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Author: Lisa Rochelle Burroughs Phipps Publisher: ISBN: Category : Languages : en Pages : 304
Book Description
Prescription drug abuse is a continuing problem in the United States. Educating physicians on issues related to prescription drug abuse is a key factor in preventing and treating this problem. High variability has been found in substance abuse terminology in the literature, textbooks, and FDA-approved product labeling. This dissertation describes a survey study designed to address how the variability in substance abuse terminology, specifically package inserts, affects the prescribing decisions made by physicians. A random sample of 1008 physicians currently licensed and residing in the Commonwealth of Virginia received a letter of explanation, a self-administered questionnaire, and a follow-up reminder and thank you. To increase response rate, a second questionnaire was sent to non-responders. Prescribing decisions made by physicians were measured as three variables: comfort level with a prior physician's choice, likelihood of refilling the prescription, and likelihood of prescribing a drug or drug class as the first physician seeing a particular patient. Physicians were presented with four case scenarios which included package insert information and selected patient characteristics. Other factors affecting physicians' decisions in prescribing controlled substances include ideas about addiction, and characteristics of the physician, patient, disease state, and drug. The patient case scenarios and other items on the questionnaire addressed these covariates. Based on the number of deliverable questionnaires returned and included in analysis, the response rate was 32.3%. More physicians associated abuse, craving, drug-seeking behavior, psychological dependence, and withdrawal with addiction than with drug dependence, while more physicians felt that physical dependence and tolerance were necessary for drug dependence. The most frequently used sources for drug information were the Physicians' Desk Reference (PDR), package inserts, and pharmacists. Four linear regression models were created for physician prescribing decisions. Physician, patient and package insert characteristics were all significant (p
Author: Lisa Rochelle Burroughs Phipps Publisher: ISBN: Category : Languages : en Pages : 304
Book Description
Prescription drug abuse is a continuing problem in the United States. Educating physicians on issues related to prescription drug abuse is a key factor in preventing and treating this problem. High variability has been found in substance abuse terminology in the literature, textbooks, and FDA-approved product labeling. This dissertation describes a survey study designed to address how the variability in substance abuse terminology, specifically package inserts, affects the prescribing decisions made by physicians. A random sample of 1008 physicians currently licensed and residing in the Commonwealth of Virginia received a letter of explanation, a self-administered questionnaire, and a follow-up reminder and thank you. To increase response rate, a second questionnaire was sent to non-responders. Prescribing decisions made by physicians were measured as three variables: comfort level with a prior physician's choice, likelihood of refilling the prescription, and likelihood of prescribing a drug or drug class as the first physician seeing a particular patient. Physicians were presented with four case scenarios which included package insert information and selected patient characteristics. Other factors affecting physicians' decisions in prescribing controlled substances include ideas about addiction, and characteristics of the physician, patient, disease state, and drug. The patient case scenarios and other items on the questionnaire addressed these covariates. Based on the number of deliverable questionnaires returned and included in analysis, the response rate was 32.3%. More physicians associated abuse, craving, drug-seeking behavior, psychological dependence, and withdrawal with addiction than with drug dependence, while more physicians felt that physical dependence and tolerance were necessary for drug dependence. The most frequently used sources for drug information were the Physicians' Desk Reference (PDR), package inserts, and pharmacists. Four linear regression models were created for physician prescribing decisions. Physician, patient and package insert characteristics were all significant (p
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: 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: 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: National Academies of Sciences, Engineering, and Medicine Publisher: National Academies Press ISBN: 0309468086 Category : Medical Languages : en Pages : 235
Book Description
Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicinesâ€"and health care at largeâ€"more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugsâ€"coupled with the broader trends in overall health care costsâ€"is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.
Author: U.S. Department of Health and Human Services Publisher: Lulu.com ISBN: 1794755136 Category : Reference Languages : en Pages : 208
Book Description
Motivation is key to substance use behavior change. Counselors can support clients' movement toward positive changes in their substance use by identifying and enhancing motivation that already exists. Motivational approaches are based on the principles of person-centered counseling. Counselors' use of empathy, not authority and power, is key to enhancing clients' motivation to change. Clients are experts in their own recovery from SUDs. Counselors should engage them in collaborative partnerships. Ambivalence about change is normal. Resistance to change is an expression of ambivalence about change, not a client trait or characteristic. Confrontational approaches increase client resistance and discord in the counseling relationship. Motivational approaches explore ambivalence in a nonjudgmental and compassionate way.
Author: Committee for the Substance Abuse Coverage Study Publisher: National Academies Press ISBN: 9780309043960 Category : Medical Languages : en Pages : 332
Book Description
Treating Drug Problems, Volume 2 presents a wealth of incisive and accessible information on the issue of drug abuse and treatment in America. Several papers lay bare the relationship between drug treatment and other aspects of drug policy, including a powerful overview of twentieth century narcotics use in America and a unique account of how the federal government has built and managed the drug treatment system from the 1960s to the present. Two papers focus on the criminal justice system. The remaining papers focus on Employer policies and practices toward illegal drugs. Patterns and cycles of cocaine use in subcultures and the popular culture. Drug treatment from a marketing, supply-and-demand perspective, including an analysis of policy options. Treating Drug Problems, Volume 2 provides important information to policy makers and administrators, drug treatment specialists, and researchers.
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: Lisa Rochelle Burroughs Phipps
Author: Lisa Rochelle Burroughs Phipps
Author: National Academies of Sciences, Engineering, and Medicine
Author: Office of the Surgeon General
Author: National Academies of Sciences, Engineering, and Medicine
Author: National Academies of Sciences, Engineering, and Medicine
Author: U.S. Department of Health and Human Services
Author: National Institute on Drug Abuse. Division of Research
Author: Committee for the Substance Abuse Coverage Study
Author: Steven M. Frenk
Author: Institute of Medicine