Education as drug policy
A realist synthesis of continuing professional development for opioid agonist therapy
Bibliographic Data
| ID | 14909438 |
|---|---|
| Authors | Grahanya Sachidanandan (Lunenfeld-Tanenbaum Research Institute), Lauren Bechard (0000-0001-6428-2340, University of Waterloo), Kate Hodgson (0000-0002-2208-5098, University of Toronto), Abhimanyu Sud (0000-0001-8354-6153, University of Toronto, corresponding author) |
| Year | 2022 |
| Volume | 108 |
| Pages | 103807 |
| Publication date | 2022-10-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | International Journal of Drug Policy (JOURNAL) |
| Journal identifiers | ISSN: 0955-3959 • E-ISSN: 1873-4758 |
| Publisher | Elsevier BV (PUBLISHER) |
| DOI | 10.1016/j.drugpo.2022.103807 |
| PMID | 35930903 |
| OpenAlex | W4289515959 |
| Language | EN |
| References cited | 98 |
BACKGROUND: Continuing professional development (CPD) for opioid agonist therapy (OAT) has been identified as a key health policy strategy to improve care for people living with opioid use disorder (OUD) and to address rising opioid-related harms. To design and deliver effective CPD programs, there is a need to clarify how they work within complex health system and policy contexts. This review synthesizes the literature on OAT CPD programs and educational theory to clarify which interventions work, for whom, and in what contexts. METHODS: A systematic review and realist synthesis of evaluations of CPD programs focused on OAT was conducted. This included record identification and screening, theory familiarization, data collection, analysis, expert consultation, and iterative context-intervention-mechanism-outcome (CIMO) configuration development. RESULTS: Twenty-four reports comprising 21 evaluation studies from 5 countries for 3373 providers were reviewed. Through iterative testing of included studies with relevant theory, five CIMO configurations were developed. The programs were categorized by who drove the learning outcomes (i.e., system/policy, instructor, learner) and their spheres of influence (i.e., micro, meso, macro). There was a predominance of instructor-driven programs driving change at the micro level, with few policy-driven macro-influential programs, inconsistent with the promotion of CPD as a clear opioid crisis policy-level intervention. CONCLUSION: OAT CPD is challenged by mismatches in program justifications, objectives, activities, and outcomes. Depending on how these program factors interact, OAT CPD can operate as a barrier or facilitator to OUD care. With more deliberate planning and consideration of program theory, programs more directly addressing diverse learner and system needs may be developed and delivered. OAT CPD as drug policy does not operate in isolation; programs may feed into each other and intercalate with other policy initiatives to have micro, meso, and macro impacts on educational and population health outcomes
Facilitator · Health care · Medical education · Opioid · Opioid use disorder · Political science · Psychological intervention · Public relations · HIV, Drug Use, Sexual Risk · Medicine · Nursing · Opioid Use Disorder Treatment · Psychology · Social Psychology · Substance Abuse Treatment and Outcomes
Realist review - a new method of systematic review designed for complex policy interventions
Deliberate Practice and Acquisition of Expert Performance
The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990–2016
Demystifying theory and its use in improvement
Models of Continuing Professional Development
From best evidence to best practice
Opioid use and stigma
Medication-Assisted Treatment of Opioid Use Disorder
Generalized expectancies for internal versus external control of reinforcement.
Intervention Stigma toward Medications for Opioid Use Disorder
Confidence‐competence alignment and the role of self‐confidence in medical education
Supporting GPs to manage drug users in general practice
A comprehensive package of support to facilitate the treatment of problem drug users in primary care
Mal/adaptations
Diversion of Methadone and Buprenorphine from Opioid Substitution Treatment
Community-Based Services for Homeless Adults Experiencing Concurrent Mental Health and Substance Use Disorders
Stimulating teachers' reflection and feedback asking
Chronic Pain and Opioid Prescribing
Solving the Global Crisis in Access to Pain Relief
The "What" and "Why" of Goal Pursuits
Self-efficacy mechanism in human agency
It’s about time
Some problems and misconceptions related to the construct of internal versus external control of reinforcement
The science-policy relationship in times of crisis
Situated Learning
| Citation velocity | historical |
|---|---|
| Highly cited | No |