VA Archives - AMERSA

New in SAj: Barriers and facilitators to changing drinking and receiving alcohol-related care: Interviews with Veterans Health Administration primary care patients who indicated interest but did not enroll in an alcohol care management intervention trial

Jul 10, 2022 by AMERSA

Most people with alcohol use disorder do not receive treatment, and primary care (PC)-based management of alcohol use disorder is a key strategy to close this gap. Understanding PC patients’ perspectives on changing drinking and receiving alcohol-related care is important for this goal, particularly among those who decline alcohol-related care. This study examined perspectives on barriers and facilitators to changing drinking and receiving alcohol-related care among Veterans Health Administration (VA) PC patients who indicated interest but did not enroll in the Choosing Healthier drinking Options In primary CarE trial (CHOICE), which tested a PC-based alcohol care management intervention.

This original research paper comes from authors Madeline C. Frost, MPH,Theresa E. Matson, MPH, Julie E. Richards, PhD MPH, Amy K. Lee, MPH, Carol E. Achtmeyer, MN ARNP, Katharine A. Bradley, MD MPH, and Emily C. Williams, PhD MPH.

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The Authors’ Own Words: Outpatient Continuing Care after Residential Substance Use Disorder Treatment in the U.S. Veterans Health Administration: Facilitators and Challenges

Jan 21, 2020 by AMERSA

The Authors’ Own Words:

We ask authors to describe their impressions regarding the implications of their accepted work, how their findings will change practice, and what is noteworthy about the work.

Outpatient Continuing Care after Residential Substance Use Disorder Treatment in the U.S. Veterans Health Administration: Facilitators and Challenges

Anna D. Rubinsky, PhD, MS; Laura S. Ellerbe, MS; Shalini Gupta, MS; Tyler E. Phelps, MLIS, MS; Thomas Bowe, PhD; Jennifer L. Burden, PhD; & Alex H. S. Harris, PhD, MS

Substance Abuse Vol. 39, Iss. 3, 2018

“We found wide variation in rates of outpatient continuing care across VHA’s 97 residential SUD treatment programs, despite policy requirements for follow-up care within a week of discharge, suggesting substantial opportunity for quality improvement. These findings also suggest that administrative data-based metrics could be useful for monitoring SUD continuing care following residential treatment. Moreover, this study identified key facilitators of and barriers to SUD continuing care. The candidate “best practices” from high-performing programs could inform the design and testing of targeted quality improvement strategies to improve rates of SUD continuing care, particularly in low-performing programs that may be high-value targets for quality improvement.”

The Authors’ Own Words: Underutilization of the current clinical capacity to provide buprenorphine treatment for Opioid Use Disorders within the Veterans Health Administration

Jan 19, 2020 by AMERSA

The Authors’ Own Words:

We ask authors to describe their impressions regarding the implications of their accepted work, how their findings will change practice, and what is noteworthy about the work.

Underutilization of the current clinical capacity to provide buprenorphine treatment for Opioid Use Disorders within the Veterans Health Administration

Helen Valenstein-Mah, PhD; Hildi Hagedorn, PhD; Chad L. Kay, PharmD; Melissa L. Christopher, PharmD; & Adam J. Gordon, MD, MPH

Substance Abuse Vol. 39, Iss. 3, 2018

“This manuscript highlights a discrepancy between the capacity of Veterans Health Administration (VHA) providers credentialed to prescribe buprenorphine, a first line treatment for Opioid Use Disorder, and the number of buprenorphine prescriptions these providers wrote over a six month period. The study found that VHA providers are prescribing buprenorphine below their capacity. These findings help to focus implementation efforts, and suggest that the VHA needs to not only focus on increasing the number of providers credentialed to prescribe buprenorphine, but also address barriers to prescribing at the patient-, provider-, and system-level to ensure veterans get effective treatment for Opioid Use Disorder.”

The Authors’ Own Words: Implementation and Evaluation of an Opioid Overdose Education and Naloxone Distribution (OEND) Program at a Veterans Affairs Medical Center (VAMC)

Jan 7, 2020 by AMERSA

The Authors’ Own Words:

We ask authors to describe their impressions regarding the implications of their accepted work, how their findings will change practice, and what is noteworthy about the work.

Implementation and Evaluation of an Opioid Overdose Education and Naloxone Distribution (OEND) Program at a Veterans Affairs Medical Center (VAMC)

Julienne B. Pauly PharmD, BCPP; Christine M. Vartan PharmD, BCPS; & Abigail T. Brooks PharmD, BCPS

Substance Abuse Vol. 39, Iss. 2, 2018

“Being that accidental opioid overdose has become a national epidemic, it is important to educate all individuals who utilize opioids on risk mitigation strategy. Patients on chronic prescribed opioid therapy were referred to participate in this VAMC OEND programming; many were surprised to learn that despite being on an opioid regimen long-term, accidental overdose can still occur. Participants were encouraged to bring a significant other/friend to the education or identify someone to teach, as the bystander will likely be applying this life-saving information. The project authors also calculated the risk index for overdose (RIOSORD) and serious opioid induced respiratory depression (OIRD) score on all OEND participants. The RIOSORD/ORID is a novel tool that can be utilized by facilities seeking to target patients for OEND or similar programming. The findings and failures of this project can be utilized by other facilities who desire to allocate resources to OEND programming.”