Initial insights from a quality improvement initiative to develop an evidence-informed young adult substance use program.

Autor: Halladay J; Peter Boris Centre for Addictions Research (PBCAR), Hamilton, Ontario.; St. Joseph's Healthcare Hamilton (SJHH), Research Institute of St. Joe's Hamilton Mental Health and Addictions Research Program, McMaster University, Hamilton, Ontario., Stead V; McMaster Department of Psychiatry and Behavioural Neurosciences, Hamilton, Ontario., McCarron C; St. Joseph's Healthcare Hamilton (SJHH), Research Institute of St. Joe's Hamilton Mental Health and Addictions Research Program, McMaster University, Hamilton, Ontario., Kennedy M; St. Joseph's Healthcare Hamilton (SJHH), Research Institute of St. Joe's Hamilton Mental Health and Addictions Research Program, McMaster University, Hamilton, Ontario., King K; St. Joseph's Healthcare Hamilton (SJHH), Research Institute of St. Joe's Hamilton Mental Health and Addictions Research Program, McMaster University, Hamilton, Ontario., Venantius M; St. Joseph's Healthcare Hamilton (SJHH), Research Institute of St. Joe's Hamilton Mental Health and Addictions Research Program, McMaster University, Hamilton, Ontario., Carter A; St. Joseph's Healthcare Hamilton (SJHH), Research Institute of St. Joe's Hamilton Mental Health and Addictions Research Program, McMaster University, Hamilton, Ontario., Syan S; Peter Boris Centre for Addictions Research (PBCAR), Hamilton, Ontario.; St. Joseph's Healthcare Hamilton (SJHH), Research Institute of St. Joe's Hamilton Mental Health and Addictions Research Program, McMaster University, Hamilton, Ontario., Matthews M; St. Joseph's Healthcare Hamilton (SJHH), Research Institute of St. Joe's Hamilton Mental Health and Addictions Research Program, McMaster University, Hamilton, Ontario., Khoshroo S; Peter Boris Centre for Addictions Research (PBCAR), Hamilton, Ontario.; St. Joseph's Healthcare Hamilton (SJHH), Research Institute of St. Joe's Hamilton Mental Health and Addictions Research Program, McMaster University, Hamilton, Ontario., Massey M; Peter Boris Centre for Addictions Research (PBCAR), Hamilton, Ontario.; St. Joseph's Healthcare Hamilton (SJHH), Research Institute of St. Joe's Hamilton Mental Health and Addictions Research Program, McMaster University, Hamilton, Ontario., Rahman L; Peter Boris Centre for Addictions Research (PBCAR), Hamilton, Ontario.; St. Joseph's Healthcare Hamilton (SJHH), Research Institute of St. Joe's Hamilton Mental Health and Addictions Research Program, McMaster University, Hamilton, Ontario., Burns J; Peter Boris Centre for Addictions Research (PBCAR), Hamilton, Ontario.; St. Joseph's Healthcare Hamilton (SJHH), Research Institute of St. Joe's Hamilton Mental Health and Addictions Research Program, McMaster University, Hamilton, Ontario., Punia K; Peter Boris Centre for Addictions Research (PBCAR), Hamilton, Ontario.; St. Joseph's Healthcare Hamilton (SJHH), Research Institute of St. Joe's Hamilton Mental Health and Addictions Research Program, McMaster University, Hamilton, Ontario., MacKillop E; McMaster Department of Psychiatry and Behavioural Neurosciences, Hamilton, Ontario., Raymond H; Peter Boris Centre for Addictions Research (PBCAR), Hamilton, Ontario.; St. Joseph's Healthcare Hamilton (SJHH), Research Institute of St. Joe's Hamilton Mental Health and Addictions Research Program, McMaster University, Hamilton, Ontario., MacKillop J; Peter Boris Centre for Addictions Research (PBCAR), Hamilton, Ontario.; St. Joseph's Healthcare Hamilton (SJHH), Research Institute of St. Joe's Hamilton Mental Health and Addictions Research Program, McMaster University, Hamilton, Ontario.; McMaster Department of Psychiatry and Behavioural Neurosciences, Hamilton, Ontario.
Jazyk: angličtina
Zdroj: Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent [J Can Acad Child Adolesc Psychiatry] 2023 Aug; Vol. 32 (3), pp. 185-201. Date of Electronic Publication: 2023 Aug 01.
Abstrakt: High rates of substance misuse during emerging adulthood (~17-25 years of age, also referred to as young adulthood) require developmentally appropriate clinical programs. This article outlines: 1) the development of an evidence-informed young adult outpatient substance use program that takes a biopsychosocial patient-centred approach to care; 2) a quality improvement process and protocol; and 3) the patient characteristics of an initial cohort. Literature reviews, program reviews, environmental scans, and consultations with interested parties (including individuals with lived expertise) were used to develop the program. A 12-week measurement-based care program was developed comprising: 1) individual measurement-based care and motivational enhancement therapy sessions; 2) group programming focused on cognitive behavioural therapy, mindfulness, distress tolerance, and emotional regulation; 3) clinical consultations for diagnostic clarification and/or medication review; and 4) an independent Community Reinforcement Approach Family Training (CRAFT) group for loved ones. A measurement system was concurrently created to collect clinical and program evaluation data at six time points. In the first 21 months of the program, 152 young adults enrolled in the program (mean age = 21 years old, 47% female gender) primarily reporting treatment targets of cannabis (68%) and alcohol (63%) and almost all presenting with co-occurring mental health concerns (95%). The initial cohort who completed the program showed symptom improvements. Collectively, the program demonstrates the feasibility of developing an evidence-informed young adult substance use program using measurement-based care, but also the need for flexibility and ongoing monitoring to meet local needs.
Competing Interests: Conflicts of Interest JM is a principal in BEAM Diagnostics, Inc. and a consultant to Clairvoyant Therapeutics, Inc. No other authors have any conflicts of interest to declare.
(Copyright © 2023 Canadian Academy of Child and Adolescent Psychiatry.)
Databáze: MEDLINE
Externí odkaz: