Slides from a webinar held by the National SBIRT ATTC. Video is on TheIRETAChannel on Youtube: http://www.youtube.com/watch?v=f6NrKuGlGRs&feature=share&list=PLiML4AFpuB72LBaPShcu2yQv_WpsGY9a9
Scores screen, gives follow-up tool for any (+) response
-AUDIT, DAST-10 and/or or PHQ-9
Provider: Scores any follow-up tools, provides brief intervention or
referral as needed
-5-10 minutes for BI
-Referral as needed based on severity
determine severity, provides brief
intervention or referral as needed
–5-10 minutes for BI
–Referral as needed based on severity
• Medical records: Documents screen
results and any interventions
Front desk: Gives screen to patient
-Single-item alcohol and drug questions
-PHQ-2 for depression
Medical records: Documents screen results and any interventions
- Brief interventions (IBAs) delivered in healthcare settings can reduce alcohol consumption and related harms. IBAs typically involve 5 minutes of advice accompanied by self-help materials.
- Studies show IBAs lead to 13-34% reductions in weekly drinking. Even brief warning-based screening achieves reductions in alcohol use.
- Implementing IBAs faces challenges like competing priorities, but can be supported by training, funding, and setting achievable targets. The core mechanism of behavior change in IBAs remains unclear.
Addiction Medicine: Closing the Gap between Science and PracticeCenter on Addiction
These slides accompany CASAColumbia's report, Addiction Medicine: Closing the Gap between Science and Practice, published in June 2012, which found that, despite the prevalence of addiction, the enormity of its consequences, the availability of effective solutions and the evidence that addiction is a disease, both screening and early intervention for risky substance use are rare, and only about 1 in 10 people with addiction involving alcohol or drugs other than nicotine receive any form of treatment.
Shoveling Up II: The Impact of Substance Abuse on Federal, State and Local Bu...Center on Addiction
This report summarizes the findings of a study that analyzed spending on substance abuse and addiction by federal, state, and local governments in 2005. The study found that a total of $467.7 billion was spent, accounting for 10.7% of combined spending. Of this, $238.2 billion (9.6% of its budget) was spent by the federal government, $135.8 billion (15.7% of budgets) by state governments, and $93.8 billion (9.0% of budgets) by local governments. Over 95% of federal and state spending went to cope with the public costs of substance abuse through areas like health care, criminal justice, and child welfare, rather than on
This document discusses the emerging epidemic of hepatitis C virus (HCV) infection among young injection drug users. Rates of HCV have increased significantly in recent years, particularly among young white adults in non-urban areas who misuse prescription opioids and transition to injecting drugs like heroin. The prescription opioid epidemic has contributed to rising HCV cases by fueling non-medical opioid use and a subsequent rise in injection drug use. Effective prevention strategies include expanding access to syringe services programs and reducing the stigma around drug use to engage more young people in harm reduction.
go to www.medicaldump.com to download this file and check out other medical powerpoints, medical powerpoint templates, medical pdfs and all other medical documents.
Closing the treatment gap in alcohol dependence thessalonika 2015Antoni Gual
Lecture on the treatment gap (underdiagnose & undertreatment) of alcohol use disorders. Presented at the 5th Conference of the Greek Psychiatric society in Thessalonika, march 21st, 2015.
Scores screen, gives follow-up tool for any (+) response
-AUDIT, DAST-10 and/or or PHQ-9
Provider: Scores any follow-up tools, provides brief intervention or
referral as needed
-5-10 minutes for BI
-Referral as needed based on severity
determine severity, provides brief
intervention or referral as needed
–5-10 minutes for BI
–Referral as needed based on severity
• Medical records: Documents screen
results and any interventions
Front desk: Gives screen to patient
-Single-item alcohol and drug questions
-PHQ-2 for depression
Medical records: Documents screen results and any interventions
- Brief interventions (IBAs) delivered in healthcare settings can reduce alcohol consumption and related harms. IBAs typically involve 5 minutes of advice accompanied by self-help materials.
- Studies show IBAs lead to 13-34% reductions in weekly drinking. Even brief warning-based screening achieves reductions in alcohol use.
- Implementing IBAs faces challenges like competing priorities, but can be supported by training, funding, and setting achievable targets. The core mechanism of behavior change in IBAs remains unclear.
Addiction Medicine: Closing the Gap between Science and PracticeCenter on Addiction
These slides accompany CASAColumbia's report, Addiction Medicine: Closing the Gap between Science and Practice, published in June 2012, which found that, despite the prevalence of addiction, the enormity of its consequences, the availability of effective solutions and the evidence that addiction is a disease, both screening and early intervention for risky substance use are rare, and only about 1 in 10 people with addiction involving alcohol or drugs other than nicotine receive any form of treatment.
Shoveling Up II: The Impact of Substance Abuse on Federal, State and Local Bu...Center on Addiction
This report summarizes the findings of a study that analyzed spending on substance abuse and addiction by federal, state, and local governments in 2005. The study found that a total of $467.7 billion was spent, accounting for 10.7% of combined spending. Of this, $238.2 billion (9.6% of its budget) was spent by the federal government, $135.8 billion (15.7% of budgets) by state governments, and $93.8 billion (9.0% of budgets) by local governments. Over 95% of federal and state spending went to cope with the public costs of substance abuse through areas like health care, criminal justice, and child welfare, rather than on
This document discusses the emerging epidemic of hepatitis C virus (HCV) infection among young injection drug users. Rates of HCV have increased significantly in recent years, particularly among young white adults in non-urban areas who misuse prescription opioids and transition to injecting drugs like heroin. The prescription opioid epidemic has contributed to rising HCV cases by fueling non-medical opioid use and a subsequent rise in injection drug use. Effective prevention strategies include expanding access to syringe services programs and reducing the stigma around drug use to engage more young people in harm reduction.
go to www.medicaldump.com to download this file and check out other medical powerpoints, medical powerpoint templates, medical pdfs and all other medical documents.
Closing the treatment gap in alcohol dependence thessalonika 2015Antoni Gual
Lecture on the treatment gap (underdiagnose & undertreatment) of alcohol use disorders. Presented at the 5th Conference of the Greek Psychiatric society in Thessalonika, march 21st, 2015.
This document summarizes a presentation on smoking cessation. It discusses the mortality benefits of quitting smoking, including reduced risks of lung cancer and COPD. It identifies opportunities for smoking cessation counseling ("teachable moments") like surgery, pregnancy, and health screenings. The 5A's approach to counseling is reviewed, including asking about tobacco use, advising to quit, assessing willingness, assisting with quit plan/medication, and arranging follow-up. Medications and their effectiveness are summarized. Financial incentives and e-cigarettes are also briefly discussed.
Don Shenker from the Alcohol Health Network presented on supporting individuals to reduce their alcohol intake. The presentation covered:
1) The importance of early intervention and prevention of alcohol misuse in workplaces through encouraging self-awareness, providing advice and signposting services.
2) Research showing brief interventions and use of the AUDIT screening tool can help identify risky drinking and lead to behavior change.
3) Two studies by the Alcohol Health Network found online alcohol screening and feedback tools completed by employees significantly reduced drinking levels.
The document provides an overview of the Pharmacy, Podiatry, Optometry, and Dentistry (PPOD) Toolkit and Guide which aims to promote a collaborative team approach to diabetes care across these specialties. It discusses the background of diabetes in the US and the role of each specialty in managing the disease. The PPOD Guide offers education on each specialty area and how they can work together to help patients control their blood sugar, blood pressure, and cholesterol levels to reduce complications. The toolkit provides resources like fact sheets and checklists to help providers implement the PPOD approach.
Community Health Improvement Plan, Clermont County Ohio, Major Themes: obesity, tobacco use, drug use, mental health, infant mortality, breastfeeding, homelessness, secondary education for healthcare professionals, chronic disease issues, access to healthcare, inujury prevention, suicide, teen pregnancy, infectious diseases, alcohol abuse and aging population.
Medication non-adherence is a significant problem for older adults that can lead to worse health outcomes and increased healthcare costs. Many factors contribute to non-adherence in older patients, including complex medication regimens, lack of understanding about their conditions and treatments, side effects, and social determinants. Assessing adherence and addressing the underlying factors through clear communication, education, and simplifying regimens can help improve medication taking in older adults.
This document discusses sepsis, post-sepsis syndrome, and the benefits of early hospice referral. Key points include:
- Sepsis affects millions worldwide each year and is a leading cause of death in hospitals. Survivors often experience post-sepsis syndrome with new physical and cognitive impairments.
- Early identification of sepsis and standardized hospital treatment can improve outcomes, but there is no consensus on best post-acute care. Hospice may be appropriate for some patients.
- Over 40% of sepsis patients who die in the hospital meet hospice eligibility guidelines upon admission due to underlying terminal conditions exacerbated by sepsis. Hospice referral rates for sepsis patients remain low compared to non-
This document discusses frequent flyers (FF), defined as patients who make 3-12 emergency department visits per year. FF account for 20-30% of annual ED visits despite constituting only 4% of patients. While FF contribute to overcrowding, overcrowding has many causes and low-complexity FF impact it little. FF often have complex medical and social issues like chronic diseases and substance abuse. They rely on the ED as a primary source of care. Targeted interventions like care management programs and on-site clinics have shown success in reducing FF visits and associated costs. Comprehensive approaches are needed to address the needs of this vulnerable population.
This document discusses frequent flyers (FF), defined as patients who make 3-12 emergency department visits per year. FF account for 20-30% of annual ED visits despite constituting only 4% of patients. While FF contribute to overcrowding, overcrowding has many causes and low-complexity FF impact it little. FF often have complex medical and social issues like chronic diseases and substance abuse. They rely on the ED as a primary source of care. Targeted interventions like care management programs and on-site clinics have shown success in reducing FF visits and associated costs. Comprehensive approaches are needed to address this mixed patient population.
The document describes a partnership program called IMPACT: Diabetes that implemented a team-based, pharmacist-integrated model of diabetes care in safety-net clinics. Key aspects of the program included establishing collaborative practice agreements to define the pharmacists' scope of practice, referring patients to pharmacists for primary care visits, and utilizing a multi-disciplinary care team approach. Initial results found improvements in A1c, lipid, and blood pressure levels as well as high rates of patient satisfaction with the pharmacist-led care model.
This document discusses guidelines for reducing chronic harms from substance use through early intervention, prevention, detection, treatment, and rehabilitation. It outlines strategies for screening and brief interventions by frontline healthcare workers to identify problematic substance use and associated physical, mental, and social harms. Screening should assess medical history, high-risk behaviors, mental health, social support systems, and impact on families. The goal is to help those at risk of harm and refer them to early treatment and support services.
De las intervenciones breves a los farmacos. malaga 2015 Antoni Gual
Conferencia sobre los problemas derivados del alcoholismo y su tratamiento, impartida el 6 de marzo del 2015 en la reunión de la Red de Trastornos Adictivos, realizada el Hospital Universitario de Málaga
Medication Adherence Trends in North CarolinaRobert Nauman
This document summarizes key findings from the 2010 North Carolina Behavioral Risk Factor Surveillance System (BRFSS) survey regarding prescription medication adherence. The BRFSS is an annual phone survey of state residents aged 18 and older on health behaviors and risks. In 2010, the NC survey included a module on prescription adherence. It found that 17% of respondents statewide reported not filling a prescription in the past year, most commonly due to concerns about side effects or believing the medication would not help. Rates varied by demographic factors. The report identifies groups most at risk of non-adherence and next steps.
Star Ratings are increasingly challenging to maintain and improve upon each year. It is incredibly important to improve upon programs each year. What you were doing last year may not earn you the same Star Rating due to increasing cut points. Focusing on pharmacy measures and the patients with diabetes may be a great way to improve upon those ratings.
The document summarizes the results of a survey of 1000 residents in Barnet, UK that was conducted to understand residents' perceptions of health and healthcare services. Some key findings from the survey include:
- 35-44 year olds were most likely to rate their health as good, while 18-24 year olds were least likely.
- Respondents of white ethnicity were more likely than non-white respondents to rate their health as good.
- Satisfaction with healthcare services, including GPs, was generally higher among white respondents, older respondents, and those in lower socioeconomic groups, while satisfaction was lower among ethnic minorities, younger people, and those in higher socioeconomic groups.
Tackling the Top 5 Barriers to Medication AdherenceHealth Dialog
A lack of medication adherence can lead to poor clinical outcomes, higher hospital admissions and rising spend for your organization. On top of that, CMS Star point rates are also increasing year after year, making it increasingly difficult to obtain a 5 Star rating. It can be tough thinking about how to start building an effective strategy to increase adherence in your population.
We will overview the top struggles with medication adherence in populations and how to use predictive analytics, tailored outreach and patient engagement, and behavior change programs to overcome them.
The path to medication adherence is filled with road blocks. In order to overcome what is stopping your population from taking their medication as prescribed understanding the barriers is key.
Here are the 11 DSM-5 criteria for substance use disorder filled in with the blank (___) replaced with "alcohol":
1. Alcohol is often taken in larger amounts or over a longer period than was intended.
2. There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
3. A great deal of time is spent in activities necessary to obtain alcohol, or recover from its effects.
4. Craving, or a strong desire or urge to use alcohol
5. Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.
6. Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused
This document summarizes a presentation on urine drug testing and monitoring prescription drug use. It discusses how prescription drug monitoring programs identify, investigate, and address fraud, waste and abuse related to prescription drug use and urine drug testing. It outlines trends seen in urine drug testing results that indicate issues with adherence, illicit drug use, and inconsistencies between prescribed medications and test results. Best practices are discussed for utilizing utilization review, case management, and other tools to help ensure appropriate use of medications and compliance with treatment regimens. The impacts of compounds, opioids, and long term opioid use are also addressed.
This document summarizes a presentation on smoking cessation. It discusses the mortality benefits of quitting smoking, including reduced risks of lung cancer and COPD. It identifies opportunities for smoking cessation counseling ("teachable moments") like surgery, pregnancy, and health screenings. The 5A's approach to counseling is reviewed, including asking about tobacco use, advising to quit, assessing willingness, assisting with quit plan/medication, and arranging follow-up. Medications and their effectiveness are summarized. Financial incentives and e-cigarettes are also briefly discussed.
Don Shenker from the Alcohol Health Network presented on supporting individuals to reduce their alcohol intake. The presentation covered:
1) The importance of early intervention and prevention of alcohol misuse in workplaces through encouraging self-awareness, providing advice and signposting services.
2) Research showing brief interventions and use of the AUDIT screening tool can help identify risky drinking and lead to behavior change.
3) Two studies by the Alcohol Health Network found online alcohol screening and feedback tools completed by employees significantly reduced drinking levels.
The document provides an overview of the Pharmacy, Podiatry, Optometry, and Dentistry (PPOD) Toolkit and Guide which aims to promote a collaborative team approach to diabetes care across these specialties. It discusses the background of diabetes in the US and the role of each specialty in managing the disease. The PPOD Guide offers education on each specialty area and how they can work together to help patients control their blood sugar, blood pressure, and cholesterol levels to reduce complications. The toolkit provides resources like fact sheets and checklists to help providers implement the PPOD approach.
Community Health Improvement Plan, Clermont County Ohio, Major Themes: obesity, tobacco use, drug use, mental health, infant mortality, breastfeeding, homelessness, secondary education for healthcare professionals, chronic disease issues, access to healthcare, inujury prevention, suicide, teen pregnancy, infectious diseases, alcohol abuse and aging population.
Medication non-adherence is a significant problem for older adults that can lead to worse health outcomes and increased healthcare costs. Many factors contribute to non-adherence in older patients, including complex medication regimens, lack of understanding about their conditions and treatments, side effects, and social determinants. Assessing adherence and addressing the underlying factors through clear communication, education, and simplifying regimens can help improve medication taking in older adults.
This document discusses sepsis, post-sepsis syndrome, and the benefits of early hospice referral. Key points include:
- Sepsis affects millions worldwide each year and is a leading cause of death in hospitals. Survivors often experience post-sepsis syndrome with new physical and cognitive impairments.
- Early identification of sepsis and standardized hospital treatment can improve outcomes, but there is no consensus on best post-acute care. Hospice may be appropriate for some patients.
- Over 40% of sepsis patients who die in the hospital meet hospice eligibility guidelines upon admission due to underlying terminal conditions exacerbated by sepsis. Hospice referral rates for sepsis patients remain low compared to non-
This document discusses frequent flyers (FF), defined as patients who make 3-12 emergency department visits per year. FF account for 20-30% of annual ED visits despite constituting only 4% of patients. While FF contribute to overcrowding, overcrowding has many causes and low-complexity FF impact it little. FF often have complex medical and social issues like chronic diseases and substance abuse. They rely on the ED as a primary source of care. Targeted interventions like care management programs and on-site clinics have shown success in reducing FF visits and associated costs. Comprehensive approaches are needed to address the needs of this vulnerable population.
This document discusses frequent flyers (FF), defined as patients who make 3-12 emergency department visits per year. FF account for 20-30% of annual ED visits despite constituting only 4% of patients. While FF contribute to overcrowding, overcrowding has many causes and low-complexity FF impact it little. FF often have complex medical and social issues like chronic diseases and substance abuse. They rely on the ED as a primary source of care. Targeted interventions like care management programs and on-site clinics have shown success in reducing FF visits and associated costs. Comprehensive approaches are needed to address this mixed patient population.
The document describes a partnership program called IMPACT: Diabetes that implemented a team-based, pharmacist-integrated model of diabetes care in safety-net clinics. Key aspects of the program included establishing collaborative practice agreements to define the pharmacists' scope of practice, referring patients to pharmacists for primary care visits, and utilizing a multi-disciplinary care team approach. Initial results found improvements in A1c, lipid, and blood pressure levels as well as high rates of patient satisfaction with the pharmacist-led care model.
This document discusses guidelines for reducing chronic harms from substance use through early intervention, prevention, detection, treatment, and rehabilitation. It outlines strategies for screening and brief interventions by frontline healthcare workers to identify problematic substance use and associated physical, mental, and social harms. Screening should assess medical history, high-risk behaviors, mental health, social support systems, and impact on families. The goal is to help those at risk of harm and refer them to early treatment and support services.
De las intervenciones breves a los farmacos. malaga 2015 Antoni Gual
Conferencia sobre los problemas derivados del alcoholismo y su tratamiento, impartida el 6 de marzo del 2015 en la reunión de la Red de Trastornos Adictivos, realizada el Hospital Universitario de Málaga
Medication Adherence Trends in North CarolinaRobert Nauman
This document summarizes key findings from the 2010 North Carolina Behavioral Risk Factor Surveillance System (BRFSS) survey regarding prescription medication adherence. The BRFSS is an annual phone survey of state residents aged 18 and older on health behaviors and risks. In 2010, the NC survey included a module on prescription adherence. It found that 17% of respondents statewide reported not filling a prescription in the past year, most commonly due to concerns about side effects or believing the medication would not help. Rates varied by demographic factors. The report identifies groups most at risk of non-adherence and next steps.
Star Ratings are increasingly challenging to maintain and improve upon each year. It is incredibly important to improve upon programs each year. What you were doing last year may not earn you the same Star Rating due to increasing cut points. Focusing on pharmacy measures and the patients with diabetes may be a great way to improve upon those ratings.
The document summarizes the results of a survey of 1000 residents in Barnet, UK that was conducted to understand residents' perceptions of health and healthcare services. Some key findings from the survey include:
- 35-44 year olds were most likely to rate their health as good, while 18-24 year olds were least likely.
- Respondents of white ethnicity were more likely than non-white respondents to rate their health as good.
- Satisfaction with healthcare services, including GPs, was generally higher among white respondents, older respondents, and those in lower socioeconomic groups, while satisfaction was lower among ethnic minorities, younger people, and those in higher socioeconomic groups.
Tackling the Top 5 Barriers to Medication AdherenceHealth Dialog
A lack of medication adherence can lead to poor clinical outcomes, higher hospital admissions and rising spend for your organization. On top of that, CMS Star point rates are also increasing year after year, making it increasingly difficult to obtain a 5 Star rating. It can be tough thinking about how to start building an effective strategy to increase adherence in your population.
We will overview the top struggles with medication adherence in populations and how to use predictive analytics, tailored outreach and patient engagement, and behavior change programs to overcome them.
The path to medication adherence is filled with road blocks. In order to overcome what is stopping your population from taking their medication as prescribed understanding the barriers is key.
Here are the 11 DSM-5 criteria for substance use disorder filled in with the blank (___) replaced with "alcohol":
1. Alcohol is often taken in larger amounts or over a longer period than was intended.
2. There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
3. A great deal of time is spent in activities necessary to obtain alcohol, or recover from its effects.
4. Craving, or a strong desire or urge to use alcohol
5. Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.
6. Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused
This document summarizes a presentation on urine drug testing and monitoring prescription drug use. It discusses how prescription drug monitoring programs identify, investigate, and address fraud, waste and abuse related to prescription drug use and urine drug testing. It outlines trends seen in urine drug testing results that indicate issues with adherence, illicit drug use, and inconsistencies between prescribed medications and test results. Best practices are discussed for utilizing utilization review, case management, and other tools to help ensure appropriate use of medications and compliance with treatment regimens. The impacts of compounds, opioids, and long term opioid use are also addressed.
Public health professionals identify issues as public health problems based on key criteria like the size and severity of the problem's impact, availability of interventions, and economic and social effects. They examine leading causes of death and illness across populations to determine which medical issues warrant public health concern and action. Public health threats can include infectious diseases and other issues that negatively impact large groups, like addiction or natural disasters. Experts consider the criteria to prioritize problems and develop evidence-based solutions to address current and emerging threats to community well-being.
This document provides information on screening for substance use in specialty populations, specifically adolescents and pregnant women. It discusses the importance of screening in these groups due to risks of substance use on development and health. Validated screening tools for each population are described, including the CRAFFT for adolescents and T-ACE and TWEAK for pregnant women. The document emphasizes the need for non-judgmental, universal screening during healthcare visits to properly identify and address substance use issues.
CDC works to prevent fetal alcohol spectrum disorders (FASDs) by promoting alcohol screening and brief interventions (SBI) for pregnant women and women of childbearing age. SBI involves screening patients for risky drinking and providing brief counseling for those who screen positive. CDC also promotes the CHOICES program to help women reduce or stop drinking and use contraception effectively. CDC collaborates with various partners like healthcare organizations and NOFAS to educate providers and advance FASD prevention strategies. CDC analyzes national data to monitor alcohol use among women and assess provider practices around alcohol SBI.
Primary medical care settings are ideal for treating chronic illnesses but are underutilized venues for addressing this particular chronic disease. Addiction treatment specialists are too few and many patients find this path to be unacceptable. The question becomes: how to get primary care medical providers to integrate the treatment of patients with opioid use disorders into their practices?
Different ways to accomplish this were the topic of the Louis Kolodner Memorial Lecture at MedChi for the second year in a row. Last year, Dr. Michael Fingerhood described the model that he has developed at Johns Hopkins Medicine. This year, Dr. Richard Schottenfeld, now the Chief of Psychiatry at Howard University, presented research studies done by Yale University and other centers. These studies demonstrated four successful interventions:
Methadone given to already stabilized opioid addiction patients in a primary care setting instead of a specialized opioid treatment program (OTP)
Buprenorphine along with medical counseling given in a primary care setting
An initial dose of buprenorphine given in a hospital emergency department along with a next-day follow up appointment for ongoing treatment
Injectable naltrexone, although more difficult to initiate for patients than was buprenorphine, was effective for those patients who were able to start it
Two barriers that needed to be reduced to achieve these successes were the disinclination of providers to use these medications and general pessimism about the prognosis of opioid use disorders. My hope is that as more successes are demonstrated, these barriers will slowly be lowered. For those interested in more details about these studies, I invite you to access the lecture slides, available here.
PYA Principal Kent Bottles, MD, who is also Chief Medical Officer of PYA Analytics, presented before healthcare information technology (IT) professionals at the Summit of the Southeast—Driving the Future of Technology held at Nashville Music City Center, September 16-17, 2014. Dr. Bottles’ presentation covered population health.
The document discusses whether intermittent drug testing should be required for healthcare workers given that 10% of medical personnel are substance abusers. It notes that drug testing is currently not required by law and identifies reasons why healthcare workers may turn to drugs, such as easy access to controlled substances and high stress careers. The document advocates for random drug testing of healthcare workers to identify problem users, reduce patient injuries, provide reassurance to patients, and decrease turnover rates. It also suggests alternative programs to termination for employees who are abusing substances through education and hospital maintenance programs.
In this global pandemic, IBD patients and their healthcare providers from around the world share similar fears and concerns. SECURE-IBD is an international database to monitor and report on COVID-19 in IBD patients. By working across borders, we are learning how factors like age, other conditions, and IBD treatments impact COVID-19 outcomes. This slide deck also shares information about other research efforts that are ongoing to better understand the impact of COVID-19 on IBD patients.
The Foundation would like to thank AbbVie Inc., Genentech, Inc., Gilead Sciences, Inc., Janssen Biotech, Inc., Shire, and Takeda Pharmaceuticals U.S.A., Inc., sponsors of our COVID-19 materials. Additional support is provided through the Foundation’s annual giving program and individual donors.
This research presentation summarizes a study on the prevalence and associated factors of substance use among HIV patients receiving ART treatment at Asella Hospital in Ethiopia. The study found that 27.5% of patients had a history of substance use, with alcohol being the most common at 13.6%. Being male, having substance-using friends or family were significantly associated with increased substance use. The study concludes substance use is an important issue among HIV patients and recommends increased awareness efforts by health professionals and further research by the university's public health department.
The document provides an agenda for an online training series on implementing SBIRT (Screening, Brief Intervention, and Referral to Treatment). It includes an overview of SBIRT and the need for these services to address substance use issues. The training covers screening tools like the AUDIT for alcohol and DAST for drugs. It also discusses providing brief interventions to help patients understand their substance use and motivate behavior change, as well as making referrals to treatment. The document emphasizes the importance of screening for substance use universally and addressing a wide range of at-risk groups like pregnant women and adolescents.
This document outlines a proposed study on the burden of care and rates of depression among primary caregivers of patients with alcohol use disorder. The study aims to estimate caregiver burden and depression prevalence, and examine correlations between these and socio-demographic and alcohol-related variables. It describes the study design as cross-sectional and outlines inclusion/exclusion criteria, sample size calculation, and methodology involving assessment of patients, identification of primary caregivers, and administration of questionnaires to measure burden, depression, alcohol dependence severity, and collect demographic details. Statistical analysis will include t-tests, chi-square tests, and use of SPSS software.
This document summarizes a presentation given by Neil Dugdale of Sobi (Swedish Orphan Biovitrum) at the 2017 Cambridge Rare Disease Network Summit. The presentation discusses Sobi's work in rare diseases, including developing orphan drugs, partnering with patient advocacy groups, and donating factor therapy to expand treatment access for hemophilia in developing countries. Sobi aims to pioneer new approaches to rare disease management through multi-stakeholder engagement and community co-creation.
Hi52Hlth: Using Mobile Technology to Access Healthcare for TeensYTH
Hi52Hlth is a mobile application (app) created to engage adolescents and young adults in the search for resources in the Houston area. The app allows the user to search for locations of clinics and community organizations with directions, articles and videos on HIV/AIDS, ability to ask questions directly to health avatars ("Tiff" and "Ty"), PEP (Post-Exposure Prophylaxis) and PrEP (Pre-Exposure Prophylaxis) information, and a frequently asked questions section.
Healthcare’s Challenging Trio: Quality, Safety, and Complexity Health Catalyst
Dr. John Haughom expands upon the challenges with patient safety and quality in today’s modern healthcare system. First brought to light in the Institute of Medicine’s (IOM) publication of “To Err is Human: Building a Safer Health System”, the situation has only grown more complex since that seminal report. With the total cost of preventable adverse events at as much as $29 billion, preventable readmissions at $17 billion, and preventable medication errors at $16.4 billion, these are all examples of terrible medical waste that must be eliminated.
This document summarizes a presentation on closing treatment gaps in the health care and criminal justice systems for opioid use disorders. It introduces the presenters and moderator and provides learning objectives focused on improving identification and treatment of opioid use disorders in health care settings and strategies for improving outcomes for frequently incarcerated individuals. Disclosures are provided for the presenters stating that they have no relevant financial relationships.
Adults and Adolescents ART Guidelines AI.pptxshillahhungwe
Adult ART according to the the new 2022 guidelines.Viral load monitoring now is categorized as target not detectable,low viraemia and high viraemia.EAC sessions now given to both low and high viraemia recipients of care and monthly repeat viral load is collected for monitoring.
Switching to second line is only done when there is high viraemia on the second repeat viral load after EAC sessions.
EVERFI Webinar: Evidence Based Prescription Drugs ProgramMichele Collu
This document provides an overview of EVERFI's new prescription drug abuse prevention course. It discusses the opioid epidemic in the United States and risk factors for prescription drug misuse among college students. The course is designed using behavioral theories and focuses on increasing knowledge of prescription drugs, teaching refusal skills, and encouraging safe usage as advised by medical professionals. The goal is to implement an evidence-informed prevention program to address this public health issue.
Health Consumers' Council's Manager of Advocacy and Research and Murdoch's Dr Norman Stomski co-presented on a recent project where 60 de-identified advocacy cases were analysed for themes and to explore how advocacy supported the mental health consumer patient journey.
The WHO has established patient safety as a global health priority in response to the large burden of harm that occurs from unsafe healthcare worldwide. Millions of patients are injured or die each year due to errors, and many common medical practices like medication errors, healthcare-associated infections, and unsafe surgery contribute significantly to this burden. In recognition of this issue, the World Health Assembly designated September 17 as World Patient Safety Day to increase awareness and promote global action. The WHO is working to provide leadership, guidelines, and support to help countries strengthen patient safety, including initiatives to reduce healthcare-associated infections, improve surgical safety, and ensure medication is used safely.
Similar to SBIRT and SAMHSA's 8 Strategic Initiatives (20)
Fexofenadine is sold under the brand name Allegra.
It is a selective peripheral H1 blocker. It is classified as a second-generation antihistamine because it is less able to pass the blood–brain barrier and causes lesser sedation, as compared to first-generation antihistamines.
It is on the World Health Organization's List of Essential Medicines. Fexofenadine has been manufactured in generic form since 2011.
- Video recording of this lecture in English language: https://youtu.be/RvdYsTzgQq8
- Video recording of this lecture in Arabic language: https://youtu.be/ECILGWtgZko
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Giloy in Ayurveda - Classical Categorization and SynonymsPlanet Ayurveda
Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Applications of NMR in Protein Structure Prediction.pptxAnagha R Anil
This presentation explores the pivotal role of Nuclear Magnetic Resonance (NMR) spectroscopy in predicting protein structures. It delves into the methodologies, advancements, and applications of NMR in determining the three-dimensional configurations of proteins, which is crucial for understanding their function and interactions.
CLASSIFICATION OF H1 ANTIHISTAMINICS-
FIRST GENERATION ANTIHISTAMINICS-
1)HIGHLY SEDATIVE-DIPHENHYDRAMINE,DIMENHYDRINATE,PROMETHAZINE,HYDROXYZINE 2)MODERATELY SEDATIVE- PHENARIMINE,CYPROHEPTADINE, MECLIZINE,CINNARIZINE
3)MILD SEDATIVE-CHLORPHENIRAMINE,DEXCHLORPHENIRAMINE
TRIPROLIDINE,CLEMASTINE
SECOND GENERATION ANTIHISTAMINICS-FEXOFENADINE,
LORATADINE,DESLORATADINE,CETIRIZINE,LEVOCETIRIZINE,
AZELASTINE,MIZOLASTINE,EBASTINE,RUPATADINE. Mechanism of action of 2nd generation antihistaminics-
These drugs competitively antagonize actions of
histamine at the H1 receptors.
Pharmacological actions-
Antagonism of histamine-The H1 antagonists effectively block histamine induced bronchoconstriction, contraction of intestinal and other smooth muscle and triple response especially wheal, flare and itch. Constriction of larger blood vessel by histamine is also antagonized.
2) Antiallergic actions-Many manifestations of immediate hypersensitivity (type I reactions)are suppressed. Urticaria, itching and angioedema are well controlled.3) CNS action-The older antihistamines produce variable degree of CNS depression.But in case of 2nd gen antihistaminics there is less CNS depressant property as these cross BBB to significantly lesser extent.
4) Anticholinergic action- many H1 blockers
in addition antagonize muscarinic actions of ACh. BUT IN 2ND gen histaminics there is Higher H1 selectivitiy : no anticholinergic side effects
Milan J. Anadkat, MD, and Dale V. Reisner discuss generalized pustular psoriasis in this CME activity titled "Supporting Patient-Centered Care in Generalized Pustular Psoriasis: Communications Strategies to Improve Shared Decision-Making." For the full presentation, please visit us at www.peervoice.com/HUM870.
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
PGx Analysis in VarSeq: A User’s PerspectiveGolden Helix
Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
1. SBIRT
Screening, Brief Intervention and Referral to
Treatment
Behavioral Health is Essential to Health
Prevention Works | Treatment is Effective | People Recover
2. SBIRT in Healthcare Settings
•
•
•
•
•
•
•
•
Emergency Rooms and Trauma Centers
Primary Care
Federally Qualified Health Centers (FQHCs)
Pediatrics
Dental Clinics
In Home Health Services
OB/Gyn Clinics
STD Clinics
2
4. 4
Emergency Rooms/Trauma Centers:
Don’t Ask-Don’t Tell?
Alcohol and Drug Abuse problems are often
unidentified
• 24-31% of all patients treated and as many as 50%
percent of severely injured trauma patients in
emergency departments test positive for alcohol use
(D’Onofrio & Degutis, 2002).
• In a study of 241 trauma surgeons, only 29%
reported screening most patients for alcohol
problems (Danielson, et.al., 1999)
5. Why should we screen in EDs and
Trauma Centers?
• Excessive alcohol use is common and results in injuries and other
health issues that bring people to EDs and Trauma Centers
• Most alcohol-related injuries do not involve people who are
dependent on alcohol
• People who aren’t dependent on alcohol can cut back on their
drinking
• A visit to an ED or Trauma Center is an opportune moment to talk to
people about the connection between excessive drinking and their
injury, illness or prescribed medications
5
6. ED and Trauma Center SBIRT
Implementation
1. Make a case for SBIRT
2. Make sure the right people are involved in
organizing the project
3. Work toward a common understanding of how
the project will work
6
7. ED and Trauma Center SBIRT
Implementation (cont.)
4. Decide who will provide the interventions
5. Decide who should be screened
6. Develop efficient screening procedures
7
8. ED and Trauma Center SBIRT
Implementation (cont.)
7. Be clear about Brief Intervention Procedures
8. Develop an efficient way to make referrals
9. Develop a sustainability plan for long term “buyin”
(Higgins-Biddle J, Hungerford D, Cates-Wessel, K. Screening and Brief Interventions (SBI) for Unhealthy
Alcohol Use: A Step-By-Step Implementation Guide for Trauma Centers. Atlanta (GA): Centers for Disease
Control and Prevention, National Center for Injury Prevention and Control; 2009
8
11. 11
Primary Care:
Also Don’t Ask-Don’t Tell?
Alcohol and Drug Abuse problems are often
unidentified
• In a study of 7,371 primary care patients, only
29% of patients reported being asked about
their use of alcohol or drugs in the past year
(D’Amico et.al., 2005)
12. Why is Management of Alcohol Misuse
Important in Primary Care and FQHCs
• A Primary Care or FQHC is often the
most regular contact a patient has with
the healthcare system
• Prevalence of alcohol use/misuse
• Morbidity and mortality
• Barrier to treatment of chronic conditions
• Cost & time saving
• Potential for effective intervention
SBIRT:
Reducing Alcohol Related Morbidity and Mortality in Primary Care
J. Paul Seale, MD, Principal Investigator
12
13. • Alcohol is the third leading cause of preventable
death in the US (CDC), (76,000 deaths, or 5% of
all deaths in 2001)
• Alcohol is attributable to 4-8% of DisabilityAdjusted Life Years (DALYs) in the US (WHO).
• Globally, alcohol causes morbidity and mortality
at a higher rate than tobacco (WHO).
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5337a2.htm, CDC, 2004;
http://www.who.int/substance_abuse/facts/alcohol/en/index.html, WHO, 2010;
http://www.who.int/substance_abuse/publications/en/APDSSummary.pdf; WHO, 2002
13
15. • Due to Chronic
Alcohol Misuse
– 46% of total
deaths
– 35% of years of
life lost
– Leading cause of
liver disease
Due to Acute
Alcohol Misuse
54% of total
deaths
65% of years of
life lost
Leading cause of
MVAs in US
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5337a2.htm, CDC, 2004
15
16. • Alcohol interacts
with many
medications
• Exacerbates
numerous chronic
medical conditions
Rehm et al, 2002; Stranges et al, 2004;
http://pubs.niaaa.nih.gov/publications/aa26.htm, NIAAA 2000;
http://pubs.niaaa.nih.gov/publications/Medicine/medicine.htm, NIAAA 2007
16
17. Patients’ Sense of
Screening’s Importance
80
%
70
60
50
Diet/Exercise
40
Smoking
30
Drinking
20
10
0
Very
Important
Very
Unimportant
http://www.cdc.gov/InjuryResponse/alcohol-screening/resources.html, 2009
17
18. Patients’ Comfort with Screening
%
80
70
60
50
Diet/Exercise
40
Smoking
30
20
Drinking
10
0
Very
Comfortable
Very
Uncomfortable
18
19. Other Benefits of SBIRT in Primary Care
and FQHCs
• Fewer hospitalizations
• Fewer ER visits
• Benefit vs. Cost (48 months f/u)
– Medical Benefit-Cost Ratio
– Societal Benefit-Cost Ratio
4.3:1
39:1
Fleming et al, 2002; Mundt, 2006; Kraemer, 2007
19
21. The Problem
9.3% of youths aged 12-17 used illicit drugs:
6.7%
marijuana, 2.9% nonmedical use of prescription-type
psychotherapeutics, 1.1% inhalants, 1.0% hallucinogens, and
0.4% cocaine
26.4% of persons aged 12-20 (~10.1 million) reported
drinking alcohol. Approximately 6.6 million (17.4%) were
binge drinkers and 2.1 million (5.%) were heavy drinkers. The
2008 rates were lower than 2007, when they were 27.9% and
18.6%, respectively.
http://www.oas.samhsa.gov/nsduh/2k8nsduh/2k8Results.cfm
http://www.oas.samhsa.gov/nsduh/2k8nsduh/2k8Results.cfm#2.11
21
22. •
Alcohol is by far the drug of choice among youth. It’s often the first one tried
•
it’s used by the most kids (Johnston et al., 2010)
•
Over the course of adolescence, the proportion of kids who drank in the
previous year rises tenfold, from 7 percent of 12-year-olds to nearly 70
percent of 18-year-olds (NIAAA, 2011)
•
Dangerous binge drinking is common and increases with age as well
•
About 1 in 14 eighth graders, 1 in 6 tenth graders, and 1 in 4 twelfth graders
report having five or more drinks in a row in the past 2 weeks (Johnston et
al., 2011)
www.niaaa.nih.gov/YouthGuide
22
23. Why SBIRT with adolescents?
• A large population of “subclinical” AOD users
exists
• Only 1 in 20 with clinical AOD involvement
get services
• Primary care offers an “opportunistic” setting
• Expands service options
• Low threshold for service engagement
• Congruent with aspects of adolescent
development
23
24. Summary of the teen BI research:
1) Small but growing literature
2) Teen outcomes:
AOD use
AOD consequences
self-efficacy
2) Abstinence not typical
3) Effects are rapid and durable
4) High satisfaction ratings by teens
5) May promote additional help-seeking
24
25. Implementation Considerations:
• Parental notification of program
• Screening best practices
• Confidentiality
• Responding to suicidality and other mental
health concerns
• Clinic capacity and willingness to support
referral to treatment recommendation
25
26. • The American Academy of Pediatrics
recommends that pediatricians provide
alcohol screening and counseling to all
adolescents and children in upper
elementary grades
• Pediatricians are uniquely positioned to
influence their young patients substance
use
26
28. Dental Clinics
• There is a direct relationship between substance
use and oral health
• Alcohol and other drugs increase the risk for oral
cancers, dental caries and other oral health
problems
• Dentists and oral surgeons prescribe
approximately 12% of immediate-release opioid
based prescription medications in the United
States.
28
29. • Significant link between oral health and
substance use disorders
– heavy drinking is associated with
approximately 75% of esophageal cancers
– heavy drinking 50% of mouth, larynx and
pharynx cancers
– increased cancer risk if the drinker smokes
– methamphetamine epidemic and “meth
mouth” phenomenon, heroin, cocaine use
poor oral health
31. Dental Prescribing Practices
• Number of prescriptions
– More than half (55.3%) of those who use prescription
drugs for non-medical purposes get the drugs from a
family member or friend
• Drug-Drug Interactions
– Risk of interactions between drugs dentists prescribe
and the drugs or alcohol some patients consume
– Demonstrating that dentists document patients
current and past substance use
33. Issues unique to pregnancy
• Prevalence of alcohol use
11%
– Binge drinking in a previous month
2%
• Prevalence of use (age 18-44)-non pregnant
55%
– Binge drinking in a previous month
13%
– Many not using contraception
>50%
• Pregnancy is a unique time, where motivation to reduce
alcohol use may be higher.
– 74% of women stop drinking during pregnancy.
34. Issues unique to pregnancy
• No known safe levels of alcohol intake
• No exact dose-response relationship
• Binge drinking may be more concerning than
similar volumes over time.
• Increased stillbirth rate
– <1 drink per week
1.37 per 1000 births
– >/=1 drink per week 8.83 per 1000 births
• Current U.S. recommendation: abstinence
35. Fetal alcohol syndrome
• Prevalence with heavy drinkers
• Offspring issues:
10-50%
– Leading cause of developmental delay in the US.
– Growth problems
– Facial dysmorphia
• Microcephaly
• Smooth philtrum, thin vermillion border, small palpebral fissures
• Maxillary hypoplasia
– Central nervous system abnormalities
• Average IQ 63
• Fine motor dysfunction
36. Faith-based organizations
• Faith-Based organizations offer a unique
opportunity to extend SBIRT into the community.
These organizations tend to be trusted by a wide
variety of diverse cultural and religious groups
• Churches, synagogues, and mosques are
embedded in communities
• Some have public health ministries
• Faith leaders have more time available to spend
with people
36
37. Faith-Based Organizations (cont.)
• SBIRT training for faith leaders is an opportunity
to disseminate accurate information about
substance use disorders
• SBIRT gives faith leaders a structured tool to
help their congregants deal with a serious issue
that affects all members of society
• Faith leaders are in touch with many community
resources
37
38. Health Fairs
• Community health fairs can be an SBIRT
opportunity
• Make sure a confidential setting is available
• May work best if part of a “healthy lifestyles”
initiative that includes healthy eating
suggestions, and screens for alcohol and
tobacco use as well as other health screens
• There needs to be a realistic plan to make
referrals is serious problems are uncovered
38