The Approach Taken to Substance Abuse by Occupational Physicians

Lambrechts, Marie-Claire; Ketterer, Frédéric; Symons, Linda; Mairiaux, Philippe; Peremans, Lieve; Remmen, Roy; Vanmeerbeek, Marc; Godderis, Lode

doi:10.1097/jom.0000000000000549

Cited by 4 publications

(7 citation statements)

References 21 publications

(29 reference statements)

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“…Our search yielded 9308 studies published between January 1, 1960, and October 5, 2021, with 1280 remaining after removal of duplicates and 552 assessed for eligibility (eFigure 1 in Supplement 1). Of 283 studies…”

Section: Resultsmentioning

confidence: 99%

“…Other substances were often reported as “other” or merely “drugs.” Cross-tabulations of each reason for reluctance with each of the most common specialties, interventions, and drugs produced no significant results; consequently, no P values are reported (Table 2). While this systematic review is of physician reluctance, 110 studies mentioned possible facilitators of physician engagement.…”

Section: Resultsmentioning

confidence: 99%

“…Most studies did not gather or report data on all reasons. When queried, institutional environment (173 of 213 articles [81.2%]) was the most common reason, followed by lack of skill (170 of 230 articles [73.9%]…”

Section: Resultsmentioning

confidence: 99%

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Physician Reluctance to Intervene in Addiction

Campopiano von Klimo,

Nolan,

Corbin

et al. 2024

JAMA Netw Open

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ImportanceThe overdose epidemic continues in the US, with 107 941 overdose deaths in 2022 and countless lives affected by the addiction crisis. Although widespread efforts to train and support physicians to implement medications and other evidence-based substance use disorder interventions have been ongoing, adoption of these evidence-based practices (EBPs) by physicians remains low.ObjectiveTo describe physician-reported reasons for reluctance to address substance use and addiction in their clinical practices using screening, treatment, harm reduction, or recovery support interventions.Data SourcesA literature search of PubMed, Embase, Scopus, medRxiv, and SSRN Medical Research Network was conducted and returned articles published from January 1, 1960, through October 5, 2021.Study SelectionPublications that included physicians, discussed substance use interventions, and presented data on reasons for reluctance to intervene in addiction were included.Data Extraction and SynthesisTwo reviewers (L.N., M.C., L.F., J.P., C.S., and S.W.) independently reviewed each publication; a third reviewer resolved discordant votes (M.C. and W.C.). This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and the theoretical domains framework was used to systematically extract reluctance reasons.Main Outcomes and MeasuresThe primary outcome was reasons for physician reluctance to address substance use disorder. The association of reasons for reluctance with practice setting and drug type was also measured. Reasons and other variables were determined according to predefined criteria.ResultsA total of 183 of 9308 returned studies reporting data collected from 66 732 physicians were included. Most studies reported survey data. Alcohol, nicotine, and opioids were the most often studied substances; screening and treatment were the most often studied interventions. The most common reluctance reasons were lack of institutional support (173 of 213 articles [81.2%]), knowledge (174 of 242 articles [71.9%]), skill (170 of 230 articles [73.9%]), and cognitive capacity (136 of 185 articles [73.5%]). Reimbursement concerns were also noted. Bivariate analysis revealed associations between these reasons and physician specialty, intervention type, and drug.Conclusions and RelevanceIn this systematic review of reasons for physician reluctance to intervene in addiction, the most common reasons were lack of institutional support, knowledge, skill, and cognitive capacity. Targeting these reasons with education and training, policy development, and program implementation may improve adoption by physicians of EBPs for substance use and addiction care. Future studies of physician-reported reasons for reluctance to adopt EBPs may be improved through use of a theoretical framework and improved adherence to and reporting of survey development best practices; development of a validated survey instrument may further improve study results.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Physician Reluctance to Intervene in Addiction

Campopiano von Klimo,

Nolan,

Corbin

et al. 2024

JAMA Netw Open

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“…OHS are services entrusted with preventive functions and are responsible for advising the employer, the workers, and their representatives to establish and maintain a safe and healthy work environment. OPs can assess the physical and psychosocial risks in different work environments, work with employers and other healthcare professions to develop strategies to address these risks effectively, and prove valuable to more vulnerable workers [ 53 , 54 ].…”

Section: Methods and Designmentioning

confidence: 99%

Exploring Work Absences and Return to Work During Social Transition and Following Gender-Affirming Care, a Mixed-Methods Approach: ‘Bridging Support Actors Through Literacy’

Van de Cauter,

Van de Velde,

Motmans

et al. 2023

J Occup Rehabil

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Purpose Research on return to work (RTW) following transition-related gender-affirming care (GAC) is lacking. We aim to study the RTW outcomes and experiences of transgender and gender diverse (TGD) people during social and medical transition to understand their needs better and provide tailored support. Methods In this convergent mixed-methods study, the questionnaires of 125 employed TGD people, who took steps in transition (social and GAC), were analyzed for personal- and work characteristics, medical work absences, RTW, support at work, and health literacy. In-depth interviews were held with twenty TGD people to explore perceived facilitators and barriers to RTW. Results One hundred and nine participants reported an average of 38 sick days after GAC. The majority (90.2%) resumed their job at the same employer. Although TGD workers felt supported, their health literacy (55.1%) was lower compared to the general population. The qualitative data analysis revealed four major themes: (1) the need and access to information; (2) having multidisciplinary TGD allies; (3) the influence of the occupational position; (4) the precarious balance between work, life, and GAC. Especially participants with a low health literacy level experienced RTW barriers by struggling: (1) to find and/or apply information; (2) to navigate (occupational) health and insurance services. Conclusion Our research has shown that RTW for TGD individuals is a multifaceted process, affected by personal factors, work-related elements, and the characteristics of the healthcare and social insurance system. Enhancing support for TGD people at work and their RTW requires a high need for centralized information and promoting health literacy while engaging relevant stakeholders, such as prevention services and employers.

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“…Another common challenge of such workers' health surveillance systems is that they are demanding in terms of working hours. In Belgium for instance, an occupational physician sees about 70% of employees regularly, thus taking up a significant portion of both employees' and physicians' time (13). Meanwhile, occupational physicians are proving ever more difficult to recruit (14)(15)(16).…”

mentioning

confidence: 99%

Short-term effectiveness of face-to-face periodic occupational health screening versus electronic screening with targeted follow-up: results from a quasi-randomized controlled trial in four Belgian hospitals

Steel¹,

Godderis²,

Luyten³

2022

Scand J Work Environ Health

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Short-term effectiveness of face-to-face periodic occupational health screening versus electronic screening with targeted follow-up: results from a quasi-randomized controlled trial in four Belgian hospitals by Steel JS, Godderis L, Luyten J We observed some immediate effects of the intervention (lower trust in the physician, absenteeism, and healthcare use). However, after 19 months, including two waves of COVID-19 hospitalizations, no significant differences were observed between employees screened through face-to-face contact and those screened electronically. From a policy point of view, the targeted approach of the intervention might prove at least as effective.

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The Approach Taken to Substance Abuse by Occupational Physicians

Abstract: The approach to substance abuse by OPs could be supported by initiatives both at the individual and the collective level. A facilitating work context seems to be particularly important in their commitment to alcohol- and drug-related issues at work.

Cited by 4 publications

References 21 publications

Physician Reluctance to Intervene in Addiction

Physician Reluctance to Intervene in Addiction

Exploring Work Absences and Return to Work During Social Transition and Following Gender-Affirming Care, a Mixed-Methods Approach: ‘Bridging Support Actors Through Literacy’

Short-term effectiveness of face-to-face periodic occupational health screening versus electronic screening with targeted follow-up: results from a quasi-randomized controlled trial in four Belgian hospitals

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