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Brown KG, Chen CY, Dong D, Lake KJ, Butelman ER. Impact of the COVID-19 Pandemic on Functions of Nursing Professionals in the Care of Opioid Use Disorder: Systematic Review. J Addict Nurs 2024; 35:107-113. [PMID: 38830000 DOI: 10.1097/jan.0000000000000573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
BACKGROUND Nursing professionals are vitally involved in the cascade of care for opioid use disorders (OUDs). The global spread of COVID-19 has had complex effects on public health aspects of major diseases, including OUDs. There are limited data on the major ways in which the COVID-19 pandemic has affected the functions of nursing professionals in the care of OUDs. METHOD This systematic review followed Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines and examined published data for trends in OUD care during the first 2 years of the COVID-19 pandemic, focusing on nursing functions. The National Library of Medicine PubMed database and the EMBASE database were examined for peer-reviewed studies with primary data published between January 1, 2020, and December 31, 2021. REVIEW FINDINGS AND CONCLUSIONS Rapid changes were observed in numerous aspects of OUDs during the early pandemic stage, as well as its care by nursing and other health professionals. These changes include increased overdoses (primarily from synthetic opioids such as fentanyl) and emergency department visits. These trends varied considerably across U.S. jurisdictions, underscoring the importance of region-specific examinations for public health policy and intervention. Out of necessity, healthcare systems and nursing professionals adapted to the challenges of OUD care in the pandemic. These adaptations included increases in telehealth services, increases in take-home doses of methadone or buprenorphine/naloxone, and expansion of layperson training in the use of naloxone for overdose reversal. It is likely that some of these adaptations will result in long-term changes in standards of care practices for OUDs by nursing professionals.
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Affiliation(s)
- Kate G Brown
- Kate G. Brown, NP, MS, Carina Y. Chen, BA, Deanna Dong, NP, MS, Kimberly J. Lake, NP, MS, and Eduardo R. Butelman, PhD, MS, Laboratory on the Biology of Addictive Diseases, The Rockefeller University, New York, New York
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Murray OB, Doyle M, McLeman BM, Marsch LA, Saunders EC, Cox KM, Watts D, Ryer J. Augmenting project ECHO for opioid use disorder with data-informed quality improvement. Addict Sci Clin Pract 2023; 18:24. [PMID: 37106399 PMCID: PMC10139906 DOI: 10.1186/s13722-023-00381-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND National opioid-related overdose fatalities totaled 650,000 from 1999 to 2021. Some of the highest rates occurred in New Hampshire, where 40% of the population lives rurally. Medications for opioid use disorder (MOUD; methadone, buprenorphine, and naltrexone) have demonstrated effectiveness in reducing opioid overdose and mortality. Methadone access barriers disproportionally impact rural areas and naltrexone uptake has been limited. Buprenorphine availability has increased and relaxed regulations reduces barriers in general medical settings common in rural areas. Barriers to prescribing buprenorphine include lack of confidence, inadequate training, and lack of access to experts. To address these barriers, learning collaboratives have trained clinics on best-practice performance data collection to inform quality improvement (QI). This project sought to explore the feasibility of training clinics to collect performance data and initiate QI alongside clinics' participation in a Project ECHO virtual collaborative for buprenorphine providers. METHODS Eighteen New Hampshire clinics participating in a Project ECHO were offered a supplemental project exploring the feasibility of performance data collection to inform QI targeting increased alignment with best practice. Feasibility was assessed descriptively, through each clinic's participation in training sessions, data collection, and QI initiatives. An end-of-project survey was conducted to understand clinic staff perceptions of how useful and acceptable they found the program. RESULTS Five of the eighteen health care clinics that participated in the Project ECHO joined the training project, four of which served rural communities in New Hampshire. All five clinics met the criteria for engagement, as each clinic attended at least one training session, submitted at least one month of performance data, and completed at least one QI initiative. Survey results showed that while clinic staff perceived the training and data collection to be useful, there were several barriers to collecting the data, including lack of staff time, and difficulty standardizing documentation within the clinic electronic health record. CONCLUSIONS Results suggest that training clinics to monitor their performance and base QI initiatives on data has potential to impact clinical best practice. While data collection was inconsistent, clinics completed several data-informed QI initiatives, indicating that smaller scale data collection might be more attainable.
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Affiliation(s)
- Owen B Murray
- Northeast Node of the Clinical Trials Network, Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, 46 Centerra Parkway, Suite 315, NH, 03766, Lebanon, USA.
| | - Marcy Doyle
- New Hampshire Citizen's Health Initiative, Institute for Health Policy and Practice, University of New Hampshire, 2 White Street, NH, 03301, Concord, USA
| | - Bethany M McLeman
- Northeast Node of the Clinical Trials Network, Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, 46 Centerra Parkway, Suite 315, NH, 03766, Lebanon, USA
| | - Lisa A Marsch
- Northeast Node of the Clinical Trials Network, Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, 46 Centerra Parkway, Suite 315, NH, 03766, Lebanon, USA
| | - Elizabeth C Saunders
- Northeast Node of the Clinical Trials Network, Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, 46 Centerra Parkway, Suite 315, NH, 03766, Lebanon, USA
| | - Katherine M Cox
- New Hampshire Citizen's Health Initiative, Institute for Health Policy and Practice, University of New Hampshire, 2 White Street, NH, 03301, Concord, USA
| | - Delitha Watts
- New Hampshire Citizen's Health Initiative, Institute for Health Policy and Practice, University of New Hampshire, 2 White Street, NH, 03301, Concord, USA
| | - Jeanne Ryer
- New Hampshire Citizen's Health Initiative, Institute for Health Policy and Practice, University of New Hampshire, 2 White Street, NH, 03301, Concord, USA
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Parker DG, Zentner D, Burack JA, Wendt DC. The impact of the COVID-19 pandemic on medications for opioid use disorder services in the U.S. and Canada: a scoping review. DRUGS: EDUCATION, PREVENTION AND POLICY 2023. [DOI: 10.1080/09687637.2023.2181147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Affiliation(s)
- Daniel G. Parker
- Department of Educational & Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Daysi Zentner
- Department of Educational & Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Jacob A. Burack
- Department of Educational & Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Dennis C. Wendt
- Department of Educational & Counselling Psychology, McGill University, Montreal, Quebec, Canada
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Poleto T, de Carvalho VDH, da Silva ALB, Clemente TRN, Silva MM, de Gusmão APH, Costa APCS, Nepomuceno TCC. Fuzzy Cognitive Scenario Mapping for Causes of Cybersecurity in Telehealth Services. Healthcare (Basel) 2021; 9:healthcare9111504. [PMID: 34828550 PMCID: PMC8624816 DOI: 10.3390/healthcare9111504] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/29/2021] [Accepted: 11/02/2021] [Indexed: 11/25/2022] Open
Abstract
Hospital organizations have adopted telehealth systems to expand their services to a portion of the Brazilian population with limited access to healthcare, mainly due to the geographical distance between their communities and hospitals. The importance and usage of those services have recently increased due to the COVID-19 state-level mobility interventions. These services work with sensitive and confidential data that contain medical records, medication prescriptions, and results of diagnostic processes. Understanding how cybersecurity impacts the development of telehealth strategies is crucial for creating secure systems for daily operations. In the application reported in this article, the Fuzzy Cognitive Maps (FCMs) translated the complexity of cybersecurity in telehealth services into intelligible and objective results in an expert-based cognitive map. The tool also allowed the construction of scenarios simulating the possible implications caused by common factors that affect telehealth systems. FCMs provide a better understanding of cybersecurity strategies using expert knowledge and scenario analysis, enabling the maturation of cybersecurity in telehealth services.
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Affiliation(s)
- Thiago Poleto
- Departamento de Administração, Universidade Federal do Pará, Belém 66075-110, Brazil; (T.P.); (A.L.B.d.S.)
| | | | | | | | - Maísa Mendonça Silva
- Departamento de Engenharia de Produção, Universidade Federal de Pernambuco, Recife 52171-900, Brazil; (M.M.S.); (A.P.C.S.C.)
| | | | - Ana Paula Cabral Seixas Costa
- Departamento de Engenharia de Produção, Universidade Federal de Pernambuco, Recife 52171-900, Brazil; (M.M.S.); (A.P.C.S.C.)
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