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Quality preventive initiative and clinical prevention intervention

Quality preventive initiative and clinical prevention intervention

Sample Answer 

Quality preventive initiative and clinical prevention intervention

Introduction

In the late 90s, the medical community got reassurance from the pharmaceutical companies that the prescription of opioid pain relievers would not lead to addictions. Years later, this has turned into a lie as statistics reveal that many Americans are not only addicted to opioids but are dying from opioid-related addiction. According to a research study by the Centers for Disease Control and Prevention, more than 130 people die in the US following an opioid overdose (Connery, 2015). This research also indicated that the government spends about $78 billion annually on prescription opioid misuse alone, which is constantly increasing the economic burden. While a solution is required to curb the prescription’s mortality and economic and social impacts, research continues to seek alternative solutions to manage opioid use disorder (OUD).

The CDC also estimates that, in 2016, approximately 2.1 million Americans were diagnosed with opioid use disorder, which includes the abuse of prescribed medications, the use of illegally obtained heroin, or diverted use of opioid medication (Schuchat, Debra, Grey, & Guy, 2017). According to medicine, opioids work by attaching themselves to the receptors in the brain, thereby sending the opioid effect signals to the brain. These signals slow breathing, blocks pain, and have a generally tranquil and anti-depressing effect that confuses the brain with pleasure instead of pain (Nelson, juurlink, & Perrone, 2015). Despite the challenges of the increasingly adverse effects of opioid prescriptions, patients should undergo behavioral and cognitive therapy management to minimize addiction because the prescriptions have yielded significant success in chronic pain management, which makes them indispensable.

Methods

After developing the research topic and the research thesis, I searched in the GCU library. The keywords for the search included opioid, opioid use disorder, cognitive behavioral therapy, and rehabilitation centers. After the search produced several articles, I synthesized the search to include articles published within the previous five years. I addressed the PICOT statement, including the population/problem, intervention, comparison, outcome, and time as discussed in Part A of this assignment. After considering a range of sources, the articles discussed in the subsequent sections of this paper proved relevant and accurate for the literature review.

Part A: Annotation

McCarthy, E., Stevens, J., Mukama, K., & Douglas, J. (2017, September). Hospitalizations, Costs, and Outcomes Associated with Heroin and Prescription Opioid Overdoses in the United States 2001-12. Addiction, 112(9), 1558-1564.

This article discusses heroin and opioid overdose disorders and hospital admissions related to these cases. The study delves into the overdose-associated costs, admissions, patient characteristics, and outcomes between 2001 and 2012. The participants of the survey were hospital admissions aged above 18 years diagnosed with OUD or heroin overdose disorder (HOD). The study sample size was 133,610 patients, which comprised 122,147 and 16,463 patients diagnosed with OUD and HOD, respectively (McCarthy, Stevens, Mukama, & Douglas, 2017).

The research measured the admission rates per 100 000 people and other demographics such as hospital length-of-stay, costs, and in-patient mortality. The research findings indicated that the HOD and OUD admissions increased by about 0.11 and 1.25 percent per 100,000 people, which led to $4.1 million and $46.0 million increase in annual expenses, respectively (McCarthy, Stevens, Mukama, & Douglas, 2017). In conclusion, this research found that the costs and rates of prescription opioid and heroin overdose-related admissions substantially increased within the period of study, which suggests that the burden of OUD may outstretch the infrastructure and finances of the hospitals in the United States (McCarthy, Stevens, Mukama, & Douglas, 2017).

Shiner, B., Westgate, L. C., Bernady, N., Schnurr, P., & Watts, B. (2017, July-September). Trends in opioid Use Disorder Diagnoses and Medication Treatment among Veterans with Posttraumatic Stress Disorder. Journal of Dual Diagnosis, 13(3), 201-202. doi:10.1080/15504263.2017.1325033

While taking into consideration the scarcity of data on the prevalence of OUD in patients diagnosed with Posttraumatic Stress Disorder (PTSD), this research study sought to determine the prevalence of OUD and the use of medications for the same in patients with PTSD. While studying the pharmacy and administrative data for 731,520 veterans who initiated PTSD treatment between 2004 and 2013, the research found that 2.7 percent were diagnosed with comorbid OUD (Shiner, Westgate, Bernady, Schnurr, & Watts, 2017). Results also suggest that 29.6 percent of this population received medication for the disorder. The study also compared the research variables with demographics such as age, marital status, race, economic status, and rural-urban balance. In conclusion, the research study’s findings suggested that OUD is uncommon but increases comorbidity among PTSD patients (Shiner, Westgate, Bernady, Schnurr, & Watts, 2017.

Kakko, J., Alho, H., Baldacchino, A., Molina, R. N., & Shaya, G. (2019, 8 30). Craving in Opioid Use Disorder: From Neurobiology to Clinical Practice. Frontiers in Psychiatry, 1-12.

The authors of this research study placed craving for opioids at the center of their research. According to this research, craving, which is defined as the overwhelmingly strong desire to use a drug, forms the essential component of opioid use disorder and other substance-related disorders (Kakko, Alho, Baldacchino, Molina, & Shaya, 2019). The study discusses the neuroendocrine and neurobiological pathways that support craving in opioid use disorder. It also delves into the significance of assessing and treating the craving in OUD in clinical practice. To improve the quality of life for the patients, the treatment should be targeted at reducing the risk of relapse since the study strongly associated craving with patients returning to the misuse of opioids (Kakko, Alho, Baldacchino, Molina, & Shaya, 2019). It suggested that opioid agonist therapy (OAT) and other non-pharmacological approaches, such as cognitive behavioral therapy, can significantly reduce the risk of relapse and craving in OUD.

Barry, D., Beitel, M., Cutter, C., Fiellin, D., Kerns, R., Moore, B., Schottenfeld, R. (2019, January 1). An Evaluation of the Feasibility, Acceptability, and Preliminary Efficacy of Cognitive-Behavioral Therapy for Opioid Use Disorder Chronic Pain. In Drug and Alcohol Dependence, 194, 460-467. doi:10.1016/j.drugalcdep.2018.10.015

This research study highlighted cognitive behavioral therapy for OUD pain and concluded that cognitive-behavioral therapy (CBT) is acceptable and feasible for opioid use disorder patients. While comparing the results of a 12-week pilot study, which assigned patients to cognitive behavioral therapy and methadone-maintained patients, the findings of the study suggested that CBT is not only feasible but also acceptable in clinical and psychological practice but also feasible in drug and substance counseling (Barry, et al., 2019). Therefore, research generally suggests that CBT can be used as a nonmedical method to manage opioid use disorder and chronic pain.

Stoicea, N., Costa, A., Uribe, A., Weaver, T., & Bergese, S. (2019, May). Current perspectives on the opioid crisis in the US healthcare system: A comprehensive literature review. Medicine (Baltimore), 98(20), e15425. doi:10.1097/MD.0000000000015425

This research study investigates the history of the use of opioids in pain management and preventing further recurrence in long-term recovery among patients. In the research study, the authors conducted searches in Google Scholar and other databases between 1999 and 2018, according to PRISMA guidelines (Stoicea, et al., 2019). Some of the keywords in the searches included opioid consumption, opioids, over-prescription, and opioid epidemic. In the findings that sampled 7160 articles, the researchers concluded that, with about 100 million people suffering from acute and chronic pain in the US in 2016, more than 66 percent of overdose cases were related to opioids.

Part B:

Pharmaceutical companies convinced the medical community in the 90s that the therapeutic use of opioids to relieve pain would not lead to addictions. However, research findings have associated the misuse of opioids with relapse in treatment and patients returning to opioid use (Kakko, Alho, Baldacchino, Molina, & Shaya, 2019). With the increasing hospital admission related to opioid abuse disorders, the economic burden is soon weighing down the efforts of the government to provide healthcare services to the citizens as well as stretching hospital finances and infrastructure (McCarthy, Stevens, Mukama, & Douglas, 2017). The healthcare sector should devise a means of managing the opioid crisis.

Subsequent studies to curb the addictions resulting from the medical use of opioids have strongly suggested cognitive behavioral therapy in clinical and psychosocial therapy sessions (Barry, et al., 2019). Therefore, while the continued use of opioids in pain management cannot be dispensed of, CBT should be administered to patients after they are put on the former treatment and management. According to the findings of a study by Barry, et al. (2019), CBT ranked higher than methadone-maintained patients in pain management through nonmedical interventions to manage pain.

Finally, despite the ongoing debates to establish working relationships between policymakers and researchers aimed at providing evidence-based policy references, more needs to be done. Additionally, further research should focus on the screening for opioid use disorder and the epidemiology of OUD since the articles that were selected did not provide sufficient evidence on the above. The reviewed articles proved that while many people might be victims of OUD, very few screenings are conducted, leading to increased relapses, which are not addressed early.

References

Barry, D., Beitel, M., Cutter, C., Fiellin, D., Kerns, R., Moore, B., Schottenfeld, R. (2019, January 1). An Evaluation of the Feasibility, Acceptability, and Preliminary Efficacy of Cognitive-Behavioral Therapy for Opioid Use Disorder Chronic Pain. In Drug and Alcohol Dependence, 194, 460-467. doi:10.1016/j.drugalcdep.2018.10.015

Connery, H. S. (2015, April). Medication-Assisted Treatment of Opioid Use Disorder: Review of the Evidence and Future Directions. Harvard Review of Psychiatry, 23(2), 63-75. doi:10.1097/HRP.0000000000000075

Kakko, J., Alho, H., Baldacchino, A., Molina, R. N., & Shaya, G. (2019, 8 30). Craving in Opioid Use Disorder: From Neurobiology to Clinical Practice. Frontiers in Psychiatry, 1-12.

McCarthy, E., Stevens, J., Mukama, K., & Douglas, J. (2017, September). Hospitalizations, Costs, and Outcomes Associated with Heroin and Prescription Opioid Overdoses in the United States 2001-12. Addiction, 112(9), 1558-1564.

Nelson, L., juurlink, D., & Perrone, J. (2015, October 13). Addressing the Opioid Epidemic. Journal of American Medical Association, 314(14), 1453-1454. doi:10.1001/jama.2015.12397

Schuchat, A., Debra, H., Grey, P., & Guy, J. (2017, August 1). New Data on Opioid Use and Prescribing in the United States. Journal of American Medical association, 318(3), 425-426. doi:10.1001/jama.2017.8913

Shiner, B., Westgate, L. C., Bernady, N., Schnurr, P., & Watts, B. (2017, July-September). Trends in opioid Use Disorder Diagnoses and Medication Treatment among Veterans with Posttraumatic Stress Disorder. Journal of Dual Diagnosis, 13(3), 201-202. doi:10.1080/15504263.2017.1325033

Stoicea, N., Costa, A., Uribe, A., Weaver, T., & Bergese, S. (2019, May). Current perspectives on the opioid crisis in the US healthcare system: A comprehensive literature review. Medicine (Baltimore), 98(20), e15425. doi:10.1097/MD.0000000000015425

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Question 


Quality preventive initiative and clinical prevention intervention

Benchmark – Part B: Literature Review

In Part A, you described the population and quality initiative related to your PICOT (Population/Problem, Intervention, Comparison, Outcome, and Time to achieve the outcome) statement. In this assignment, you will formalize your PICOT and research process.

Use the GCU Library to perform a search for peer-reviewed research articles. Find five peer-reviewed primary source translational research articles.

In a paper of 1,250-1,500 words, synthesize the research into a literature review. The literature review should provide an overview for the reader that illustrates the research related to your particular PICOT. Include the following:

Introduction: Describe the clinical issue or problem you are addressing.

Quality preventive initiative and clinical prevention intervention

Quality preventive initiative and clinical prevention intervention

Methods: Describe the criteria you used in choosing your articles
Synthesize the Literature: Part A: Discuss the main components of each article (subjects, methods, key findings) and provide rationale for how this supports your PICOT; Part B: Compare and contrast the articles: Discuss limitations, controversies, and similarities/differences of the studies.
Areas of Further Study: Analyze the evidence presented in your articles to identify what is known, unknown, and requires further study.
You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

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