Author: Tara Fouts Publisher: ISBN: Category : Drugs Languages : en Pages : 90
Book Description
"Prescription opioid misuse has become a growing problem in the United States, and there has been a significant increase in the number of nonfatal overdose and overdose deaths since the 1990s. Idaho has also experienced an increase in the number of drug-induced deaths over time, increasing nearly 30% from 2012 to 2016. The Centers for Disease Control and Prevention indicates overprescribing and dispensing of prescription opioids is a main driver to the increase in overdoses. Evidence-based early intervention methods, such as screening, brief intervention, and referral to treatment (SBIRT), can be utilized in health care settings to identify risky behaviors among individuals who may not be seeking help for substance problems. However, limited research has been done to examine SBIRT in a pharmacy setting and in pharmacist perceptions toward performing SBIRT for prescription opioid misuse. The purpose of this study was to develop an instrument based on the Theory of Planned Behavior (TPB) to measure pharmacist perceptions toward using SBIRT for prescription misuse and then test initial validity and reliability. To construct appropriate questions, survey items for attitude, subjective norms, perceived behavioral control, past behavior, and intention were developed from a previous TPB instrument on the utilization of the prescription monitoring program. After data was collected, psychometric testing was initiated and included factor analysis, testing the internal consistency of the subscales, and a correlation to determine the degree of similarity between subscales. A Principal Component Analysis (PCA) was used to extract factors in this study with a non-orthogonal rotation (Direct Oblimin). Items were retained if they loaded onto a factor at |0.4| or higher. Findings supported the eight-factor solution that was conceptually hypothesized with strong internal consistency for each construct. Cronbach's alpha scores were 0.7 and above for all factors except for past behavior. These results offer a foundation for future research to build on the instrument and inform interventions that may shape pharmacist readiness in prescription misuse early intervention strategies."--Boise State University ScholarWorks.
Author: Deepika Rao Publisher: ISBN: Category : Languages : en Pages : 0
Book Description
While opioids are effective analgesics when taken correctly, long - term opioid usage carries some safety risks, including risk of misuse, development of opioid use disorders, or overdose death. However, stringent opioid prescribing guidelines may lead to reduced prescriptions and lack of access to opioids for patients who need them. Prevention of opioid use disorders and opioid safety initiatives must be balanced with patient needs. Screening and brief interventions (SBI) can offer opportunities to identify opioid misuse and safety risks and accordingly intervene without a significant increase in workload for healthcare professionals. As pharmacists are one of the most accessible healthcare professionals and medication experts, they are uniquely positioned to offer patient-centered SBI. We conducted a scoping literature review to identify gaps in current literature on pharmacy-based screening and brief interventions. We found that existing studies did not involve patient perceptions, lacked implementation focus, and did not involve robust qualitative methodologies. Therefore, the objective of our study was to develop a patient-centered opioid misuse SBI for the community pharmacy setting. We used the Consolidated Framework for Implementation Research (CFIR) to design the study instruments, guide analysis, and interpret findings. Using qualitative interviews of patients and pharmacists, we explored their perceptions, needs, and barriers to participating in the SBI. We also used a building approach to mixed methods integration to develop a quantitative implementation measure based on qualitative pharmacist themes and quotes. The quantitative questionnaire was then evaluated for initial face and construct validity. Finally, we used a template analysis approach to compare themes from pharmacist and patient interviews and interpret the results for future implementation of the SBI. The study resulted in several important pharmacist themes categorized according to the CFIR domains of individual characteristics, inner setting, innovation characteristics, and outer setting. Analysis of patient interviews resulted in four main themes: opioid and care experience, knowledge and beliefs, SBI and care needs, and implementation barriers and solutions. A 36- item questionnaire was developed based on pharmacist interviews specific to the SBI and setting, with good face and initial construct validity. Template analysis of patient and pharmacist interviews resulted in SBI features and implications for its implementation. Overall, the study is an important exploration into pharmacy-based opioid misuse SBI with a focus on patient centeredness and implementation. Barriers and facilitators of SBI participation from both stakeholder groups were identified. The findings from the study can be used to implement and pilot test a SBI within pharmacy settings in the future.
Author: National Academies of Sciences, Engineering, and Medicine Publisher: National Academies Press ISBN: 0309459575 Category : Medical Languages : en Pages : 483
Book Description
Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
Author: National Academies of Sciences, Engineering, and Medicine Publisher: National Academies Press ISBN: 0309486483 Category : Medical Languages : en Pages : 175
Book Description
The opioid crisis in the United States has come about because of excessive use of these drugs for both legal and illicit purposes and unprecedented levels of consequent opioid use disorder (OUD). More than 2 million people in the United States are estimated to have OUD, which is caused by prolonged use of prescription opioids, heroin, or other illicit opioids. OUD is a life-threatening condition associated with a 20-fold greater risk of early death due to overdose, infectious diseases, trauma, and suicide. Mortality related to OUD continues to escalate as this public health crisis gathers momentum across the country, with opioid overdoses killing more than 47,000 people in 2017 in the United States. Efforts to date have made no real headway in stemming this crisis, in large part because tools that already existâ€"like evidence-based medicationsâ€"are not being deployed to maximum impact. To support the dissemination of accurate patient-focused information about treatments for addiction, and to help provide scientific solutions to the current opioid crisis, this report studies the evidence base on medication assisted treatment (MAT) for OUD. It examines available evidence on the range of parameters and circumstances in which MAT can be effectively delivered and identifies additional research needed.
Author: Katrin Auspurg Publisher: SAGE Publications ISBN: 1483324303 Category : Social Science Languages : en Pages : 246
Book Description
Filling a gap in the literature of the field, Factorial Survey Experiments provides researchers with a practical guide to using the factorial survey method to assess respondents’ beliefs about the world, judgment principles, or decision rules through multi-dimensional stimuli (“vignettes”) that resemble real-life decision-making situations. Using insightful examples to illustrate their arguments, authors Katrin Auspurg and Thomas Hinz guide researchers through all relevant steps, including how to set up the factorial experimental design (drawing samples of vignettes and respondents), how to handle the practical challenges that must be mastered when an experimental plan with many different treatments is embedded in a survey format, and how to deal with questions of data analysis. In addition to providing the “how-tos” of designing factorial survey experiments, the authors cover recent developments of similar methods, such as conjoint analyses, choice experiments, and more advanced statistical tools.
Author: National Academies of Sciences, Engineering, and Medicine Publisher: National Academies Press ISBN: 0309439124 Category : Social Science Languages : en Pages : 171
Book Description
Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.
Author: Office of the Surgeon General Publisher: Createspace Independent Publishing Platform ISBN: 9781974580620 Category : Languages : en Pages : 420
Book Description
All across the United States, individuals, families, communities, and health care systems are struggling to cope with substance use, misuse, and substance use disorders. Substance misuse and substance use disorders have devastating effects, disrupt the future plans of too many young people, and all too often, end lives prematurely and tragically. Substance misuse is a major public health challenge and a priority for our nation to address. The effects of substance use are cumulative and costly for our society, placing burdens on workplaces, the health care system, families, states, and communities. The Report discusses opportunities to bring substance use disorder treatment and mainstream health care systems into alignment so that they can address a person's overall health, rather than a substance misuse or a physical health condition alone or in isolation. It also provides suggestions and recommendations for action that everyone-individuals, families, community leaders, law enforcement, health care professionals, policymakers, and researchers-can take to prevent substance misuse and reduce its consequences.
Author: Institute of Medicine Publisher: National Academies Press ISBN: 030921484X Category : Medical Languages : en Pages : 383
Book Description
Chronic pain costs the nation up to $635 billion each year in medical treatment and lost productivity. The 2010 Patient Protection and Affordable Care Act required the Department of Health and Human Services (HHS) to enlist the Institute of Medicine (IOM) in examining pain as a public health problem. In this report, the IOM offers a blueprint for action in transforming prevention, care, education, and research, with the goal of providing relief for people with pain in America. To reach the vast multitude of people with various types of pain, the nation must adopt a population-level prevention and management strategy. The IOM recommends that HHS develop a comprehensive plan with specific goals, actions, and timeframes. Better data are needed to help shape efforts, especially on the groups of people currently underdiagnosed and undertreated, and the IOM encourages federal and state agencies and private organizations to accelerate the collection of data on pain incidence, prevalence, and treatments. Because pain varies from patient to patient, healthcare providers should increasingly aim at tailoring pain care to each person's experience, and self-management of pain should be promoted. In addition, because there are major gaps in knowledge about pain across health care and society alike, the IOM recommends that federal agencies and other stakeholders redesign education programs to bridge these gaps. Pain is a major driver for visits to physicians, a major reason for taking medications, a major cause of disability, and a key factor in quality of life and productivity. Given the burden of pain in human lives, dollars, and social consequences, relieving pain should be a national priority.
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309133661 Category : Medical Languages : en Pages : 528
Book Description
Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.
Author: Tricia E. Wright Publisher: ISBN: 1108400981 Category : Health & Fitness Languages : en Pages : 155
Book Description
Gain guidance and support when treating the high-risk population of women confronting (or battling) opioid-use disorders during pregnancy.
Author: Tara Fouts
Author: Deepika Rao
Author: National Academies of Sciences, Engineering, and Medicine
Author: National Academies of Sciences, Engineering, and Medicine
Author: Katrin Auspurg
Author: National Academies of Sciences, Engineering, and Medicine
Author: Office of the Surgeon General
Author: Institute of Medicine
Author: Institute of Medicine
Author: Tricia E. Wright