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1
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Mancheño-Velasco C, Narváez-Camargo M, Dacosta-Sánchez D, Sánchez-García M, Lozano ÓM. Examining Profiles and Treatment Outcomes in Dual Diagnosis: Comparison of Coordinated Treatment With Mental Health Services Versus Addiction Center Alone. A Real-World Data Analysis. J Dual Diagn 2024; 20:266-278. [PMID: 38478999 DOI: 10.1080/15504263.2024.2323976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
OBJECTIVE The aim of this work was to examine the profile and treatment outcomes of patients with dual pathology depending on whether the patients were attending addiction centers or are being treated in a coordinated model by mental health services. METHODS Data from 7225 dual diagnosis patients were used, of whom 2417 (33.5%) received treatment in the mental health coordinated modality. Clinical information was taken from the patients' electronic health record. RESULTS Differences were found in patients' sociodemographic and comorbidity profiles according to treatment modality. In general, coordinated care yielded favorable outcomes (higher attendance and lower dropout rates but no differences in retention). The logistic regression analysis identified predictors of patient profiles in coordinated care, emphasizing having a severe mental health disorder (OR = 3.878, 95% CI [3.443, 4.368]; p = .000), being referred by social/health services, or having retired status. Main differences were observed according to the comorbid diagnosis presented, particularly in cases in which the patient had impulse control, hyperkinetic, or cluster C personality disorder. CONCLUSIONS While therapeutic outcomes are influenced by associated comorbidities, the disorders prognosis can be favorable with appropriate treatment. Furthermore, analysis of differences according to treatment modality allows for predicting the type of patient who will receive a particular service, which enables the development of tailored treatments.
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Affiliation(s)
| | - Marta Narváez-Camargo
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
| | | | - Manuel Sánchez-García
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
- Research Center on Natural Resources, Health and the Environment, University of Huelva, Huelva, Spain
| | - Óscar M Lozano
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
- Research Center on Natural Resources, Health and the Environment, University of Huelva, Huelva, Spain
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Sergerie-Richard S, Dupuis F, Cassivi C. For a better understanding of the relationship between caregivers and young adults living with a concomitant substance-related mental health and substance use disorder: an integrative review. Rech Soins Infirm 2023; 153:24-39. [PMID: 37709664 DOI: 10.3917/rsi.153.0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
Introduction The importance of a quality relationship between young adults living with dual diagnosis and their health care providers is well documented. Context Although this complex phenomenon was mostly studied from an individual perspective, the results indicated the systemic nature of this relationship. Objective This study aims to better understand the relationship between young adults living with dual diagnosis and their health care providers, with a systemic perspective. Method Six data bases were consulted; manual research in gray literature and references screening enhanced the process. Results Of a total of 532 studies and reports identified, 44 were included in the review. Thematic data analysis was carried out, and two themes were identified: the health care system as a constraining environment; and the relationship at the heart of care. Discussion This study confirms the joint role played by the young adult in question and their health care provider in developing and maintaining the relationship, by acknowledging the importance of the care, of mutual confidence, and of a hierarchic relationship. Conclusion This integrative review provides a basis for future nursing interventions that foreground the relationship and take a systemic approach.
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Affiliation(s)
- Sophie Sergerie-Richard
- Infirmière, M.Sc, Faculté des sciences infirmières de l’Université de Montréal, Montréal, Québec, Canada
| | - France Dupuis
- Infirmière, Ph.D, professeure agrégée, Faculté des sciences infirmières de l’Université de Montréal, Montréal, Québec, Canada
| | - Christine Cassivi
- Infirmière, M.Sc, Faculté des sciences infirmières de l’Université de Montréal, Montréal, Québec, Canada
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Guiding Principles for Managing Co-occurring Alcohol/Other Drug and Mental Health Conditions: a Scoping Review. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00926-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
AbstractThis scoping review aimed to synthesise the published literature on guiding principles for managing co-occurring alcohol/other drug (AOD) and mental health conditions in AOD treatment settings. Systematic search of key electronic databases (January 1, 2010, to February 17, 2021) produced 4583 articles, and independent title/abstract and full text screening left 43 articles for inclusion. Fifteen guiding principles were identified, most commonly: build a strong therapeutic relationship (n = 24 articles), provide holistic care (n = 12), involve peer support (n = 7), ensure continuity of care (n = 6), support the professional development and competence of workers (n = 6), and provide trauma-informed care (n = 5). Remaining principles were identified in < 5 articles. Limited empirical literature examined the impact of guiding principles on patient- and treatment-related outcomes. This review provides the first comprehensive synthesis of the international literature to derive guiding principles for managing co-occurring AOD and mental health conditions in AOD treatment. Further empirical research is needed to determine the effectiveness of principles at improving outcomes.
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Experiences and perceptions of nurses participating in an interprofessional, videoconference-based educational programme on concurrent mental health and substance use disorders: a qualitative study. BMC Nurs 2022; 21:177. [PMID: 35787275 PMCID: PMC9251915 DOI: 10.1186/s12912-022-00943-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 06/14/2022] [Indexed: 11/29/2022] Open
Abstract
Background Individuals with co-occurring mental health and substance use disorders (i.e., concurrent disorders) have complex healthcare needs, which can be challenging for nurses to manage. Providing optimal care for this subpopulation requires nurses to develop high-level competencies despite limited resources at their disposal and the isolated settings in which many of them work. The Extension for Healthcare Community Outcomes (ECHO®) is a promising collaborative learning and capacity building model that uses videoconference technology to support and train healthcare professionals in the management of complex and chronic health conditions. The aim of this study was to explore the experiences and perceptions of nurses participating in a Canadian ECHO programme on concurrent disorders about the competencies they developed and used in their clinical practice, and which factors have influenced this process. Methods The study was qualitative, guided by an interpretive description approach. Individual semi-structured interviews were held with ten nurses who had participated in the programme between 2018 and 2020. A thematic analysis was conducted iteratively using an inductive approach to progressive data coding and organization. Results Four themes and eighteen sub-themes were identified. During their participation in ECHO, the nurses perceived as having further developed eight clinical nursing competencies. Nurses viewed ECHO as a unique opportunity to open themselves to their peers’ experiences and reflect on their own knowledge. Learning from experts in the field of concurrent disorders helped them to build their confidence in managing complex clinical situations. The nurses’ sense of belonging to a community further enhanced their engagement in the programme, and learning was facilitated through the programme’s interprofessional environment. Nevertheless, the lack of contextualized educative content linked to local realities, the limited resources in concurrent disorders, and time constraints were experienced as factors limiting competency development. Conclusions ECHO is a promising alternative to conventional, in-person continuing education programmes to improve the development of advanced competencies among nurses providing care to individuals with chronic and complex health conditions. These findings can inform clinicians, educators, researchers, and decision makers who are developing, implementing, evaluating, and escalating future educational interventions in the field of CDs. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-022-00943-w.
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Puértolas-Gracia B, Barbaglia MG, Gotsens M, Parés-Badell O, Brugal MT, Torrens M, Treviño L, Rodríguez-Díaz C, Vázquez-Vázquez JM, Pascual A, Coromina-Gimferrer M, Jiménez-Dueñas M, Oliva I, González E, Mestre N, Bartroli M. Lifetime Dual Disorder Screening and Treatment Retention: A Pilot Cohort Study. J Clin Med 2022; 11:jcm11133760. [PMID: 35807045 PMCID: PMC9267195 DOI: 10.3390/jcm11133760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/29/2022] [Accepted: 06/14/2022] [Indexed: 02/04/2023] Open
Abstract
The coexistence of a substance use disorder and another mental disorder in the same individual has been called dual disorder or dual diagnosis. This study aimed to examine the prevalence of lifetime dual disorder in individuals with alcohol or cocaine use disorder and their retention in treatment. We conducted a pilot cohort study of individuals (n = 1356) with alcohol or cocaine use disorder admitted to treatment in the public outpatient services of Barcelona (Spain) from January 2015 to August 2017 (followed-up until February 2018). Descriptive statistics, Kaplan−Meier survival curves and a multivariable Cox regression model were estimated. The lifetime prevalence of screening positive for dual disorder was 74%. At 1 year of follow-up, >75% of the cohort remained in treatment. On multivariable analysis, the factors associated with treatment dropout were a positive screening for lifetime dual disorder (HR = 1.26; 95% CI = 1.00−1.60), alcohol use (HR = 1.35; 95% CI = 1.04−1.77), polysubstance use (alcohol or cocaine and cannabis use) (HR = 1.60; 95% CI = 1.03−2.49) and living alone (HR = 1.34; 95% CI = 1.04−1.72). Lifetime dual disorder is a prevalent issue among individuals with alcohol or cocaine use disorders and could influence their dropout from treatment in public outpatient drug dependence care centres, along with alcohol use, polysubstance use and social conditions, such as living alone. We need a large-scale study with prolonged follow-up to confirm these preliminary results.
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Affiliation(s)
- Beatriz Puértolas-Gracia
- Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain; (B.P.-G.); (M.G.); (O.P.-B.); (M.T.B.); (L.T.); (C.R.-D.); (J.M.V.-V.); (A.P.); (M.C.-G.); (M.J.-D.); (I.O.); (E.G.); (N.M.); (M.B.)
- Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), 08003 Barcelona, Spain;
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain
- CIBER Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - María Gabriela Barbaglia
- Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain; (B.P.-G.); (M.G.); (O.P.-B.); (M.T.B.); (L.T.); (C.R.-D.); (J.M.V.-V.); (A.P.); (M.C.-G.); (M.J.-D.); (I.O.); (E.G.); (N.M.); (M.B.)
- Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), 08003 Barcelona, Spain;
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain
- Biomedical Research Institute Sant Pau, IIB Sant Pau, Sant Antoni Mª Claret 167, 08025 Barcelona, Spain
- Red de Investigación en Atención Primaria en Adicciones (RIAPAd), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-93202-7702
| | - Mercè Gotsens
- Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain; (B.P.-G.); (M.G.); (O.P.-B.); (M.T.B.); (L.T.); (C.R.-D.); (J.M.V.-V.); (A.P.); (M.C.-G.); (M.J.-D.); (I.O.); (E.G.); (N.M.); (M.B.)
| | - Oleguer Parés-Badell
- Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain; (B.P.-G.); (M.G.); (O.P.-B.); (M.T.B.); (L.T.); (C.R.-D.); (J.M.V.-V.); (A.P.); (M.C.-G.); (M.J.-D.); (I.O.); (E.G.); (N.M.); (M.B.)
| | - María Teresa Brugal
- Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain; (B.P.-G.); (M.G.); (O.P.-B.); (M.T.B.); (L.T.); (C.R.-D.); (J.M.V.-V.); (A.P.); (M.C.-G.); (M.J.-D.); (I.O.); (E.G.); (N.M.); (M.B.)
| | - Marta Torrens
- Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), 08003 Barcelona, Spain;
- Red de Investigación en Atención Primaria en Adicciones (RIAPAd), 28029 Madrid, Spain
- Faculty of Medicine, Universitat Autònoma de Barcelona (UAB), 08193 Barcelona, Spain
- Faculty of Medicine, Universitat de Vic i Catalunya Central, Vic, 08500 Barcelona, Spain
| | - Lara Treviño
- Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain; (B.P.-G.); (M.G.); (O.P.-B.); (M.T.B.); (L.T.); (C.R.-D.); (J.M.V.-V.); (A.P.); (M.C.-G.); (M.J.-D.); (I.O.); (E.G.); (N.M.); (M.B.)
| | - Concepción Rodríguez-Díaz
- Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain; (B.P.-G.); (M.G.); (O.P.-B.); (M.T.B.); (L.T.); (C.R.-D.); (J.M.V.-V.); (A.P.); (M.C.-G.); (M.J.-D.); (I.O.); (E.G.); (N.M.); (M.B.)
| | - José María Vázquez-Vázquez
- Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain; (B.P.-G.); (M.G.); (O.P.-B.); (M.T.B.); (L.T.); (C.R.-D.); (J.M.V.-V.); (A.P.); (M.C.-G.); (M.J.-D.); (I.O.); (E.G.); (N.M.); (M.B.)
| | - Alicia Pascual
- Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain; (B.P.-G.); (M.G.); (O.P.-B.); (M.T.B.); (L.T.); (C.R.-D.); (J.M.V.-V.); (A.P.); (M.C.-G.); (M.J.-D.); (I.O.); (E.G.); (N.M.); (M.B.)
| | - Marcela Coromina-Gimferrer
- Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain; (B.P.-G.); (M.G.); (O.P.-B.); (M.T.B.); (L.T.); (C.R.-D.); (J.M.V.-V.); (A.P.); (M.C.-G.); (M.J.-D.); (I.O.); (E.G.); (N.M.); (M.B.)
| | - Míriam Jiménez-Dueñas
- Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain; (B.P.-G.); (M.G.); (O.P.-B.); (M.T.B.); (L.T.); (C.R.-D.); (J.M.V.-V.); (A.P.); (M.C.-G.); (M.J.-D.); (I.O.); (E.G.); (N.M.); (M.B.)
| | - Israel Oliva
- Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain; (B.P.-G.); (M.G.); (O.P.-B.); (M.T.B.); (L.T.); (C.R.-D.); (J.M.V.-V.); (A.P.); (M.C.-G.); (M.J.-D.); (I.O.); (E.G.); (N.M.); (M.B.)
| | - Erick González
- Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain; (B.P.-G.); (M.G.); (O.P.-B.); (M.T.B.); (L.T.); (C.R.-D.); (J.M.V.-V.); (A.P.); (M.C.-G.); (M.J.-D.); (I.O.); (E.G.); (N.M.); (M.B.)
| | - Nicanor Mestre
- Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain; (B.P.-G.); (M.G.); (O.P.-B.); (M.T.B.); (L.T.); (C.R.-D.); (J.M.V.-V.); (A.P.); (M.C.-G.); (M.J.-D.); (I.O.); (E.G.); (N.M.); (M.B.)
| | - Montse Bartroli
- Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain; (B.P.-G.); (M.G.); (O.P.-B.); (M.T.B.); (L.T.); (C.R.-D.); (J.M.V.-V.); (A.P.); (M.C.-G.); (M.J.-D.); (I.O.); (E.G.); (N.M.); (M.B.)
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain
- Biomedical Research Institute Sant Pau, IIB Sant Pau, Sant Antoni Mª Claret 167, 08025 Barcelona, Spain
- Red de Investigación en Atención Primaria en Adicciones (RIAPAd), 28029 Madrid, Spain
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Roncero C, Remon-Gallo D, Casado-Espada N, Aguilar L, Gamonal-Limcaoco S, Gallego MT, Bote B, Montejo AL, Buch-Vicent B. Healthcare professionals' perception and satisfaction with mental health tele-medicine during the COVID-19 outbreak: A real-world experience in telepsychiatry. Front Psychiatry 2022; 13:981346. [PMID: 36405902 PMCID: PMC9673754 DOI: 10.3389/fpsyt.2022.981346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/28/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The use of telemedicine is increasingly being implemented, showing numerous benefits over other methods. A good example of this is the use of telemedicine following the breakdown caused by the COVID-19 pandemic. Previous experiences with telemedicine (TM) have not been significantly explored in relation to the professionals' own perspectives. OBJECTIVE Identify and explore the perceptions and interests of mental health professionals who have performed TM during the period of pandemia. METHODS A questionnaire on mental health professionals' perceptions of and satisfaction of TM, the Font Roja Work Satisfaction Questionnaire, was adapted and used. Data collected included 112 Psychiatric Service professionals who conducted TM in March 2020, after the country had been under lockdown for 10 weeks. Over 12.000 medical consultations were carried out by the phone, showing an overwhelming response to this method. RESULTS High levels of satisfaction were recorded amongst professionals. TM would function as a complement to the traditional system of face-to-face visits (n-112, f-109, 96.5%). Only 9.7% (f-11) believed that digital or virtual interventions would completely replace face-to-face visits. 60.8% did not consider this monotonous work. The older the health workers were, the more satisfied they felt during their follow-up telephone consultation. The greater the previous experience, the more satisfaction was shown. There were gender differences: female mental health workers reported a greater level of comfort. CONCLUSION TM can be implemented with less effort, but it requires time, methods, and resources to be managed. Satisfaction among professionals is high, especially among those with more clinical experience. Patient satisfaction must be contrasted against this.
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Affiliation(s)
- Carlos Roncero
- Psychiatric Service, University of Salamanca Health Care Complex, Salamanca, Spain.,Salamanca Institute of Biomedicine, University of Salamanca, Salamanca, Spain.,Psychiatric Unit, School of Medicine, University of Salamanca, Salamanca, Spain
| | - Diego Remon-Gallo
- Salamanca Institute of Biomedicine, University of Salamanca, Salamanca, Spain.,Psychiatric Unit, School of Medicine, University of Salamanca, Salamanca, Spain
| | - Nerea Casado-Espada
- Psychiatric Service, University of Salamanca Health Care Complex, Salamanca, Spain.,Salamanca Institute of Biomedicine, University of Salamanca, Salamanca, Spain.,Psychiatric Unit, School of Medicine, University of Salamanca, Salamanca, Spain
| | - Lourdes Aguilar
- Psychiatric Service, University of Salamanca Health Care Complex, Salamanca, Spain.,Salamanca Institute of Biomedicine, University of Salamanca, Salamanca, Spain.,Psychiatric Unit, School of Medicine, University of Salamanca, Salamanca, Spain
| | - Sinta Gamonal-Limcaoco
- Psychiatric Service, University of Salamanca Health Care Complex, Salamanca, Spain.,Salamanca Institute of Biomedicine, University of Salamanca, Salamanca, Spain
| | - María Teresa Gallego
- Psychiatric Service, University of Salamanca Health Care Complex, Salamanca, Spain
| | - Berta Bote
- Psychiatric Service, University of Salamanca Health Care Complex, Salamanca, Spain.,Psychiatric Unit, School of Medicine, University of Salamanca, Salamanca, Spain
| | - Angel Luis Montejo
- Psychiatric Service, University of Salamanca Health Care Complex, Salamanca, Spain.,Salamanca Institute of Biomedicine, University of Salamanca, Salamanca, Spain.,School of Nursing, University of Salamanca, Salamanca, Spain
| | - Barbara Buch-Vicent
- Salamanca Institute of Biomedicine, University of Salamanca, Salamanca, Spain.,Faculty of Psychology, University of Salamanca, Salamanca, Spain
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Orocio-Contreras M, Nieto-Caraveo A. Structured diagnosis and timely treatment of dual diagnosis: effect on the retention rate in outpatient treatment for substance use disorders. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1983046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Marisol Orocio-Contreras
- Public Health Department at Faculty of Medicine, Autonomous University of San Luis Potosí, San Luis Potosí, Mexico
| | - Amado Nieto-Caraveo
- Public Health Department at Faculty of Medicine, Autonomous University of San Luis Potosí, San Luis Potosí, Mexico
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Understanding How Semantic Structures of Individuals With Drug Addiction Transform As a Key to Effective Psychotherapy. ADDICTIVE DISORDERS & THEIR TREATMENT 2021. [DOI: 10.1097/adt.0000000000000283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chicoine G, Côté J, Pepin J, Pluye P, Boyer L, Fontaine G, Rouleau G, Dubreucq S, Jutras-Aswad D. Impact of a videoconferencing educational programme for the management of concurrent disorders on nurses' competency development and clinical practice: protocol for a convergent mixed methods study. BMJ Open 2021; 11:e042875. [PMID: 33727265 PMCID: PMC7970219 DOI: 10.1136/bmjopen-2020-042875] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Extension for Community Healthcare Outcomes (Project ECHO©) is an innovative model for continuing professional development that uses videoconferencing technology to support and train general practitioners remotely. The model has been replicated to a variety of settings and locations for capacity building in healthcare professionals caring for patients with chronic and complex health conditions. Limited research has been conducted so far on the impact of ECHO in the field of concurrent mental health and substance use disorders (ie, concurrent disorders (CDs)). Therefore, this mixed methods study aims to develop a comprehensive understanding of an ECHO programme impact for CD management on nurses' competency development and clinical practice. METHODS AND ANALYSIS The proposed mixed methods study, based on a convergent parallel design, will be conducted in the province of Quebec, Canada, to collect, analyse and interpret quantitative (QUAN) and qualitative (QUAL) data from a specific ECHO Program on CDs. In the QUAN component, an observational prospective cohort study will be conducted over a 12-month period. All nurses who participated in the programme between 2018 and 2020 and who consent to research will be recruited to collect data on the extent of their learning and practice outcomes at three time points. Alongside the surveys, nurses will be invited to participate in individual semistructured interviews. In-depth QUAL data will be subjected to a thematic analysis and will assist in exploring how and in which conditions nurses developed and mobilised their competencies in clinical practice. A comparison-of-results strategy will be used in the final integration component of the study. ETHICS AND DISSEMINATION This study protocol was approved by the Ethics Committee of the Université de Montréal Hospital Center (#19.295) and the Université de Montréal Ethics Committee (CERSES-20-017 R). We aim to disseminate the findings through international academic conferences, international peer-reviewed journals and professional media.
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Affiliation(s)
- Gabrielle Chicoine
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Research Center, Université de Montréal Hospital Center, Montreal, Quebec, Canada
- Research Chair in Innovative Nursing Practices, Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
| | - José Côté
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Research Center, Université de Montréal Hospital Center, Montreal, Quebec, Canada
- Research Chair in Innovative Nursing Practices, Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
| | - Jacinthe Pepin
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
| | - Pierre Pluye
- Department of Family Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Louise Boyer
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
| | - Guillaume Fontaine
- Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Research Center, Institut de Cardiologie de Montréal, Montreal, Quebec, Canada
| | - Geneviève Rouleau
- Research Chair in Innovative Nursing Practices, Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
- Institute for Health System Solutions and Virtual Care, Women's College Hospital Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, Ontario, Canada
| | - Simon Dubreucq
- Research Center, Université de Montréal Hospital Center, Montreal, Quebec, Canada
- Psychiatry Department, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Didier Jutras-Aswad
- Research Center, Université de Montréal Hospital Center, Montreal, Quebec, Canada
- Psychiatry Department, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
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Roncero C, Remon D, Casado-Espada NM, Aguilar L, Gamonal-Limcaoco S, Gallego MT, Bote B, Montejo AL, Buch B. Perception and satisfaction in telemedicine on Mental Health among professionals during the COVID outbreak. A real-world experience in telepsychiatry. (Preprint). JMIR Form Res 2020. [DOI: 10.2196/22224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Torales J, Castaldelli-Maia JM, da Silva AG, Campos MW, González-Urbieta I, Barrios I. Even More Complex…. When Mental Disorder Meets Addiction in Youth: Dual Pathology. Curr Drug Res Rev 2019; 11:40-43. [PMID: 30829179 DOI: 10.2174/2589977511666181128165358] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 11/06/2018] [Accepted: 11/22/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND The management of mental disorders in child and adolescent is challenging. In addition, when substance use disorders are associated with mental disorders, important complications are noted. Dual pathology and Substance-induced disorders should be distinguished in cases like this. OBJECTIVE To summarize the latest information on the epidemiology, etiology and management aspects of dual pathology in adolescents. METHODS PubMed, Web of Science, PsycINFO and SciELO databases were searched to perform a narrative review. RESULTS Dual pathology is the term used to designate the co-occurrence of an addictive disorder and at least one other mental health disorder, independently. To distinguish dual pathology from substance- induced disorders, the temporal association between the disorders in a longitudinal assessment should be emphasized. If the symptoms of the mental disorder appear prior to the substance use or after a long period of abstinence, a diagnosis of dual pathology should be considered. Patients with dual pathology present greater psychosocial issues, more medical problems, and worse prognosis than those with substance-induced disorders. The proposed etiological models agree that biological, psychological and social factors are shared in the development of these conditions. CONCLUSION Healthcare systems should focus on creating policies that will allow early detection, preventive public health measures, and an integrated and coordinated care for these patients. Public health policies should create means to promote awareness and prevention of these pathologies since early initiation of treatment (pharmacological, psychotherapeutic, family therapy, education in schools, behavioral interventions and treatment of comorbidities) reduces the risks associated to substance use disorders and other negative consequences.
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Affiliation(s)
- Julio Torales
- Departamento de Psiquiatria, Universidad Nacional de Asuncion, Asuncion, Paraguay
| | | | | | - Marcela W Campos
- Department of Neuropsychopharmacology, Universidad Favaloro, Buenos Aires, Argentina
| | | | - Iván Barrios
- Departamento de Psiquiatria, Universidad Nacional de Asuncion, Asuncion, Paraguay
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Schuman-Olivier Z, Borodovsky JT, Steinkamp J, Munir Q, Butler K, Greene MA, Goldblatt J, Xie HY, Marsch LA. MySafeRx: a mobile technology platform integrating motivational coaching, adherence monitoring, and electronic pill dispensing for enhancing buprenorphine/naloxone adherence during opioid use disorder treatment: a pilot study. Addict Sci Clin Pract 2018; 13:21. [PMID: 30249279 PMCID: PMC6154900 DOI: 10.1186/s13722-018-0122-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 09/18/2018] [Indexed: 12/22/2022] Open
Abstract
Background While buprenorphine/naloxone (B/N) is approved for opioid use disorder treatment, effective delivery of B/N comes with significant challenges. Most notably, many patients do not take medication daily as prescribed; this non-adherence worsens treatment outcomes, increases healthcare costs, and leads to persistent worries of diversion among providers and policymakers. The present study examines the feasibility, usability, and acceptability of MySafeRx—a mobile technology platform integrating motivational coaching, adherence monitoring, and electronic pill dispensing designed to address the challenges of office-based opioid treatment (OBOT) with B/N. Methods The MySafeRx platform integrates electronic pill dispensers, text-messaging, and videoconferencing to provide supervised self-administration of medication and daily motivational coaching through an Android app interface. High-risk early adults (18–39 years old) who were enrolled in OBOT with B/N and had documented illicit opioid use in the past month during opioid agonist therapy (n = 12) participated in a 28-day single-arm observational study of the MySafeRx platform in addition to standard care. Results Two-thirds of participants who completed the study achieved an average of > 5 days per week of supervised B/N self-administration. Visual confirmation of medication adherence was demonstrated for an average of 72% of study days among all participants. All participants achieved platform technical proficiency within 60 min, reporting good levels of usability and acceptability. Illicit opioid abstinence rates confirmed by urine toxicology increased by 53% during MySafeRx but fell 43% within 3 weeks post-intervention. Conclusion The MySafeRx medication adherence and remote coaching mobile platform is acceptable and can be feasibly implemented in real-world opioid use disorder treatment settings during high-risk periods (i.e., initial stabilization, after illicit opioid lapse), resulting in reduced illicit opioid use; however, the effect did not last after intervention completion, suggesting longer duration or extended taper of program may be needed. ClinicalTrials.Gov NCT02942199 10/24/16 https://clinicaltrials.gov/ct2/show/NCT02942199 Electronic supplementary material The online version of this article (10.1186/s13722-018-0122-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Zev Schuman-Olivier
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, Hanover, USA. .,Department of Psychiatry, Harvard Medical School, Boston, USA. .,Cambridge Health Alliance, Outpatient Addiction Services, Department of Psychiatry, Harvard Medical School, 26 Central Street, Somerville, MA, 02143, USA.
| | - Jacob T Borodovsky
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, Hanover, USA
| | - Jackson Steinkamp
- Cambridge Health Alliance, Outpatient Addiction Services, Department of Psychiatry, Harvard Medical School, 26 Central Street, Somerville, MA, 02143, USA.,Boston University School of Medicine, Boston, USA
| | - Qays Munir
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, Hanover, USA.,Cambridge Health Alliance, Outpatient Addiction Services, Department of Psychiatry, Harvard Medical School, 26 Central Street, Somerville, MA, 02143, USA
| | - Kyle Butler
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, Hanover, USA
| | - Mary Ann Greene
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, Hanover, USA
| | - Jonah Goldblatt
- Cambridge Health Alliance, Outpatient Addiction Services, Department of Psychiatry, Harvard Medical School, 26 Central Street, Somerville, MA, 02143, USA.,Tufts University School of Medicine, Boston, USA
| | - Hai Yi Xie
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, Hanover, USA
| | - Lisa A Marsch
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, Hanover, USA
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The Role of Education on Dual Disorders: A Discussion Paper. ADDICTIVE DISORDERS & THEIR TREATMENT 2017. [DOI: 10.1097/adt.0000000000000114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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