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Developing a Curriculum and Interprofessional Care Model to Address the Opioid EpidemicFlack, Gina R., Fox, Beth A., Click, Ivy A. 28 April 2019 (has links)
No description available.
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Development of an Instrument to Assess Influences on Family Physician Opioid Therapy PrescribingBasden, Jeri Ann, Rafalski, Matthew, Click, Ivy A., Tudiver, Fred, Anderson, Heather 24 November 2014 (has links)
Rationale: Prescription drug abuse and misuse (PDA/M) is a significant problem in Central Appalachia and continues to grow. Since 2000, Tennessee has seen a 250% increase in prescription overdose deaths. Nationally, most prescription painkillers are prescribed by primary care doctors and dentists, rather than specialists. Objective: To develop and test a survey instrument aimed at understanding family physician knowledge, attitudes, and beliefs about opioid therapy prescribing. Design: Survey development. Setting: Survey questions were developed based on results of five focus groups held in primary care clinics in Northeast Tennessee and Southwest Virginia. Surveys were validated and tested by faculty and residents in three family medicine residency clinics in Northeast Tennessee. Participants: Survey questions were face validated for clarity and relevance by family physician attendings and third year residents (N=29). All faculty attendings and residents (N≈85) at the same family medicine residency clinics will be invited to complete the survey for psychometric testing. Main and Secondary Outcome Measures: Survey questions have been face validated for clarity and relevance. Data from the psychometric testing phase will be analyzed for internal consistency and inter-item correlations. Exploratory factor analysis will be used to identify underlying constructs. Results: Based on the results of the focus groups and physician expertise, a 51-item instrument was developed. Following face validation, wording was clarified on 25 questions, 3 questions were removed, and 5 questions were added, resulting in a 53-item instrument. Psychometric testing has not been completed at this time, but will be completed at the time of presentation. Conclusions: Researchers intend to use the findings to improve policies and practice guidelines for primary care clinics in the Appalachian region. Results will be used to design CME activities to decrease PDA/M and to help foster more effective and responsible prescribing of pain medication.
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Responding to the Opioid Crisis: Perspectives from Family PhysiciansTroxler, Joyce 11 October 2018 (has links)
No description available.
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Opioid Prescribing and Health Outcomes in Opioid Naive Patients in Indiana: Analysis of A Statewide Health Information Exchange DatabaseSariya Udayachalerm (9183161) 29 July 2020 (has links)
<p>Widespread use of prescription opioids has been a major
public health concern since 1999. Many consequences are associated with the
problem, such as opioid misuse, abuse, and drug overdose deaths. Opioids are
not the only medications involved with drug overdose deaths. Due to stricter
control of prescription opioids, those who misused opioids are associated with
initiation of another illicit drug abuse. This results in increased drug
overdose death involving heroin and semisynthetic/synthetic opioids. Another
risk factor for increased overdose death is concurrent use of opioids with
other central nervous system (CNS) depressants and some anticonvulsants.
Concurrent use of opioids and benzodiazepine, z-drugs (zolpidem and zaleplon),
gabapentin, and/or pregabalin is associated with increased risk of respiratory
depression and drug overdose death. To combat problematic opioid use, many
mitigation strategies were introduced. However, opioid-related problems remain.</p>
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Describing connections to substance use disorder treatment from a medical monitoring program servicing the homelessLeung, Brandon 11 July 2020 (has links)
INTRODUCTION: Drug overdose death is now the leading cause of mortality among homeless adults in Boston, with opioids implicated in a majority of those deaths. Harm reduction interventions help minimize the risks associated with substance use, and are critical in supporting individuals with substance use disorder. Medical monitoring programs are an effective harm reduction strategy that work to prevent fatal drug overdoses and keep people safe while still actively using.
METHODS: Visit data from the Supportive Place for Observation and Treatment (SPOT) was compiled and analyzed. The two measures of interest were the count of referrals to substance use disorder treatment and the count of visits prior to the first referral to treatment. Chi-square tests of independence, odds ratios, and binary logistic regression models were used to describe the association between factors of interest and referrals to substance use disorder treatment.
RESULTS: Gender and age did not show any significant association to a connection to treatment. Overdose history (Adjusted Odds Ratio 6.59), reported stimulant use (AOR 2.59), and documented health or harm reduction education (AOR 5.14) were all associated with increased odds of being referred to substance use disorder treatment. Heavy sedation (AOR 0.55) was associated with decreased odds of a treatment referral.When examining factors associated with rapid connection to treatment, male gender (OR 1.87) was associated with increased odds, while overdose history (AOR 0.42) was associated with decreased odds.
DISCUSSION: The two most impactful factors associated with increased odds of connecting to substance use disorder treatment were reported overdose history and documented education. Both of these factors suggests that a strength of SPOT is its ability to form and maintain meaningful connections with participants. One way that SPOT could improve referral outcomes would be to increase its ability to engage participants, such as through the recruitment of more harm reduction specialists or peer recovery coaches.
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Emotion Regulation and Coping Motives: an EMA Study of the Path Between Negative Affect and CravingLancaster, Joseph Henry 22 June 2022 (has links)
No description available.
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CD8+ T Cell Mediated Immunity is Disrupted by Ex Vivo and In Vivo Opioid UseMazahery, Claire 01 June 2020 (has links)
No description available.
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Opioid Prescription and Use After Laparoscopic CholecystectomyHaslam, Valynn Christina 01 June 2017 (has links)
Background: Opioid abuse has become a serious public health issue. While adequate pain management is an ethical responsibility for health care providers, responsible stewardship of controlled substances is of equal concern. Opioids are often prescribed for treatment of acute pain post-operatively. The purpose of this study is to examine opioid prescription practices and use of opioids after laparoscopic cholecystectomy. Methods: A convenience sample of 42 patients scheduled for laparoscopic cholecystectomy were enrolled in the study. Using a descriptive study design, patients were interviewed by phone 6-10 days post-operatively using a scripted questionnaire. The average number of excess prescribed opioid medication pills, patient perception of prescribed quantity, duration of opioid use, and average pain score with and without activity on the date of contact was determined. Participants were also asked about any instruction received regarding proper medication disposal. Results: A final sample of 34 patients met inclusion criteria and completed the phone questionnaire. Average number of excess pills ranged from 0-42 (M:14; SD 11.7). Nearly half of patients (47%) perceived the prescribed quantity as 'too many', 41% indicated the prescription quantity was 'just right' but many had left-over pills, and 11.8% believed the prescribed quantity to be 'too few'. The average number of days of opioid use following surgery was 4.2 days with 71% of patients using opioids for five or fewer days. The average pain score at the time of the interview was 2.0 without activity, and 4.1 with activity. Almost all (88%) patients did not recall any instruction or knowledge of appropriate medication disposal. A few participants volunteered plans to dispose of unused medications by various means, while others indicated they planned to keep excess pills. Conclusion: Pain management experts advise using around-the-clock regimens of over-thecounter analgesics (i.e. acetaminophen or non-steroidal anti-inflammatory medication (NSAID)) and using opioids sparingly as an adjunct therapy following uncomplicated laparoscopic cholecystectomy. The data in this study indicated currently prescribed opioid quantities after laparoscopic cholecystectomy are more than adequate and could be decreased without affecting adequate pain management. In addition, the data show a large majority of patients are not provided with personalized instruction on proper medication disposal procedures.
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A Replication and Extension of a Prediction Tool Identifying Need for Treatment Among Opioid Exposed InfantsParrish, Loni 01 May 2020 (has links)
The incidences of maternal opioid use and neonatal opioid withdrawal syndrome (NOWS) have increased by nearly 400% over the past decade. Isemann and colleagues (2017) developed prediction tools (TiTE/TiTE2) to differentiate, within the first two days of life, between infants who will require pharmacotherapy for NOWS from those infants who will not require pharmacotherapy for NOWS. The goal of the current experiment was to replicate and extend their prediction model. The present experiments successfully replicated Isemann et al., (2017) results and also established alternative cutoff values for requiring treatment that provide better balance between all four metrics. Moreover, new prediction models (TEN/TEN2) were proposed based on a factor analysis of modified Finnegan scores across the first 48 hours of life. Area Under the Curve-Receiver Operating Characteristic curve analyses indicated that the TEN2 was the best prediction model compared to the TiTE2 and the TEN.
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The Role of Emotion Dysregulation in the Relationship between Anhedonia and Opioid CravingKromash, Rachelle 01 May 2022 (has links)
Research on factors that predict opioid cravings is lacking. Anhedonia may be a predictor of cravings and particularly relevant to cravings when people struggle to regulate emotions but has yet to be examined among justice-involved populations. This study aimed to examine the relationship between anhedonia, opioid cravings, and emotion dysregulation (ED) in this population. Participants completed several measures. The results showed that anhedonia and opioid cravings were significantly related at the bivariate level, but not in moderation models. The DERS-36 total score and ‘DERS Impulse’ subscale had a significant, positive effect on cravings in moderation models. In a higher severity sample of people who used heroin, there was a significant interaction wherein the relationship between anhedonia and cravings was positive at high levels of difficulty controlling behaviors when distressed. These findings indicate the need to understand how anhedonia and ED influence opioid cravings among justice-involved people with severe heroin use.
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