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Saturday, January 23, 2021
Home News Helping patients through the holiday

Helping patients through the holiday

Orthopedics   Opioids   Patient Communication   Policy

Today’s Read: 3.5 minutes

The holidays can be difficult. Today we focus on how to have better conversations about self-harm, and preventing readmission and overdoses. Plus, we found our grow-old role model.

MORNING BRIEF

Preventing overdoses during the pandemic

More than 40 states have reported increases in opioid-related deaths since the beginning of the pandemic. Nationwide there’s been an 18% increase in overdoses since 2020, according to ODMAP, a mapping program that collects suspected fatal and non-fatal overdoses in real-time across jurisdictions in the United States.

Now researchers at the Johns Hopkins Bloomberg School of Public Health offers recommendations aimed at federal, state, and local policymakers to address this growing public health issue. The report recommends for government to:

  • Declare community-based organizations that provide support services, linkages to substance use treatment, and access to safer drug use supplies to be essential services during the pandemic.
  • Issue emergency orders that make it easier to distribute harm reduction materials such as clean syringes and naloxone to community-based organizations and service providers.
  • Expand access to substance use treatment, including medications like methadone and buprenorphine.
  • Provide funds to the Substance Abuse and Mental Health Services Administration to expand buprenorphine distribution via telehealth and delivery of methadone to patients at home.
  • Eliminate requirements that limit access to or billing for telemedicine.
  • Increase mobile treatment services to reach those living in poverty or experiencing homelessness and ensure treatment providers have access to adequate PPE to protect themselves and the patients.

To read the other recommendations, see the full report here. Considering that opioid-overdoses are still a public health consideration for communities, reach out to local officials about whether any of these recommendations can be implemented in your community.

Talking about self-harm and suicide

Patients may find it difficult to disclose their thoughts of self-harm because of the way healthcare providers ask about them, warns a study published in Patient Education and Counseling

Specifically, HCPs can better help patients with mental health concerns if they ask them separate questions about self-harm and suicide. By adopting a more open questioning style, HCPs can encourage less ambiguous discussions and provide an easier transition to an in-depth examination about whether patients are having distressing thoughts. 

The study also found that HCPs were overwhelmingly focused on the possibility that patients might act upon their thoughts. While this allowed them to put appropriate measures in place, it risked ignoring those patients who found their own thoughts of self-harm distressing. It also potentially closed the door on patients who actively wanted to address their situation. 

The takeaways: First, when adopting such a style, be prepared for the possibility that patients might say “yes” when asked about thoughts of self-harm.  Second, have psychologists in your trusted referral network.

Preventing readmissions after surgery

Hospital readmissions occur after joint replacement surgery for any number of reasons with a wide-degree of variability.  However, a few digital tools have shown promise in reducing the likelihood of readmission and variability of care outcomes: wearable activity trackers, text messages that detailed post-operative goals and enabled communication with the care team, and pain score tracking.

Specifically, patients who had these tools incorporated into their at-home recovery plan are four times less likely to return to the hospital than patients who don’t receive such attention, according to a clinical trial published in JAMA Network Open.

Researchers enrolled 242 patients, who either had total hip or knee replacement surgery, then randomly placed them into two groups: one receiving the typical standard of care at their hospitals, and the other enrolled in the hovering program called HomeConnect+.  The result: Just 3% of those in HomeConnect+ needed to return to the hospital after their surgery, compared to 12% of those not in the program.

The researchers theorized that with remote monitoring, providers are able to respond to issues that arise between post-op appointments faster and before they develop into larger problems.

ONE BIG NUMBER

1:1

The ratio between mmHg difference found between two arms and increased percent of predicted 10-year risk of one of the following: new angina, a heart attack, or stroke. The study in Hypertension concluded that the greater the inter-arm blood pressure difference, the greater the patient’s additional health risk.

DAILY DIVERSION

May we all age as well as this woman.

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