ASAM Practice Pearls

Overcoming Barriers to MOUD at Discharge: Ensuring Continuity of Care from Skilled Nursing Facilities


Listen Later

EP 01
🎙 Special Series: Advances in Buprenorphine Education

This episode is part of a special series on improving hospital and clinic-based buprenorphine treatment for opioid use disorder.

 

In this episode of ASAM Practice Pearls, Dr. Stephen Holt is joined by addiction medicine experts Dr. Carolyn Chan and Dr. Shawn Cohen. They explore key challenges and solutions in ensuring continuity of care for patients receiving medication for opioid use disorder (MOUD) during discharge from skilled nursing facilities.

----more----

Looking for this episode's transcript? Download it HERE

Have an idea for a future episode? Share it with us at  [email protected].
Host

Stephen Holt, MD, MS, FACP, FASAM

Dr. Stephen Holt has been an attending physician at Yale-New Haven Hospital since 2008 and is an Associate Professor of Medicine at Yale School of Medicine. He is the Director of the Yale Addiction Recovery Clinic and the Associate Program Director for Yale's Primary Care Internal Medicine Residency Program. He is board-certified in Addiction Medicine and Internal Medicine. He has published and lectures frequently on a variety of addiction medicine topics and has won numerous teaching awards at the local, regional, and national levels.

Experts

Carolyn Chan, MD, MHS

Dr. Carolyn Chan is board-certified in both internal and addiction medicine. She completed her IM residency at UH Hospitals Cleveland Medical Center, followed by an addiction medicine and medical education fellowship at Yale. She provides care in both inpatient and outpatient addiction medicine settings. Currently, she is the Program Director of the University of Cincinnati Addiction Medicine Fellowship and is committed to educating all health professionals on how to provide evidence-based care to individuals with substance use disorders.

Shawn Cohen, MD

Dr. Shawn Cohen is an addiction medicine doctor at Yale New Haven Hospital. He provides care on a hospital-based addiction consult service and is interested in lowering barriers to MOUD, improving the care of patients experiencing alcohol withdrawal, and making the hospital a more person-centered and less stigmatizing place for people who use substances.

📖 Show Segments
  • 00:03 - Introduction
  • 02:35 - Barriers to Continuity of Care
  • 07:43 - Navigating Prior Authorizations
  • 10:24 - Methadone Discharge Planning
  • 14:19 - Extended-release Buprenorphine at Discharge
  • 17:44 - Engaging Family and Caregivers
  • 19:23 - Staff Education and Advocacy
  • 22:14 - Discharge Planning Example Scenarios
  • 25:11 - Revisit Case Scenario
  • 25:50 - Conclusion and Additional Learning Opportunities
  • 📋 Key Takeaways
    • Build relationships with local stakeholders. Collaborate with nursing facility administrators, intake personnel, and buprenorphine clinics to facilitate smoother transitions for patients.
    • Address stigma and education gaps. Work closely with facilities to improve their understanding of MOUD and the importance of comprehensive addiction treatment.
    • Be proactive in discharge planning. Arrange follow-up appointments and maintain open communication with all relevant parties to prevent care gaps.
    • Anticipate common barriers. Stay ahead of issues like prior authorizations by verifying medication access before discharge.
    • Strive for incremental improvements. Small changes can lead to significant advancements in patient care over time.
    • Emphasize clear communication. Ensure nursing homes and facilities fully understand discharge plans and patient needs.
    • Encourage patient engagement. Motivate patients to involve their support systems in their recovery journey.
    • 🔗 Resources
      • ASAM’s Advanced Buprenorphine Education Series: Explore here.
      • Skilled Nursing Facility SUD Toolkit (Massachusetts): Access here.
      • Methadone 72-Hour Rule in Hospitals: Read more.
      • Methadone 72-Hour Rule in Bridge Clinics: Read more.
      • DOJ Guidance: ADA & Opioid Treatment Discrimination: View PDF.
      • Legal Action Center Toolkit on Healthcare Discrimination: Access here.
      • Grand Rounds on MOUD in Skilled Nursing Facilities: Watch here.
      • 📢 Join the Discussion

        Share your thoughts using #ASAMPracticePearls — we’d love to hear from you!

         

        ...more
        View all episodesView all episodes
        Download on the App Store

        ASAM Practice PearlsBy ASAM Education

        • 4.9
        • 4.9
        • 4.9
        • 4.9
        • 4.9

        4.9

        15 ratings


        More shows like ASAM Practice Pearls

        View all
        NEI Podcast by Neuroscience Education Institute

        NEI Podcast

        129 Listeners

        JAMA Clinical Reviews by JAMA Network

        JAMA Clinical Reviews

        496 Listeners

        AFP: American Family Physician Podcast by American Academy of Family Physicians

        AFP: American Family Physician Podcast

        707 Listeners

        Mayo Clinic Talks by Mayo Clinic

        Mayo Clinic Talks

        281 Listeners

        Frankly Speaking About Family Medicine by Pri-Med

        Frankly Speaking About Family Medicine

        253 Listeners

        The Curbsiders Internal Medicine Podcast by The Curbsiders Internal Medicine Podcast

        The Curbsiders Internal Medicine Podcast

        3,336 Listeners

        Core IM | Internal Medicine Podcast by Core IM Team

        Core IM | Internal Medicine Podcast

        1,095 Listeners

        Annals On Call Podcast by American College of Physicians

        Annals On Call Podcast

        185 Listeners

        The Clinical Problem Solvers by The Clinical Problem Solvers

        The Clinical Problem Solvers

        519 Listeners

        The Carlat Psychiatry Podcast by Pocket Psychiatry: A Carlat Podcast

        The Carlat Psychiatry Podcast

        562 Listeners

        Run the List by Walker Redd, Emily Gutowski, Navin Kumar, Joyce Zhou, Blake Smith

        Run the List

        248 Listeners

        The Curious Clinicians by The Curious Clinicians

        The Curious Clinicians

        366 Listeners

        This Week in Addiction Medicine from ASAM by American Society of Addiction Medicine

        This Week in Addiction Medicine from ASAM

        8 Listeners

        Psychiatry Boot Camp by Mark Mullen, MD

        Psychiatry Boot Camp

        175 Listeners

        PsychRounds: The Psychiatry Podcast by Dr. Tanner Hewitt, Dr. Larry Wang and Dr. Bradley Miller

        PsychRounds: The Psychiatry Podcast

        112 Listeners