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Enhancing Future Healthcare Professional Education Surrounding Substance Use Disorders

Journal: Journal of Addiction Medicine Date: 2023/10, 17(5):Pages: e296-e297. doi: Subito , type of study: cross sectional study

Full text    (https://journals.lww.com/journaladdictionmedicine/citation/2023/09000/2023_poster_abstracts.32.aspx)

Keywords:

addiction [11]
cross sectional study [597]
medical students [402]
opioids [32]
osteopathic medicine [1540]
overdose prevention [1]
substance abuse [5]
USA [1086]

Abstract:

Background & Introduction: The opioid crisis remains a significant public health concern in the United States, with radically increasing rates of overdose deaths in recent years. Healthcare professionals report feeling inadequately prepared in this care area, while healthcare professional schools have limited curricular time to address this issue thoroughly. A recent review of this research was published, summarizing several studies evaluating attitudes and perceptions surrounding naloxone and buprenorphine dispensing. Barriers to dispensing include concerns about the clientele, moral and ethical issues, lack of education and training, workflow, and management support. Studies also found an association between education & training, increasing comfort levels and willingness to discuss and dispense these medications. In response, faculty and addiction professionals have cooperated to include opportunities for healthcare professional students to improve their understanding and comfort levels in addressing substance use disorder (SUD) and providing overdose prevention within their future practices. Methods: Roseman University College of Pharmacy (RUCOP) students attend harm reduction, overdose detection, and opioid overdose reversal training during first-year orientation. Additionally, RUCOP and Touro University (TU) faculty cooperatively designed and facilitated an Interprofessional Education (IPE) event to improve future healthcare professionals' understanding and comfort levels in addressing SUD and providing overdose prevention. Surrounding this event, an anonymous cross-sectional study was conducted with PRE- and POST-IPE surveys in Qualtrics. In 2022, 245 healthcare professional students were invited to complete a 17-question survey covering their understanding and comfort level with educating and counseling on naloxone, and familiarity with community resources. PRE- and POST-IPE survey results were compared in SPSS version 28 with an alpha set to 0.05 for superiority. Following completion of the IPE training, pharmacy students (in their terminal year) were provided an opportunity to shadow (1-2 days) or rotate (6 weeks) within a comprehensive outpatient substance use disorder treatment center as part of the Ambulatory Care advanced pharmacy practice experience (APPE). Upon completion, students completed an exit survey with free-form questions to assess perception or practice change. Results: In 2022, a total of 245 healthcare professional students participated in the SUD-focused IPE event; 229 (93.5%) completed the PRE-IPE survey and 129 (52.7%) completed the POST-IPE survey. Over 80% of respondents were 25 - 34 years of age, 60% were female, and approximately one-third were from pharmacy (RUCOP), one-third from physician assistant (TU-PA), and one-third from doctor of osteopathic medicine (TU-DO) programs. Significant improvements were observed with respect to level of understanding of naloxone (0.52, 95%CI 0.44-0.62) and comfort level surrounding counseling (0.99, 95%CI 0.85-1.14) and initiating naloxone conversations in high-risk patients (0.45, 95%CI 0.32-0.58) and persons living with opioid use disorder (0.54, 95%CI 0.43-0.66). Respondents reported improved familiarity with community opioid use disorder and overdose prevention resources (1.16, 95%CI 1.07-1.26). Following APPE rotations and shadowing opportunities, students provided responses themed around reduced stigma and increased compassionate care for persons with substance use disorders. Conclusion & Discussion: Early efforts to integrate more directed education allowed harm reduction and naloxone training during orientation for incoming students. This training also addressed and discussed community resources, stigmatizing language, and counseling on safe-use practices. Further along, RUCOP & TU faculty coordinated interprofessional education events to advance healthcare professional students' comfort levels in identifying and addressing substance use disorder, including an introduction to the screening, brief intervention, and referral to treatment (BIRT) principles and strategies. Finally, a RUCOP advanced pharmacy practice rotation was established, allowing students to engage within a comprehensive outpatient recovery treatment center. Collaborations with community partners have also expanded to expose students to enhanced learning opportunities. Through a layered-education approach, healthcare professional students gain a heightened level of awareness surrounding opioid use disorders; are more comfortable initiating conversation and addressing substance use disorder with a non-stigmatizing patient-centered approach; and report changes in perceptions of recovery that they will carry into their future practices.


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