Critical Appraisal
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Critical Appraisal
It is vital for nurses or any other medical practitioner to be informed of the best methods and practices that they can use to treat patients suffering from opioid addiction. They would then serve as a resource, educators, and even influence patients based on best evidence. To get informed knowledge in regards to managing opioid addiction, four research journals will be reviewed to identify the quality of research, identify their trustworthiness, and their relevance in managing opioid addiction. Through this, I would enhance my skills, know-how, and also have the capacity of determining if the research evidence is true and also related to patients that I will be treating.
A study conducted by Nyamathi, Nandy, Greengold, Marfisee, Khalilifard, Cohen, and Leake (2010), focused on motivational interviewing(MI) which is a non-conformational process that is designed to help an individual to adjust his/her behavior. A randomized method was carried out to compare three-group to identify which group was effective. This study showed that both MI carried out for individuals and group sessions were effective.
Another study by Kouimtsidis, Reynolds, Coulton, and Drummond (2012) on how behavior therapy works with an opioid dependent client was carried out where 60 clients were randomized. From the study, 29 patients who were offered both standard methadone maintenance therapy(MMT) and CBT showed significant improvement and had a lower emotional discharge compared to the 31 who received only MMT.
Further, a study conducted by Brigham, Slesnick, Winhusen, Lewis, Guo, and Somoza (2014) assessed the effectiveness of using community reinforcement and family training for treatment retention (CRAFT) in the context of buprenorphine treatment. In this study, two individual sessions for identified participants(IPs) and 12 for concerned significant other(CSO) were carried out. IPs that were assigned to the CRAFT group had a reduction of opioid usage as compared to those who were not allocated to the group. Nonetheless, the participants that had parental family CSO had higher treatment retention as compared to those that did not.
Equally important, Prieto, McEwen, Davidson, Al-Tayyib, Gawenus, Sangareddy, and Shlay (2019) carried out a study to identify the factors that are affecting opioid decision making together with the challenges that arise when prescribing opioid in ambulatory settings. This study used an open-ended question and was conducted online and 83 palliative clinicians took part. Some of the challenges that arose from this study included clinicians’ deference in approach to care, medication access, and insurance and managing problem outside the typical palliative care scope.
All the first three studies addressed some of the most effective methods that opioid addiction can be managed. Though possible, some challenges need to be addressed. For instance, lack of information regarding using specific medication in conjunction with a given type of psychosocial intervention to treat different patients of different subpopulation is a great challenge. By developing best practices and clinical guidance in managing opioid patients will be effective for different patient populations. By doing so, it will address issues like differences in approach to care and also managing problem outside the typical palliative care scope
References
Brigham, G. S., Slesnick, N., Winhusen, T. M., Lewis, D. F., Guo, X., & Somoza, E. (2014). A randomized pilot clinical trial to evaluate the efficacy of Community Reinforcement and Family Training for Treatment Retention (CRAFT-T) for improving outcomes for patients completing opioid detoxification. Drug and Alcohol Dependence, 138, 240-243.
Kouimtsidis, C., Reynolds, M., Coulton, S., & Drummond, C. (2012). How does cognitive behaviour therapy work with opioid-dependent clients? Results of the UKCBTMM study. Drugs: education, prevention and policy, 19(3), 253-258.
Nyamathi, A. M., Nandy, K., Greengold, B., Marfisee, M., Khalilifard, F., Cohen, A., & Leake, B. (2010). Effectiveness of intervention on improvement of drug use among methadone maintained adults. Journal of Addictive Diseases, 30(1), 6-16.
Prieto, J. T., McEwen, D., Davidson, A. J., Al-Tayyib, A., Gawenus, L., Sangareddy, S. R. P., … & Shlay, J. C. (2019). Monitoring opioid addiction and treatment: Do you know if your population is engaged?. Drug and alcohol dependence, 202, 56-60.
