Primary Care Residents Delivering Care: Integration of Office-Based Opioid Treatment into an Internal Medicine Residency Curriculum

Sobel, Halle G.; Goedde, Michael; Maruti, Sanchit; Strout, Emily K Hadley; Wahlberg, Elizabeth A; Kennedy, Amanda G.

doi:10.1007/s40596-019-01069-z

Cited by 5 publications

(16 citation statements)

References 13 publications

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“…Of the 18 included studies, two were randomized control trials (Rossom et al, 2021; Zittleman et al, 2020), seven were cross‐sectional (Foti et al, 2021; Harder et al, 2021; Hawkins et al, 2021; Sell & Visconti, 2020; Sinclair et al, 2020; Wolk et al, 2019), seven were pretest–posttest (Cantone et al, 2018; Cavitt et al, 2022; Coplin, 2019; Kirk et al, 2020; Lockett et al, 2018; Pytell et al, 2019; Sobel et al, 2019; Tofighi et al, 2019), one was a narrative review (Louie et al, 2019), and one was a report from the National Academy of State Health Policy (Townley & Dorr, 2017). The defining attributes, antecedents, consequences, case scenarios, and empirical referents of PCP confidence in addressing OUD were informed by a critical analysis of the 18 included studies.…”

Section: Resultsmentioning

confidence: 99%

“…Asking providers to evaluate their confidence on a scale (i.e., from strongly disagree to strongly agree; Lockett et al, 2018) suggests that there are certain levels of PCP confidence. The authors of studies with pretest–posttest designs included in this concept analysis evaluated PCP confidence pre‐ and postimplementation of an intervention to examine whether confidence changed following an implementation strategy such as training or education (Coplin, 2019; Lockett et al, 2018; Pytell et al, 2019; Rossom et al, 2021; Sobel et al, 2019; Tofighi et al, 2019; Zittleman et al, 2020). For example, Lockett et al (2018) evaluated PCP confidence in addressing OUD before and after a one hour educational session focused on OUD and naloxone kit administration.…”

Section: Resultsmentioning

confidence: 99%

“…Training influences PCP confidence by contributing to the experience PCPs have in addressing OUD (Harder et al, 2021; Kirk et al, 2020; Townley & Dorr, 2017; Wolk et al, 2019). Didactic sessions with case discussions (Tofighi et al, 2019), pairing PCPs with experienced OUD providers for mentoring and observation (Louie et al, 2019; Sobel et al, 2019; Tofighi et al, 2019), or team‐based learning opportunities (Zittleman et al, 2020) were all associated with increased PCP confidence in addressing OUD. Primary care providers who were trained through independent longitudinal management of a few (i.e., 3–5) patients with OUD under the supervision of an experienced provider also reported increased confidence (Coplin, 2019; Louie et al, 2019; Sobel et al, 2019).…”

Section: Resultsmentioning

confidence: 99%

“…The findings of five studies suggested that team‐based, supportive care environments including those with access to collaborating behavioral health clinicians, nurse case managers, or pharmacists for consultations was associated with increased PCP confidence (Cantone et al, 2018; Coplin, 2019; Louie et al, 2019; Sinclair et al, 2020; Wolk et al, 2019). The results of four studies suggest that simply having a buprenorphine waiver (a resource for treating OUD) was associated with increased PCP confidence (Coplin, 2019; Harder et al, 2021; Louie et al, 2019; Sobel et al, 2019). Support systems and resource availability may contribute to feelings of readiness to address OUD, a defining attribute of PCP confidence.…”

Section: Resultsmentioning

confidence: 99%

“…The findings of this concept analysis suggest that experience—defined as “something personally encountered, undergone, or lived through” (Merriam‐Webster, 2021c)—may be an attribute found in most confident PCPs who addressed OUD. In their pretest‐posttest study, Sobel et al (2019) fostered PCP residents' confidence through expanded experiences caring for patients with OUD. Compared to X‐waivered providers (i.e., those with a federal waiver to prescribe buprenorphine, the gold‐standard treatment for OUD), nonwaivered PCPs may be less confident in addressing OUD (Rossom et al, 2021).…”

Section: Resultsmentioning

confidence: 99%

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Primary care provider confidence in addressing opioid use disorder: A concept analysis

Turi

McMenamin

Wolk

et al. 2023

Research in Nursing & Health

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Primary care providers (PCPs) are well‐positioned to provide care for opioid use disorder (OUD), yet very few address OUD regularly. One contributing factor may be PCPs' lack of confidence in their ability to effectively treat OUD. Evidence demonstrates that clinician confidence in home care and hospital settings is associated with improved care delivery and patient outcomes. However, a conceptual definition of PCP confidence in addressing OUD has yet to be established. The aim of this concept analysis is to enhance conceptual understanding of PCP confidence in addressing OUD and inform future measurement strategies. Following Walker and Avant's method of concept analysis, PubMed, PsycINFO, and Google Scholar were searched in October 2021. Manuscripts were included if they referenced confidence in relation to PCPs who provide care to adult patients with OUD. Studies conducted outside the US and not published in English were excluded. The search resulted in 18 studies which were synthesized to conceptualize PCP confidence in addressing OUD. Defining attributes include self‐efficacy, experience, and readiness to address OUD. These attributes may be influenced by organizational culture, training, support, and resources. Consequences of PCP confidence addressing OUD may include improved patient outcomes, improved delivery of and access to OUD care, and PCP attitude changes. This concept analysis—which grounds the concept of PCP confidence in addressing OUD in the theoretical and empirical literature—lays the framework for future measurement of the concept. This represents a critical first step towards developing strategies to enhance PCP confidence in addressing OUD.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Primary care provider confidence in addressing opioid use disorder: A concept analysis

Turi

McMenamin

Wolk

et al. 2023

Research in Nursing & Health

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Promoting scholarship in improvement science: A model for academic clinical departments

DeVoe

Kennedy

Tompkins

et al. 2022

Learning Health Systems

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Introduction Clinical departments at academic medical centers strive to deliver clinical care, provide education and training, support faculty development, and promote scholarship. These departments have experienced increasing demands to improve the quality, safety, and value of care delivery. However, many academic departments lack a sufficient number of clinical faculty members with expertise in improvement science to lead initiatives, teach, and generate scholarship. In this article, we describe the structure, activities, and early outcomes of a program within an academic department of medicine to promote scholarly improvement work. Methods The Department of Medicine at the University of Vermont Medical Center launched a Quality Program with three primary goals: (a) improve care delivery, (b) provide education and training, and (c) promote scholarship in improvement science. The program serves as a resource center for students, trainees and faculty, offering education and training, analytic support, consultation in design and methodology, and project management. It strives to integrate education, research, and care delivery to learn, apply evidence and improve health care. Results Over the first 3 years of full implementation, the Quality Program supported an average of 123 projects annually, including prospective clinical quality improvement initiatives, retrospective assessment of clinical programs and practices, and curriculum development and evaluation. The projects have yielded a total of 127 scholarly products, defined as peer‐reviewed publications and abstracts, posters, and oral presentations at local, regional, and national conferences. Conclusions The Quality Program may serve as a practical model for promoting care delivery improvement, training, and scholarship in improvement science while advancing the goals of a learning health system at the level of an academic clinical department. Dedicated resources within such departments offer the potential to enhance care delivery while promoting academic success for faculty and trainees in improvement science.

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Leading a Substance Use Disorder Clinic

Chan,

Tetrault,

Holt

2023

Leading an Academic Medical Practice

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Primary Care Residents Delivering Care: Integration of Office-Based Opioid Treatment into an Internal Medicine Residency Curriculum

Cited by 5 publications

References 13 publications

Primary care provider confidence in addressing opioid use disorder: A concept analysis

Primary care provider confidence in addressing opioid use disorder: A concept analysis

Promoting scholarship in improvement science: A model for academic clinical departments

Leading a Substance Use Disorder Clinic

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