Question 2: Biopsychosocial Population Health Policy Proposal

2

Biopsychosocial Population Health Policy Proposal

Jessica Ramos

Capella University

FPX:6026 Biopsychosocial Concepts for Advanced Nursing Practice 2

Dr. Toni Loftus

November 14, 2021

Biopsychosocial Population Health Policy Proposal

Opioid use disorder (OUD) has remained a health issue among veterans. The challenges of warzones, including physical trauma or acute pain, make veterans one of the groups at risk of developing OUD. Although opioid prescription has been falling in the US in the last ten years, OUD remains a serious problem in the veteran population (Dembek, Chekol, & Wu, 2020). OUD has negative implications on veterans’ health outcomes. Opioid misuse is significantly related to heroin initiation among military veterans and can lead to death following overdose. Moreover, the non-medical use of opioids in the veteran population can lead to addiction and opioid dependency (Dembek, Chekol, & Wu, 2020). Although the Veteran Health Administration has actively been addressing this issue, the high prevalence of OUD among military veterans indicates the adoption of new initiatives to safeguard the health of this vulnerable population. The paper proposes a health policy and guidelines to help address OUD among veterans.

Proposed Policy

A policy that can help address veterans' opioid use disorder problem is the standardization of care provision within psychiatric and medical care settings offering OUD treatment. One guideline to achieve standardized care in VA and non-VA treatment facilities is to develop quality metrics (Madras et al., 2020). Agencies that accredit or license substance abuse treatment centers can use these metrics to assess programs. Another guideline is to halt funding, licensing, and accrediting OUD treatment not founded on evidence. Reducing no-value or low-value care preserves scarce resources for services that effectively improve patients' health outcomes (Madras et al., 2020). Lastly, the proposed policy involves incentivization of facilities to follow up veterans after discharge. Comment by Toni: This is a great concept. However, you need to develop a clear policy. A policy should have a specific statement that provides the goal of the policy. It should also present a scope which identifies individuals that the policy is aimed at. It should also include evidence-based practice guidelines which are the clear steps that will lead to achievement of the policy’s goal. Here is a policy development example tha you might find helpful: Policy Statement: All Flexpath 6026 students must successfully complete three assessments in order to successfully complete the course. Scope: Who will be responsible for carrying out the practice guidelines? Notice how the policy is aimed at a specific group? It does not include all flexpath students or all Capella students. That is the policy’s scope. The policy statement has a specific goal – to successfully complete the course. Practice Guidelines: 1. All students will have three attempts to successfully complete each assessment. 2. Students will have 12 weeks to complete the course. 3. All assessments will be evaluated using the scoring guide for each assessment. Notice how the guidelines provide clear steps for meeting the goal of the policy – which is to successfully complete the course.

Advocacy for Need of the Proposed Policy

70 % of individuals with OUD do not receive substance abuse treatment (Madras et al., 2020). For people who access specialty care, under 30% receive buprenorphine or methadone treatment (Madras et al., 2020). On the other hand, the share of people in treatment who receive evidence-based medication treatment of OUD (MOUD) using agents such as naltrexone has been rising but remains low. Between 2007 and 2016, the percentage of treatment facilities offering MOUD rose from 20 to 36% (Madras et al., 2020). Although this is commendable, the low adoption of evidence-based practices by specialty treatment centers is concerning. Besides, most primary care facilities in rural areas have not integrated substance use treatment and screening in their system. In rural areas that lack specialty addiction healthcare services, primary care professionals such as nurses are crucial in caring for individuals with OUD. An insufficient number of primary healthcare providers are screening for substance abuse use disorders in these settings.

Interprofessional Approach to Implementing the Proposed Policy

Implementation of the proposed policy requires collaborative efforts of individuals from various professions. Firstly, officials from accreditation organizations such as the Joint Commission should be involved in the implementation team. Such officials will create quality metrics to evaluate whether substance use treatment centers provide evidence-based care (Madras et al., 2020). Second, primary care providers and therapists must be trained in providing evidence-based care to patients with OUD. A significant focus should be given to skills needed when providing care to veterans with substance abuse disorders. Telemedicine can be used to prescribe buprenorphine for veterans in rural areas (Brunet et al., 2020). Lastly, state legislators have a critical role in the implementation of this policy proposal. Collaboration among these professionals during the implementation of the proposed policy will reduce inefficiencies, lower healthcare costs, and improve veteran care and health outcomes. Comment by Toni: This discussion should be focused on your policy and practice guidelines. How will the team function to implement the policy?

In conclusion, the paper proposes the standardization of care in psychiatric and medical settings that offer OUD specialty care. In these settings, there is a lack of evidence-based care practices. Also, the number of primary care facilities screening for OUD in rural areas is substantially low. Interprofessional collaboration is critical in implementing the proposed policy. Comment by Toni: Conclusion section should have a section header.

References

Brunet, N., Moore, D., Lendvai Wischik, D., Mattocks, K., & Rosen, M. (2020). Increasing Buprenorphine Access for Veterans with Opioid Use Disorder in Rural Clinics Using Telemedicine. Substance Abuse, 1-8. https://doi.org/10.1080/08897077.2020.1728466

Dembek, Z., Chekol, T., & Wu, A. (2020). The Opioid Epidemic: Challenge to Military Medicine and National Security. Military Medicine, 185(5-6), e662-e667. https://doi.org/10.1093/milmed/usz487

Madras, B. K., Ahmad, N. J., Wen, J., & Sharfstein, J. (2020). Improving access to evidence-based medical treatment for opioid use disorder: strategies to address key barriers within the treatment system. NAM Perspectives. Retrieved November 12, 2021. From https://www.rcorp-ta.org/sites/default/files/2020-06/Improving-Access-to-Evidence-Based-Medical-Treatment-for-OUD_FINAL.pdf