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Caring Through Complexity: Developing a Palliative Care Opioid and Stimulant Use Disorder Workflow.

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Summary
This summary is machine-generated.

Palliative care providers reported increased comfort managing patients with opioid or stimulant use disorder (OUD/STuD) after implementing an evidence-based workflow and targeted education. This quality improvement project addressed a critical gap in care for complex patient populations.

Keywords:
Palliative careopioid use disorderpilot projectsubstance use disorder

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Area of Science:

  • Palliative Care
  • Addiction Medicine
  • Quality Improvement

Background:

  • Caring for patients with serious illness and opioid or stimulant use disorder (OUD/STuD) presents unique challenges for palliative care (PC) providers.
  • PC providers often lack specialized training in addiction medicine, leading to discomfort in managing this population.

Purpose of the Study:

  • To assess PC team comfort levels in managing patients with OUD/STuD.
  • To implement targeted educational interventions and develop an institutional PC workflow for OUD/STuD care.
  • To improve the quality of care for patients with OUD/STuD within a palliative care setting.

Main Methods:

  • A quality improvement project was conducted in an academic health system's PC program.
  • Pre- and post-intervention surveys assessed provider comfort levels.
  • An evidence-based, locally adapted workflow for opioid prescribing and clinic management was developed and implemented.
  • Educational sessions focused on buprenorphine for pain, substance use risk assessment, and safe opioid management.

Main Results:

  • Initially, 66% of PC providers felt uncomfortable managing patients with OUD/STuD, with only 19% of prescribers comfortable managing opioids for this group.
  • Following the intervention, provider discomfort decreased to 35%, and prescriber comfort in managing opioids increased to 52%.
  • The workflow was applied to ten cancer patients, with iterative updates based on clinical challenges.

Conclusions:

  • Developing and implementing evidence-based, localized workflows and educational programs can significantly enhance PC provider confidence.
  • Targeted interventions are effective in improving the management of patients with OUD/STuD within palliative care.
  • This approach addresses a critical need for improved interdisciplinary care for complex patient populations.