Internal Medicine Residents’ Training in Substance Use Disorders: A Survey of the Quality of Instruction and Residents’ Self-Perceived Preparedness to Diagnose and Treat Addiction

Wakeman, Sarah E.; Baggett, Meridale V; Kanter, Genevieve P.; Campbell, Eric G.

doi:10.1080/08897077.2013.797540

Cited by 76 publications

(85 citation statements)

References 19 publications

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“…Such differences based on specialty may be attributable to differences in awareness of opioid-related morbidity and mortality, professional guidelines, and local practice patterns. [35][36][37] To promote physicians' awareness and use of prescription drug monitoring programs, knowledge gaps and access barriers must be overcome. Despite the ubiquity of these programs, our findings suggest that roughly one in four physicians in states with such programs remain unaware of their presence.…”

Section: Discussionmentioning

confidence: 99%

Most Primary Care Physicians Are Aware Of Prescription Drug Monitoring Programs, But Many Find The Data Difficult To Access

et al. 2015

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State prescription drug monitoring programs are common tools intended to reduce prescription drug abuse and diversion, or the nonmedical use of a prescribed drug. The success of these programs depends largely upon physicians' awareness and use of them. We conducted a nationally representative mail survey of 1,000 practicing primary care physicians in 2014 to characterize their attitudes toward and awareness and use of prescription drug monitoring programs. A total of 420 eligible physicians (adjusted response rate: 58 percent) returned completed surveys. Among all physicians surveyed, 72 percent were aware of their state's prescription drug monitoring program, and 53 percent reported using one of the programs. We identified several barriers that may prevent greater use of the programs, including the time-consuming nature of information retrieval and the lack of an intuitive format for data provided by the programs. These results suggest that the majority of US primary care physicians are aware of and use prescription drug monitoring programs at least on occasion, although many did not access these programs routinely. To increase the use of the programs in clinical practice, states should consider implementing legal mandates, investing in prescriber education and outreach, and taking measures to enhance ease of access to and use of the programs.

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Section: Discussionmentioning

confidence: 99%

Most Primary Care Physicians Are Aware Of Prescription Drug Monitoring Programs, But Many Find The Data Difficult To Access

et al. 2015

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“…14 It was designed to measure learners’ self-reported changes in knowledge, specific to management of SUDs in hospital. All learners who completed the elective between May 2015–May 2016 were eligible to participate unless they: i) completed the elective more than once or ii) their elective was shorter than one week.…”

Section: Methodsmentioning

confidence: 99%

Impact of a Brief Addiction Medicine Training Experience on Knowledge Self-Assessment among Medical Learners

et al. 2017

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Background Implementation of evidence-based approaches to the treatment of various substance use disorders is needed to tackle the existing epidemic of substance use and related harms. Most clinicians, however, lack knowledge and practical experience with these approaches. Given this deficit, the authors examined the impact of an inpatient elective in addiction medicine amongst medical trainees on addiction-related knowledge and medical management. Methods Trainees who completed an elective with a hospital-based Addiction Medicine Consult Team (AMCT) in Vancouver, Canada from May 2015–May 2016, completed a nine-item self-evaluation scale before and immediately after the elective. Results A total of 48 participants completed both pre and post AMCT elective surveys. On average, participants were 28 years old (Inter Quartile Range [IQR] = 27–29), and contributed 20 days (IQR = 13–27) of clinical service. Knowledge of addiction medicine increased significantly post elective [mean difference (MD) = 8.63, standard deviation (SD) = 18.44; P = 0.002]. The most and the least improved areas of knowledge were relapse prevention and substance use screening, respectively. Conclusions Completion of a clinical elective with a hospital-based Addiction Medicine Consult Team appears to improve medical trainees’ addiction-related knowledge. Further evaluation and expansion of addiction medicine education is warranted to develop the next generation of skilled addiction care providers.

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“…First, our findings underscore the need for additional training for physicians, nurses, social workers, and others around SUD. 19 Training should focus on understanding SUD as a chronic illness, recognition and treatment of withdrawal, and knowledge of MAT. In addition, it is particularly important for social workers to understand that providing a list of resources without other support can feel dismissive to some patients and may weaken the therapeutic relationship.…”

Section: Iscussionmentioning

confidence: 99%

“It’s been an Experience, a Life Learning Experience”: A Qualitative Study of Hospitalized Patients with Substance Use Disorders

et al. 2016

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BACKGROUND: Individuals with substance use disorders (SUD) have high rates of chronic illness and readmission, yet few are engaged in addiction treatment. Hospitalization may be a reachable moment for initiating and coordinating addiction care, but little is known about motivation for change in the inpatient setting. OBJECTIVE: To explore the experiences of hospitalized adults with SUD and to better understand patient and system level factors impacting readiness for change. DESIGN: We performed a qualitative study using individual interviews. The study was nested within a larger mixed-methods needs assessment. PARTICIPANTS AND SETTING: Hospitalized adults admitted to medical or surgical units at an urban academic medical center who reported high-risk alcohol or drug use on AUDIT-C or single-item drug use screener. APPROACH: We conducted a thematic analysis, using an inductive approach at a semantic level. KEY RESULTS: Thirty-two patients participated. The mean age was 43 years; 75% were men, and 68% identified as white. Participants reported moderate to high-risk alcohol (39%), amphetamine (46%), and opioid (65%) use. Emergent themes highlight the influence of hospitalization at the patient, provider, and health system levels. Many patients experienced hospitalization as a wake-up call, where mortality was motivation for change and hospitalization disrupted substance use. However, many participants voiced complex narratives of social chaos, trauma, homelessness, and chronic pain. Participants valued providers who understood SUD and the importance of treatment choice. Patient experience suggests the importance of peers in the hospital setting, access to medication-assisted treatment, and coordinated care post-discharge. CONCLUSIONS: This study supports that hospitalization offers an opportunity to initiate and coordinate addiction care, and provides insights into patient, provider, and health system factors which can leverage the reachability of this moment.

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Internal Medicine Residents’ Training in Substance Use Disorders: A Survey of the Quality of Instruction and Residents’ Self-Perceived Preparedness to Diagnose and Treat Addiction

Cited by 76 publications

References 19 publications

Most Primary Care Physicians Are Aware Of Prescription Drug Monitoring Programs, But Many Find The Data Difficult To Access

Most Primary Care Physicians Are Aware Of Prescription Drug Monitoring Programs, But Many Find The Data Difficult To Access

Impact of a Brief Addiction Medicine Training Experience on Knowledge Self-Assessment among Medical Learners

“It’s been an Experience, a Life Learning Experience”: A Qualitative Study of Hospitalized Patients with Substance Use Disorders

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