Category: Change

Dennis McCarty receives prestigious Kentucky award 2022

Dennis McCarty, Ph.D., an Emeritus Professor in the School of Public Health at the Portland State University and Oregon Health & Science University, has been inducted to the University of Kentucky College of Arts & Sciences Hall of Fame 2022.  This blog celebrates Dr McCarty‘s work and contribution to my research career. Please, see the event details below.

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Family physician and practice characteristics in audit and feedback

Audit and feedback interventions elicit behaviour change by describing existing patterns of behaviour and providing education about desired ideal behaviours. But these effects vary based on their design and delivery.
Although many studies showed the effectiveness of such interventions on clinician prescribing behaviours, few have looked at the prescriber and practice characteristics most predictive of behaviour changes.
Understanding which clinicians are most likely to respond positively is necessary for improving quality of care.


How was this review done?

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Boost for Oral Opioid Agonist Therapy

Although opioid agonist treatment is effective in treating opioid use disorders, retention in such treatment is suboptimal in part due to quality of care issues. A new initiative sought to boost treatment of opioid use disorders so that people stay there longer. This article describes how teams did in a structured quality improvement initiative in Vancouver, Canada. (more…)

Does alcohol use change after shift to Methadose?

alcohol drink, methadose
Do people drink more when they switch to Methadose? It is 10 times more concentrated than methadone –  proven treatment of opioid use disorder. We did not find more drinking after the switch. But others found changes in opioid use patterns coinciding with the change.

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We talked to 787 people receiving methadone for opioid use disorder in Vancouver, Canada.  Our new study followed them as they switched from methadone (1mg/mL) to Methadose (10mg/mL). We asked whether their drinking has changed after the switch – between 2013 and 2015. 16% said they drank too much at least once in the last six months. Those who drank too much were not more likely to do so after the shift to Methadose. The Substance Use& Misuse journal has published the study this week. 
Persons on methadone for opioid use disorder may report going through opioid withdrawal and increasing their illicit opioid use when switched to Methadose. We need to understand impacts of these changes on other forms of drug use. Careful and planned information about upcoming changes may help people cope with the potential risks better.

Conclusion

In sum, change is the law of life. Those who do not change do not survive in nature. For complex systems, such as health care, change management is the key to success. Healthy, happy and satisfied patients are healthcare’s success best proof. If they self-report negative experiences following methadone changes, their opinions should inform change management in order to build a better, patient-centered care. Their opinions, together with our findings, could help future formulary decisions in addiction treatment. Various methadone formulations may have little short-term impact on heavy alcohol use. Let’s evaluate the long-term impact.

Bring Audrey back: Teaching medical students about substance disorders

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When is the best time to teach medical students about substance related disorders?  In a new commentary published online in Annals of Internal Medicine, we bring Audrey’s story and call for better addiction medicine education for physicians.

For over 20 years at the University of British Columbia, the first year medical students have had 20 hours of teaching on the theme Addiction Medicine and Inter-collegial Responsibility which has been both highly rated by medical students and has improved their motivational interviewing.  (more…)