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Loverock A, Marshall T, Viste D, Safi F, Rioux W, Sedaghat N, Kennedy M, Ghosh SM. Electronic harm reduction interventions for drug overdose monitoring and prevention: A scoping review. Drug Alcohol Depend 2023; 250:110878. [PMID: 37441959 DOI: 10.1016/j.drugalcdep.2023.110878] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Novel strategies are required to address rising overdose deaths across the globe. We sought to identify the breadth and depth of the existing evidence around electronic harm reduction (e-harm reduction) interventions that aimed to reduce the harms associated with substance use. METHODS We conducted a scoping review according to the PRISMA-ScR and PRISMA for Searching guidelines. A health sciences librarian systematically searched seven health databases from inception until January 20, 2023. Citation chaining and reference lists of included studies were searched to identify additional articles. Two reviewers independently screened, extracted and charted the data. Additionally, we conducted a gray literature search and environmental scan to supplement the findings. RESULTS A total of 51 studies met the criteria for inclusion (30 peer-reviewed articles and 21 non-peer reviewed). Most peer-reviewed studies were conducted in Western countries (USA = 23, Canada = 3, Europe = 3, China = 1) and among adult samples (adult = 27, youth/adults =1, unspecified = 2). Study designs were predominantly quantitative (n = 24), with a minority using qualitative (n = 4) or mixed methods (n = 2). Most e-harm reduction interventions were harm reduction (n = 15), followed by education (n = 6), treatment (n = 2), and combined/other approaches (n = 7). Interventions utilized web-based/mobile applications (n = 15), telephone/telehealth (n = 10), and other technology (n = 5). CONCLUSIONS While e-harm reduction technology is promising, further research is required to establish the efficacy and effectiveness of these novel interventions.
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Affiliation(s)
- Alexandra Loverock
- School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405 87 Ave, Edmonton, Alberta T6G 1C9, Canada.
| | - Tyler Marshall
- Department of Medicine, Cumming School of Medicine, University of Calgary, 2500 University Dr NW, Calgary, Alberta T2N 1N4, Canada
| | - Dylan Viste
- Department of Medicine, Cumming School of Medicine, University of Calgary, 2500 University Dr NW, Calgary, Alberta T2N 1N4, Canada
| | - Fahad Safi
- Faculty of Medicine & Dentistry, University of Alberta, 2J2.00 Walter C Mackenzie Health Sciences Centre, 8440 112 St. NW Edmonton, Alberta T6G 2R7, Canada
| | - Will Rioux
- Faculty of Medicine & Dentistry, University of Alberta, 2J2.00 Walter C Mackenzie Health Sciences Centre, 8440 112 St. NW Edmonton, Alberta T6G 2R7, Canada
| | - Navid Sedaghat
- Faculty of Medicine & Dentistry, University of Alberta, 2J2.00 Walter C Mackenzie Health Sciences Centre, 8440 112 St. NW Edmonton, Alberta T6G 2R7, Canada
| | | | - S Monty Ghosh
- Department of Medicine, Cumming School of Medicine, University of Calgary, 2500 University Dr NW, Calgary, Alberta T2N 1N4, Canada; Faculty of Medicine & Dentistry, University of Alberta, 2J2.00 Walter C Mackenzie Health Sciences Centre, 8440 112 St. NW Edmonton, Alberta T6G 2R7, Canada
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Safi F, Rioux W, Rider N, Fornssler B, Jones S, Ghosh SM. Feasibility and acceptability of inserts promoting virtual overdose monitoring services (VOMS) in naloxone kits: a qualitative study. Harm Reduct J 2023; 20:64. [PMID: 37158926 PMCID: PMC10165834 DOI: 10.1186/s12954-023-00792-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/03/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND In response to the ongoing opioid epidemic, there have been efforts to develop novel harm reduction strategies alongside scaling of currently implemented programs. Virtual overdose monitoring services (VOMS) are a novel intervention which aims to reduce substance-related mortality through technology for those who are out of reach of current supervised consumption sites. Scaling of naloxone programs presents a unique opportunity to promote VOMS to people at risk of substance-related mortality. This study aims to explore the feasibility and acceptability of naloxone kit inserts in promoting awareness of VOMS. METHOD We used purposive and snowball sampling to recruit 52 key informants, including people who use drugs (PWUD) with experience using VOMS (n = 16), PWUD with no prior experience using VOMS (n = 9), family members of PWUD (n = 5), healthcare and emergency services professionals (n = 10), community-based harm reduction organizations (n = 6), and VOMS administrators/peer support workers (n = 6). Two evaluators completed semi-structured interviews. Interview transcripts were analyzed using thematic analysis informed to identify key themes. RESULTS Four key interrelated themes emerged, including the acceptability of naloxone kit inserts to promote VOMS, best practices for implementation, key messaging to include within promotional materials and facilitators to dissemination of harm reduction material. Participants highlighted that messaging should be promoted both inside and outside the kits, should be concise, provide basic information about VOMS and can be facilitated through current distribution streams. Messaging could further be used to draw attention to local harm reduction services and could be promoted on other supplies, including lighters and safer consumption supplies. CONCLUSION Findings demonstrate that it is acceptable to promote VOMS within naloxone kits and highlight interviewees preferred ways to do so. Key themes that emerged from interviewees can be used to inform the dissemination of harm reduction information, including VOMS and bolster current strategies for reducing illicit drug overdose.
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Affiliation(s)
- Fahad Safi
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - William Rioux
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Nathan Rider
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Barbara Fornssler
- School of Public Health, University of Saskatchewan, Saskatoon, Canada
| | | | - S Monty Ghosh
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
- Department of Internal Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
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3
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COVID-19 and the opportunity for gender-responsive virtual and remote substance use treatment and harm reduction services. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 108:103815. [PMID: 35969920 PMCID: PMC9359504 DOI: 10.1016/j.drugpo.2022.103815] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/26/2022] [Accepted: 07/31/2022] [Indexed: 11/21/2022]
Abstract
The COVID-19 pandemic has increased the uptake of virtual and remote service delivery in the substance use field, which was previously uncommon. This swift uptake of virtual services provides an opportunity to improve service design to meet the diverse needs of women and gender-diverse people. Such services have the potential to better meet the needs of women and gender-diverse people by allowing for increased choice, control, and autonomy, enabling empowerment, facilitating greater considerations of power relations, violence, childcare responsibilities, and fostering greater inclusion of trans and non-binary people. This commentary aims to identify how virtual and remote delivery of substance use treatment and harm reduction services can be gender-responsive. We highlight the role gender transformative services play in meeting the unique needs of women and gender-diverse people who use drugs both during and after the COVID-19 pandemic. By using the unique window of opportunity COVID-19 has created to develop and deliver gender-transformative programs, we can help address the detrimental gaps in service accessibility and effectiveness that have persistently been experienced by women and gender-diverse people who use drugs.
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4
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Ibrahim FA, Malathesh BC, Gajera G, Pandey P, Nirisha P L, Jyrwa S, Kumar CN, Manjunatha N, Jain S, Bairy BK, Bada Math S. Chhattisgarh community mental healthcare tele-mentoring program (CHaMP): Digitally driven initiative to reach the unreached. Int J Soc Psychiatry 2022; 68:954-957. [PMID: 33860714 DOI: 10.1177/00207640211011191] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Harnessing technology is one accepted method to leapfrog the barrier of inadequate trained human resources for mental health. The Chhattisgarh Community Mental Healthcare Tele-Mentoring Program (CHaMP) is a collaborative digitally driven initiative of the Government of Chhattisgarh (GOC) and the National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru the aim of which is to train the Primary Care Doctors (PCDs) and Rural Medical Assistants (RMA) to identify, screen and treat/refer cases of mental health disorders presenting to the primary care settings (n = 2150). The objective of this article is to give a brief overview of the initiative. METHODS CHaMP consists of the following modules: (a) a brief on-site training (b) eLearning and Skill Development (eLSD) and (c) Collaborative Video Consultation (CVC). The latter two are andragogic training methods delivered digitally. RESULTS AND CONCLUSION From August 2019 to May 2020, 501 PCDs and RMAs have been covered. During this time, they have cared 15,000 patients suffering from mental illness, which hitherto was not the case. Technology that is easily available and usable has the potential to overcome the big hurdle of inadequate mental health human resources in India.
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Affiliation(s)
- Ferose Azeez Ibrahim
- Dorothy Pattison Hospital, Black Country Healthcare NHS Foundation Trust, CHaMP initiative, Department of Psychiatry, NIMHANS, Bengaluru, Karnataka, India
| | - Barikar C Malathesh
- Telemedicine Centre, Department of Psychiatry, NIMHANS, Bengaluru, Karnataka, India
| | - Gopi Gajera
- CHaMP initiative, Department of Psychiatry, NIMHANS, Bengaluru, Karnataka, India
| | - Praveen Pandey
- CHaMP initiative, Department of Psychiatry, NIMHANS, Bengaluru, Karnataka, India
| | - Lakshmi Nirisha P
- Telemedicine Centre, Department of Psychiatry, NIMHANS, Bengaluru, Karnataka, India
| | - Sonakshi Jyrwa
- Department of Psychiatry, AIIMS Nagpur and Ex-Senior Resident, CHaMP initiative, Department of Psychiatry, NIMHANS, Bengaluru, Karnataka, India
| | | | | | - Sumi Jain
- NCDs and Mental Health, Government of Chhattisgarh, Raipur, Chhattisgarh, India
| | - Bhavya K Bairy
- NIMHANS Digital Academy, NIMHANS, Bengaluru, Karnataka, India
| | - Suresh Bada Math
- Community Psychiatry Services, NIMHANS, Bengaluru, Karnataka, India
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Digital Treatment Paths for Substance Use Disorders (SUDs). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127322. [PMID: 35742572 PMCID: PMC9224394 DOI: 10.3390/ijerph19127322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 06/10/2022] [Indexed: 11/29/2022]
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6
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Lin EJD, Schroeder M, Huang Y, Linwood SL. Digital Health for the Opioid Crisis: A Historical Analysis of NIH Funding from 2013 to 2017. Digit Health 2022. [DOI: 10.36255/exon-publications-digital-health-opioid-crisis] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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7
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Martínez-Miranda J, Espinosa-Curiel IE. Serious games supporting the prevention and treatment of alcohol and drugs consumption in youth: a scoping review (Preprint). JMIR Serious Games 2022; 10:e39086. [PMID: 36006694 PMCID: PMC9459843 DOI: 10.2196/39086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/23/2022] [Accepted: 07/21/2022] [Indexed: 11/18/2022] Open
Abstract
Background The consumption of alcohol and drugs, particularly in adolescents and young adults, has increased worldwide in the last several years, representing a significant public health challenge. Serious games have the potential to support preventive and treatment interventions for substance use, facilitating the acquisition of relevant knowledge and the motivation for changes in attitudes and behaviors regarding substance consumption. Objective This scoping review aims to analyze a set of 7 relevant characteristics of current serious games designed to support the prevention and treatment of alcohol and drug consumption in adolescents and young adults—the substance addressed, the type of intervention, the theoretical basis, the computational techniques used, the mechanism for data security and privacy, the evaluation procedure followed, and the main results obtained. Methods The review was performed by following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Data were retrieved from January 2010 to May 2022, using PubMed, Scopus (Elsevier), IEEE Xplore, and ACM Digital as data sources. The eligibility criteria included studies that described serious games designed to support the prevention or treatment of alcohol and drug consumption, targeted a population aged between 12 and 30 years, and included an evaluation procedure. Authors (JMM and IEEC) individually screened the titles and abstracts, and then full articles were reviewed for a final inclusion decision. Results A total of 629 records were obtained, and 29 (4.6%) fulfilled the inclusion criteria. Most of the serious games (14/29, 48%) were focused on the prevention or treatment of alcohol use. The type of intervention that was the most supported was prevention (18/29, 62%), and most studies mentioned the theory, theoretical construct, or therapeutic technique used as a foundation (22/29, 76%). Most of the studies only provided information about the platform for execution (23/29, 79%), and few described the use of computational techniques, such as virtual reality or motion-based interaction (5/29, 17%). A small set of studies (10/29, 34%) explicitly mentioned how data security and privacy were addressed. Most of the reported evaluation protocols were pilot studies (11/29, 38%), followed by randomized controlled trials (10/29, 34%), and the reported results were positive in terms of acceptability, usability, and efficacy. However, more research is needed to assess long-term effects. Conclusions Given the increasing interest in the use of serious games as digital interventions to support the prevention or treatment of substance use, knowing their main features is highly important. This review highlights whether and how current serious games incorporate 7 key features that are useful to consider for the further development of the area.
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Affiliation(s)
- Juan Martínez-Miranda
- Centro de Investigación Científica y de Educación Superior de Ensenada, Unidad de Transferencia Tecnológica Tepic, Tepic, Mexico
| | - Ismael Edrein Espinosa-Curiel
- Centro de Investigación Científica y de Educación Superior de Ensenada, Unidad de Transferencia Tecnológica Tepic, Tepic, Mexico
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8
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Shetty K, Tewathia N, Bamney U, Rawat V. Micro- and macro-level economic implications of digital addictions: A case study. MGM JOURNAL OF MEDICAL SCIENCES 2022. [DOI: 10.4103/mgmj.mgmj_199_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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9
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Edsall A, Dinh TTT, Mai PP, Hoffman K, Nguyen HT, Khuyen TT, Trang NT, Bart G, Giang LM, Korthuis PT. Provider Perspectives on Integration of Substance Use Disorder and HIV Care in Vietnam: A Qualitative Study. J Behav Health Serv Res 2021; 48:274-286. [PMID: 32940824 PMCID: PMC7965786 DOI: 10.1007/s11414-020-09730-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
UNAIDS recommends integration of medications for substance use disorders (SUD) with HIV care to improve HIV outcomes. Yet, integration of HIV and SUD services remains limited in many countries. The objective of this study was to assess provider perceptions of care integration in Vietnam. Qualitative interviews were conducted with 43 providers (nurses, physicians, counselors, pharmacists, and clinic managers) in 8 HIV clinics in northern Vietnam, 2013-2015. Providers identified five themes informing HIV and SUD treatment integration: (1) treatment for alcohol use disorder is often neglected compared to other SUD treatment; (2) structural challenges must be addressed to increase integration feasibility; (3) workforce limitations; (4) societal and healthcare stigmatization of SUD; and (5) providers' conflicting views regarding integration challenges. The experience of providers in Vietnam may be useful to other countries attempting to integrate HIV and SUD services.
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Affiliation(s)
- Andrew Edsall
- Oregon Health & Science University School of Medicine, Portland, OR, USA
| | | | | | - Kim Hoffman
- Portland State University-Oregon Health & Science University School of Public Health, Portland, OR, USA.
| | - Hang T Nguyen
- Portland State University-Oregon Health & Science University School of Public Health, Portland, OR, USA
| | | | | | - Gavin Bart
- Hennepin Healthcare and University of Minnesota, Minneapolis, MN, USA
| | | | - P Todd Korthuis
- Department of Medicine, Oregon Health & Science University, Portland, OR, USA
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Potas N, Açıkalın ŞN, Erçetin ŞŞ, Koçtürk N, Neyişci N, Çevik MS, Görgülü D. Technology addiction of adolescents in the COVID-19 era: Mediating effect of attitude on awareness and behavior. CURRENT PSYCHOLOGY 2021; 41:1687-1703. [PMID: 33613012 PMCID: PMC7881321 DOI: 10.1007/s12144-021-01470-8] [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] [Accepted: 02/03/2021] [Indexed: 12/28/2022]
Abstract
Adolescents have been called the "digital natives of the technology age", but determining adolescents' awareness, attitudes and behavior with respect to technology addiction (TA) is important for developing balanced and effective approaches to support their physical and psychological well-being after the COVID-19 pandemic. For this reason, the present study investigates the impact of attitudes on TA behavior in 382 adolescents by gender and extent of technology use. Three scales were used to determine adolescents' TA awareness, attitude, and behavior. The results of the dual-moderated mediation model show that gender and duration of technology use (h) moderated the full mediation of attitude on awareness and behavior in TA (F = 39.29, df = 9;372, p < .01). The indirect effect in males with 16.04 h per day of technology use is stronger (.24) than the indirect effect in males with 4.90 h per day of technology use (.13). In addition, the simple slope plot shows that when attitude scores increase, addictive behavior rises in females (simple slope = .74, t = 8.79, p < .01). On the other hand, with 16.04 h per day of technology use, when attitude scores decrease, addictive behavior rises in females (simple slope = .69, t = 7.59, p < .01). Furthermore, when the attitude scores increase, addictive behavior rises in males (simple slope = .85, t = 13.26, p < .01). As a result, the psychoeducational intervention programs to be implemented for TA should not only focus on awareness, but should also encompass behavioral, cognitive and lifestyle changes.
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Affiliation(s)
- Nihan Potas
- Department of Health Care Management, Ankara Hacı Bayram Veli University, Ankara, Turkey
| | - Şuay Nilhan Açıkalın
- Department of International Relations, Ankara Hacı Bayram Veli University, Ankara, Turkey
| | | | - Nilüfer Koçtürk
- Department of Education Science, Hacettepe University, Ankara, Turkey
| | - Nilay Neyişci
- Department of Education Science, Hacettepe University, Ankara, Turkey
| | | | - Deniz Görgülü
- Department of Education Science, Hacettepe University, Ankara, Turkey
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Perri M, Guta A, Gagnon M, Bonn M, Leece P, Bayoumi AM, Rai N, Touesnard N, Strike C. Developing a digital health strategy for people who use drugs: Lessons from COVID-19. Digit Health 2021; 7:20552076211028404. [PMID: 34262782 PMCID: PMC8243112 DOI: 10.1177/20552076211028404] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 06/09/2021] [Indexed: 12/12/2022] Open
Abstract
COVID-19 has significantly exacerbated negative health and social outcomes for people who use drugs (PWUD) around the world. The closure of harm reduction services, ongoing barriers to employment and housing, and pre-existing physical and mental health conditions have increased harms for diverse communities of PWUD. Adapting current models of health and human service delivery to better meet the needs of PWUD is essential in minimizing not only COVID-19 but also drug-related morbidity and mortality. This article draws on research, practice, and advocacy experiences, and discusses the potential for digital health tools such as remote monitoring and telecare to improve the continuum of care for PWUD. We call for a digital health strategy for PWUD and provide recommendations for future program development and implementation.
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Affiliation(s)
- Melissa Perri
- Dalla Lana School of Public Health, University of Toronto,
Toronto, Canada
- MAP Center for Urban Health Solutions, St. Michael’s Hospital,
Toronto, Canada
| | - Adrian Guta
- School of Social Work, University of Windsor, Windsor,
Canada
| | - Marilou Gagnon
- Canadian Institute for Substance Use Research, Victoria,
Canada
| | - Matt Bonn
- Canadian Association of People Who Use Drugs, Dartmouth,
Canada
- Canadian Students for Sensible Drug Policy, Ottawa, Canada
| | - Pamela Leece
- Dalla Lana School of Public Health, University of Toronto,
Toronto, Canada
- Public Health Ontario, Toronto, Canada
- Department of Family and Community Medicine, University of
Toronto Faculty of Medicine, Toronto, Canada
| | - Ahmed M Bayoumi
- MAP Center for Urban Health Solutions, St. Michael’s Hospital,
Toronto, Canada
- Institute of Health Policy, Management and Evaluation,
University of Toronto, Toronto, Canada
| | - Nanky Rai
- Department of Family and Community Medicine, University of
Toronto Faculty of Medicine, Toronto, Canada
| | | | - Carol Strike
- Dalla Lana School of Public Health, University of Toronto,
Toronto, Canada
- MAP Center for Urban Health Solutions, St. Michael’s Hospital,
Toronto, Canada
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12
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Tripathi R, Singh S, Bhad R. The need, scope, challenges, and potential solutions for enhancing addiction psychiatry training in India. Indian J Psychiatry 2020; 62:728-731. [PMID: 33896982 PMCID: PMC8052883 DOI: 10.4103/psychiatry.indianjpsychiatry_355_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 10/27/2019] [Accepted: 01/19/2020] [Indexed: 11/04/2022] Open
Abstract
Addictive disorders have become increasingly common in India. The health consequences of addictive disorders are immense, and the need for specialized addiction treatment and training far exceeds the capacity and human resources that currently exist. At the same time, increasing demand and treatment gap, need for specialized care, and the emerging sector of medical tourism in the country open avenues for superspecialty training in addiction psychiatry as an attractive career option for Indian psychiatrists. Human resource development and capacity building in the addiction psychiatry field in India is the need of the hour. In the present article, we describe the existing scenario and challenges related to addiction psychiatry training among postgraduate psychiatry trainees and psychiatrists in India and scope for the future.
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Affiliation(s)
- Richa Tripathi
- Department of Psychiatry and National Drug Dependence Treatment Centre (NDDTC), All India Institute of Medical Sciences, New Delhi, India
| | - Shalini Singh
- Department of Psychiatry and National Drug Dependence Treatment Centre (NDDTC), All India Institute of Medical Sciences, New Delhi, India
| | - Roshan Bhad
- Department of Psychiatry and National Drug Dependence Treatment Centre (NDDTC), All India Institute of Medical Sciences, New Delhi, India
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13
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Ransing RS, Agrawal G, Bagul K, Pevekar K. Inequity in Distribution of Psychiatry Trainee Seats and Institutes Across Indian States: A Critical Analysis. J Neurosci Rural Pract 2020; 11:299-308. [PMID: 32405186 PMCID: PMC7214092 DOI: 10.1055/s-0040-1709973] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background The delivery of mental health services largely depends on the adequacy of human resources. In India, the deficit of psychiatrists is more than 90% and is one of the major challenges that needs to be tackled to address the huge burden of mental illness. Psychiatry trainee institutes play a vital role in reducing human resource deficit and inequality in delivering mental health care. However, the distribution pattern of psychiatry trainee seats and institutes across Indian states is unknown. Therefore, we estimated the number of psychiatry trainee seats and institutes in each Indian state and union territory (UT). Materials and Methods In this cross-sectional study, psychiatry trainee seats and institutes were searched on the official web sites of Medical Council of India and National Board of Examinations. The data available on these web sites until December 2019 were included. State-wise data were compared using proportion and percentages. The psychiatry trainee index (PTI) was calculated and compared across Indian states and UTs. Results Among 221 Indian psychiatry trainee institutes considered in the present study, 116 (52.48%) were private institutes and 105 (47.51%) were government institutes. Overall, more psychiatry trainee seats were reported in government institutes ( n = 565, 65.89%) than in private institutes. National PTI was considered fair (0.06), and based on their PTIs, Indian states and UTs were classified as follows: worst ( n = 9), poor ( n = 8), fair ( n = 9), average ( n = 7), good ( n = 1), and excellent ( n = 2). Conclusion A huge deficit of psychiatry trainees and institutes exists in more than two-thirds of Indian states and UTs, along with a huge maldistribution of seats. PTI and its distribution across the states and UTs are a crucial indicator of the need to improve the access and equity of mental health care.
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Affiliation(s)
- Ramdas S Ransing
- Department of Psychiatry, BKL Walawalkar Rural Medical College, Sawarde, Ratnagiri, Maharashtra, India
| | - Girish Agrawal
- Department of Psychiatry, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashtra, India
| | - Koustubh Bagul
- Department of Psychiatry, Mahatma Gandhi Memorial Medical College, Indore, Madhya Pradesh, India
| | - Krishna Pevekar
- Department of Psychiatry, BKL Walawalkar Rural Medical College, Sawarde, Ratnagiri, Maharashtra, India
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14
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Blasiak A, Khong J, Kee T. CURATE.AI: Optimizing Personalized Medicine with Artificial Intelligence. SLAS Technol 2019; 25:95-105. [PMID: 31771394 DOI: 10.1177/2472630319890316] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The clinical team attending to a patient upon a diagnosis is faced with two main questions: what treatment, and at what dose? Clinical trials' results provide the basis for guidance and support for official protocols that clinicians use to base their decisions upon. However, individuals rarely demonstrate the reported response from relevant clinical trials, often the average from a group representing a population or subpopulation. The decision complexity increases with combination treatments where drugs administered together can interact with each other, which is often the case. Additionally, the individual's response to the treatment varies over time with the changes in his or her condition, whether via the indication or physiology. In practice, the drug and the dose selection depend greatly on the medical protocol of the healthcare provider and the medical team's experience. As such, the results are inherently varied and often suboptimal. Big data approaches have emerged as an excellent decision-making support tool, but their application is limited by multiple challenges, the main one being the availability of sufficiently big datasets with good quality, representative information. An alternative approach-phenotypic personalized medicine (PPM)-finds an appropriate drug combination (quadratic phenotypic optimization platform [QPOP]) and an appropriate dosing strategy over time (CURATE.AI) based on small data collected exclusively from the treated individual. PPM-based approaches have demonstrated superior results over the current standard of care. The side effects are limited while the desired output is maximized, which directly translates into improving the length and quality of individuals' lives.
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Affiliation(s)
- Agata Blasiak
- Department of Bioengineering, National University of Singapore, Singapore.,The N.1 Institute for Health (N.1), National University of Singapore, Singapore
| | - Jeffrey Khong
- Department of Bioengineering, National University of Singapore, Singapore.,The N.1 Institute for Health (N.1), National University of Singapore, Singapore
| | - Theodore Kee
- Department of Bioengineering, National University of Singapore, Singapore.,The N.1 Institute for Health (N.1), National University of Singapore, Singapore
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Stubbe DE. Additive Benefit in Addiction Treatment: Human and Technology-Based Patient Engagement. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2019; 17:148-151. [PMID: 31975972 PMCID: PMC6527003 DOI: 10.1176/appi.focus.20190001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Dorothy E Stubbe
- Yale University School of Medicine Child Study Center, New Haven, Connecticut
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