nearly 40% experienced transportation and financial issues. The vast majority found the MOUD program beneficial in coping with withdrawal symptoms, dealing with their addiction, and supporting recovery. Conclusion OUD patients found the ACCs and the MOUD program helpful for their transition to the treatment stage. The MOUD program can improve some patients’ reluctance to engage with a healthcare system by addressing barriers related to transportation to appointments and financial issues.

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Section: Discussionmentioning

confidence: 99%

Emergency Department-Based Medication for Opioid Use Disorder Program: Addressing Gaps in Linkages to Care

Seaberg,

McKinnon,

Haselton

et al. 2024

Cureus

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“…People with substance use disorders have complex health care needs exacerbated by stigma [7]. With rising rates of drug and alcohol problems in Australia and internationally, there is a need for a ‘sustainable approach to preventing and managing [substance use disorder] as a chronic disease’ and ‘coordinated, compassionate, and science‐based care’ [8, p. 1]. The Flinders Chronic Condition Management Program is an evidence‐based chronic condition management program being trialled in an outpatient drug and alcohol setting in Australia.…”

Section: Discussionmentioning

confidence: 99%

“…People experiencing SUDs furthermore experience significant stigma and inequity relating to social determinants of health [6,7]. SUDs are chronic, relapsing disorders [8] where comorbidity with other chronic conditions is also commonly experienced [5,9]. More than two decades ago, McLellan et al [10] reviewed the literature comparing the diagnoses, heritability, aetiology, pathophysiology and treatment response of drug dependence compared to chronic conditions (asthma, hypertension and type 2 diabetes).…”

Section: Introductionmentioning

confidence: 99%

“…More than two decades ago, McLellan et al [10] reviewed the literature comparing the diagnoses, heritability, aetiology, pathophysiology and treatment response of drug dependence compared to chronic conditions (asthma, hypertension and type 2 diabetes). They concluded that drug dependence should be managed as a chronic, relapsing condition, a conclusion that has since been echoed by many others [8,[11][12][13][14][15][16][17][18] who support the management of SUDs through personcentred, wholistic chronic condition models such as the Chronic Care Model. The Chronic Care Model proposes the community, the health system, self-management support, delivery system design, decision support and clinical information systems are essential to effective chronic condition management [16].…”

Section: Introductionmentioning

confidence: 99%

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Barriers and facilitators to the implementation of the Flinders Chronic Condition Management Program in outpatient drug and alcohol settings in Australia

Oster,

Hunter,

Schultz

et al. 2023

Drug and Alcohol Review

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IntroductionThere has been a growing call for drug and/or alcohol dependence to be managed as a chronic condition. The Flinders Chronic Condition Management Program (Flinders Program) was implemented in a drug and alcohol service in Australia in 2019–2022 to explore the feasibility of chronic condition management in outpatient clinics. Implementation involved: adaptation of the Flinders Program; adaptation of clinical procedures; training clinicians and managers; training Flinders Program Accredited Trainers; and system integration. This study aims to explore barriers and enablers to implementation.MethodsA qualitative formative evaluation was undertaken. Data included implementation documents (n = 7), responses to open‐ended questions in post‐training surveys (n = 27), and focus groups and interviews with implementation staff, clinicians, managers and a trainer (n = 16). Data were analysed using the Consolidated Framework for Implementation Research in a ‘coding reliability’ approach to thematic analysis.ResultsParticipants responded positively to the Flinders Program's philosophy, processes, tools and training. However, barriers were identified across three Consolidated Framework for Implementation Research domains: (i) outer setting (client suitability and incompatibility with external policies and incentives); (ii) characteristics of individuals (low self‐efficacy); and (iii) inner setting (lack of system and workflow integration).Discussion and ConclusionsExecutive support and systems integration are important for the implementation of the Flinders Program in drug and alcohol services. This needs to be achieved within externally mandated key performance indicators for outpatient services. Further research is needed to fully evaluate the potential of a chronic condition management framework in Australian outpatient drug and alcohol services.

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Substance Use Disorders and the Law

Jain,

Aoun

2024

Psychiatry and the Law

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Guide for Future Directions for the Addiction and OUD Treatment Ecosystem

Cited by 4 publications

References 35 publications

Emergency Department-Based Medication for Opioid Use Disorder Program: Addressing Gaps in Linkages to Care

Emergency Department-Based Medication for Opioid Use Disorder Program: Addressing Gaps in Linkages to Care

Barriers and facilitators to the implementation of the Flinders Chronic Condition Management Program in outpatient drug and alcohol settings in Australia

Substance Use Disorders and the Law

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