Improving Access to Primary Care for Chronic Drug Users CDUs
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Slide 1 :
Improving Access to Primary Health Care for Chronic Drug Users (CDUs) H. Virginia McCoy, PhD Sarah E. Messiah, MPH Wei Zhao, MD, MS
Slide 2 :
Problems Encountered by CDUs Lack of ‘access’Lack of insuranceRace/ethnicityLocationSocial class and cultureAge and genderExposure to violenceMedical diagnosisTransportation problems Health problemsSeizureStrokeNeurological disordersDuodenal ulcerEndocrine abnormalitiesPulmonary complicationsHIVTBHepatitis
Slide 3 :
Epidemiology CDUs have greater health needs than non-drug users At least one health problem in 12 months(95% IV drug users, 90% other CDUs, 79% non-drug users) Health care providers lack knowledge of substance abuse Very few providers use standardized methods to identify drug users (HSRC, University of Miami)
Slide 4 :
Provider Expertise Intervention at Primary Care (PC), Emergency Dept (ED) and Drug Tx (DT) Aim – To improve the competencies of health care providers in caring for CDUs Objectives* To increase the knowledge of current research on drug abuse * To increase awareness about latest medical research and treatment on drug abuse * To improve patient-provider relationship * To train providers in ED and PC to identify and screen for signs and symptoms of substance abuse problems and triage for health related problems (DAST and CAGE)
Slide 5 :
Selection of Intervention and Comparison Sites First level criteria – “Yes” to following1. Interested in improving access and availability for CDUs 2. No opposition from neighborhood(s) and staffs Second level criteria – Any of the following1. Planning to add services designed specifically for CDUs 2. CDUs would not encounter rude or unkind staff 3. Reported that CDUs self-identified as substance users when presenting for services
Slide 6 :
Participants in the Intervention ED & PC – (n=105) “knowledge about drug use” and “understanding toward drug users” (pre-/posttest) ED & PC – (n=153) evaluation of Module One ; (n=127) evaluation of Module Two DT – (n=11) “knowledge about drug use” and “understanding toward drug users” (pre-/posttest) DT – (n=10) evaluation of training
Slide 7 :
Results of Provider Expertise
Slide 8 :
Intervention(I) v/s Comparison(C)
Slide 9 :
Discussion Objective to increase awareness about current research and health needs of CDUs was achieved among PC and ED providers Provider-patient relationship and its allied trainings have brought about significant improvement in PC & DT providers ED and PC started using CAGE questionnaire at intake
Slide 10 :
Challenges and Limitations Available primary care services were insufficient to introduce the newer health care needs and approaches Project staff met hostile attitudes from the providers who had previous difficult cases It is a short term assessment and any long term outcomes need further research
Slide 11 :
Conclusion Study findings are significant and will provide a strong base for further research and stronger designs Study was successful in testing a number of strategies to improve access to primary care among CDUs Study has provided a variety of strategies to close the gap between providers’ and patients’ perspectives towards primary care for CDUs
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PowerPoint Presentation on Improving Access to Primary Care for Chronic Drug Users (CDUs) or PowerPoint Presentation on A research study conducted intervention programs to improve access to primary care for CDUs. An Emergency Department, A Primary Care clinic, and a Drug Treatment Program were the sites for research.
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