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Alcohol Detoxification in Ambulatory Setting

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1. Alcohol Detoxification in Ambulatory Setting

Alcohol Detoxification in Ambulatory Setting Alcohol Detoxification in Ambulatory Setting Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer (...) Administration 4 Alcohol Detoxification in Ambulatory Setting Alcohol Detoxification in Ambulatory Setting Aka: Alcohol Detoxification in Ambulatory Setting , Outpatient Alcohol Withdrawal Protocol From Related Chapters II. Indications with tolerance and withdrawal risk III. Contraindications Long-term intake of large amounts of Abnormal laboratory findings positive for other substances Acute illness Comorbid illness necessitating inpatient management Serious cardiopulmonary conditions Uncontrolled Acute

2018 FP Notebook

2. Ambulatory Alcohol Detoxification With Remote Monitoring

Ambulatory Alcohol Detoxification With Remote Monitoring Ambulatory Alcohol Detoxification With Remote Monitoring - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Ambulatory Alcohol Detoxification (...) Collaborator: SoberLink, LLC Information provided by (Responsible Party): Anna Lembke, Stanford University Study Details Study Description Go to Brief Summary: This study is designed to examine the feasibility and impact of the use of remote monitoring devices during an outpatient ambulatory alcohol detoxification treatment for patients with alcohol use disorders. Condition or disease Intervention/treatment Phase Alcohol Use Disorder Device: Remote Monitoring with Ambulatory Detox Not Applicable Detailed

2018 Clinical Trials

3. Alcohol Detoxification in Ambulatory Setting

Alcohol Detoxification in Ambulatory Setting Alcohol Detoxification in Ambulatory Setting Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer (...) Administration 4 Alcohol Detoxification in Ambulatory Setting Alcohol Detoxification in Ambulatory Setting Aka: Alcohol Detoxification in Ambulatory Setting , Outpatient Alcohol Withdrawal Protocol From Related Chapters II. Indications with tolerance and withdrawal risk III. Contraindications Long-term intake of large amounts of Abnormal laboratory findings positive for other substances Acute illness Comorbid illness necessitating inpatient management Serious cardiopulmonary conditions Uncontrolled Acute

2015 FP Notebook

4. Alcohol: Adult Unhealthy Drinking

and Behavioral Health can assist in assessments/engagement. • Ambulatory treatment/management of alcohol withdrawal. • Medications for managing alcohol craving and alcohol use disorder. In Behavioral Health • Mental health care: individual and group psychotherapy, psychiatric care and psychological testing. • Chemical dependency care (through a contracted network of providers): assessment and evaluation, chemical dependency counseling, and residential treatment. • Inpatient detoxification (through (...) for withdrawal treatment There is insufficient evidence from published studies to determine the optimal setting for alcohol detoxification. However, there is a consensus that patients with risk factors for complicated withdrawal

2016 Kaiser Permanente Clinical Guidelines

5. Pharmacological Treatment of Patients with Alcohol Use Disorder

, whereas assessment of past and current tobacco use were also high but showed opportunity for improve- ment. The typical practices of other psychiatrists and mental health professionals are unknown, but rates of tobacco use screening have been declining among psychiatrists practicing in ambulatory settings (Rogers and Sherman 2014). Data from ambulatory settings (Glass et al. 2016) suggest that many individuals receive screening for alcohol use, but approximately one-third of individuals do not. Rates (...) , and treatment is associated with reductions in the risk of relapse and AUD- associated mortality. The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder seeks to reduce these substantial psychosocial and public health consequences of AUD for millions of affected individu- als. The guideline focuses specifically on evidence-based pharmacological treatments for AUD in outpatient settings and includes additional information on assessment

2017 American Psychiatric Association

6. Managing opioid use disorder in primary care: PEER simplified guideline

creating recommen- dations on their use. 22 Management of comorbid conditions in patients with OUD Management of comorbidities in patients taking OAT can be challenging. Unfortunately, randomized con- trolled evidence in this area is severely lacking. With regard to the management of acute pain in patients taking OAT, 1 RCT reported morphine was superior to meperidine in an emergency setting. 22 This is not always applicable in an ambulatory setting, and nonopioid options were not explored. Similarly (...) Eli Orrantia MD MSc CCFP FCFP Kim Reich RSW Nick Wong MD CCFP(AM) FCFP Nicolas Dugré PharmD MSc Adrienne J. Lindblad ACPR PharmD Abstract Objective To use the best available evidence and principles of shared, informed decision making to develop a clinical practice guideline for a simplified approach to managing opioid use disorder (OUD) in primary care. Methods Eleven health care and allied health professionals representing various practice settings, professions, and locations created a list

2019 CPG Infobase

7. Evidence Brief - Barriers and Facilitators to Use of Medications for Opioid Use Disorder

: · Develop clinical policies informed by evidence; · Implement effective services to improve patient outcomes and to support VA clinical practice guidelines and performance measures; and · Set the direction for future research to address gaps in clinical knowledge. The program is comprised of four ESP Centers across the US and a Coordinating Center located in Portland, Oregon. Center Directors are VA clinicians and recognized leaders in the field of evidence synthesis with close ties to the AHRQ Evidence (...) for OUD? 12 Patient-identified Barriers to OUD Medication Use 12 Patient-identified Facilitators to Use of OUD Medications 14 Provider-Identified Barriers to Prescribing OUD Medications 16 Provider-identified Facilitators to OUD Medication Prescribing 19 Systems-level Barriers and Facilitators to OUD Medication Use 20 Key Question 2: Do these barriers and facilitators vary by patient characteristics, provider characteristics, or setting? 21 Patient Characteristics 21 Provider Characteristics

2019 Veterans Affairs Evidence-based Synthesis Program Reports

8. Alcoholism

). Diagnostic and statistical manual of mental disorders : DSM-5 (5 ed.). Washington, DC: American Psychiatric Association. pp. 490–97. . ^ . from the original on 3 June 2015 . Retrieved 9 May 2015 . ^ Moonat, S; Pandey, SC (2012). . Alcohol Research : Current Reviews . 34 (4): 495–505. . . ^ Morgan-Lopez, AA; Fals-Stewart, W (May 2006). . Exp Clin Psychopharmacol . 14 (2): 265–73. : . . . ^ Blondell, RD (February 2005). "Ambulatory detoxification of patients with alcohol dependence". Am Fam Physician . 71 (...) a person remains in the community with close supervision. Mental illness or other may complicate treatment. After detoxification, support such as or are used to help keep a person from returning to drinking. One commonly used form of support is the group . The medications , or may also be used to help prevent further drinking. The estimates that as of 2010 there were 208 million people with alcoholism worldwide (4.1% of the population over 15 years of age). In the United States, about 17 million (7

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2012 Wikipedia

9. Organisation of mental health care for adults in Belgium

of mental health care for adults in Belgium. Health Services Research (HSR) Brussels: Belgian Health Care Knowledge Centre (KCE). 2019. KCE Reports 318. D/2019/10.273/50 Chapter 07: Smith P, Nicaise P, Neyens I, Hermans K, Thunus S, Walker C, Van Audenhove C, Lorant V. Values and sets of possible organisational solutions: a choice-based stakeholder analysis survey. In: Mistiaen P, Cornelis J, Detollenaere J, Devriese S, Farfan-Portet MI, Ricour C (Editors) Organisation of mental health care for adults (...) 2.3.2 Priorities and plans at the federated level 48 2.4 KEY MESSAGES 50 3 REFERENCES 51 CHAPTER 02 PREVALENCE OF MENTAL HEALTH PROBLEMS 56 AUTHORS: DETOLLENAERE J 1 , GISLE L 2 , MISTIAEN P 1 56 1 INTRODUCTION 56 2 METHODS 56 2.1 PREVALENCE OF MENTAL HEALTH PROBLEMS 56 2.2 MENTAL HEALTH CARE SERVICE USE 57 3 RESULTS 57 3.1 PREVALENCE OF MENTAL HEALTH PROBLEMS 57 3.1.1 Mental distress and mental disorders 57 3.1.2 Emotional problems 58 3.1.3 Problematic alcohol problems 59 3.1.4 Suicidal thoughts

2019 Belgian Health Care Knowledge Centre

10. Withdrawal Management Services in Canada: The National Treatment Indicators Report

, not all provinces and territories were able to provide data, and this report does not include every source of data on WM service events (e.g., private treatment). Please refer to the Methods section for all limitations. Withdrawal Management Services WM services (sometimes referred to as detoxification or detox) offer support and care for the safe management of withdrawal symptoms and medical complications when someone who has a substance use disorder is ceasing to use the substance (Diaper, Law (...) , & Melichar, 2014; Mattick & Hall, 1996). WM services can be medically supervised, including with pharmacological support provided in hospital, in medically staffed residential settings, in doctors’ offices or through mobile services (e.g., home visits), with varying levels of psychosocial supports. Non-pharmacological or psychosocial WM can also be offered in community-based clinics. WM services should include the promotion of transition to active treatment. For example, individuals accessing WM services

2019 Canadian Centre on Substance Abuse

11. Implementing Supervised Injection Services

the recommendations that are applicable to your setting and that can be used to address your organization’s existing needs or gaps. 4. Develop a plan for implementing recommendations, sustaining best practices, and evaluating outcomes. 5. Lobby governments to ensure that legislation and regulation support the implementation of the recommendations (e.g., scope of practice, affordable housing, and health human resources). 6. Advocate for funding to support the implementation of recommendations. Implementation (...) , and research positions in a range of health-care organizations, practice areas, and academic settings. These experts work with people who inject drugs who are receiving services and supports in a wide range of health-care settings (e.g., SIS, community health centres, harm reduction programs, public health, and primary health care) or represent other sectors (such as post-secondary institutions and professional unions). To determine the purpose and scope of this Guideline, the RNAO Best Practice Guideline

2018 Registered Nurses' Association of Ontario

12. Management of Opioid Therapy (OT) for Chronic Pain

and appropriately occur when clinicians take into account the needs of individual patients, available resources, and limitations unique to an institution or type of practice. Every healthcare professional making use of these guidelines is responsible for evaluating the appropriateness of applying them in the setting of any particular clinical situation. These guidelines are not intended to represent TRICARE policy. Further, inclusion of recommendations for specific testing and/or therapeutic interventions (...) , 2016.[33] The aim of the guideline is to assist primary care providers in offering safe and effective treatment for patients with chronic pain in the outpatient setting (not including active cancer treatment, palliative care, or end-of-life care). It is also aimed at improving communication between providers and patients and decreasing adverse outcomes associated with LOT. The CDC guideline, similar to the VA/DoD OT CPG, covered topics including initiation and continuation of OT, management of OT

2017 VA/DoD Clinical Practice Guidelines

13. American Association of Clinical Endocrinologists and American College of Endocrinology Clinical Practice Guidelines for Comprehensive Medical Care of Patients with Obesity

Summary 4-30 Evidence Base 30 Post-hoc Question: By inductive evaluation of all evidence-based recommendations, what are the core recommendations for medical care of patients with obesity? 30 Q1. Do the 3 phases of chronic disease prevention and treatment (i.e., primary, secondary, and tertiary) apply to the disease of obesity? 31 Q2. How should the degree of adiposity be measured in the clinical setting? 33 Q2.1. What is the best way to optimally screen or aggressively case-find for overweight (...) and obesity? Q2.2. What are the best anthropomorphic criteria for defining excess adiposity in the diagnosis of overweight and obesity in the clinical setting? 34 Q2.3. Does waist circumference provide information in addition to body mass index (BMI) to indicate adiposity risk? 34 Q2.4. Do BMI and waist circumference accurately capture adiposity risk at all levels of BMI, ethnicity, gender, and age? 34 Q3. What are the weight-related complications that are either caused or exacerbated by excess adiposity

2016 American Association of Clinical Endocrinologists

14. The effects of online brief interventions for the prevention and treatment of methamphetamine use

) 35 presented information that included: types of drugs and their effects; problem solving; communication; and harm minimisation. Table 2 included two BIs to treat youth amphetamine use. 26,34 Recruitment. Madras, et al. (2009) 25 recruited adult patients in six USA states in healthcare sites (inpatient, emergency departments, ambulatory, primary and specialty healthcare settings, and community health clinics). Marsden, et al. (2006) 26 recruited youth substance users through youth drug workers (...) 6 References 25 Included articles 26 7 Appendices 28 Appendix Table A: Excluded papers 28 Appendix 1: search strategy for PSYCHINFO 29 Appendix 2: search strategy for Medline 30 Appendix 3: Search strategy for Embase 30 Abbreviations list ANZCTR Australia New Zealand Clinical Trial Registry AREAS Academic Role Expectations and Alcohol Scale BI Brief Intervention BMI Brief Motivational Intervention BRSE Benzodiazepine Refusal Self Efficacy BT Brief Treatment BWSQ Benzodiazepine Withdrawal Symptom

2015 Sax Institute Evidence Check

15. Commissioning Primary health care

of commissioning at individual, group and population level 8 Factors found to facilitate or impede commissioning 13 Case studies 13 5 Question 2 17 Key Findings 17 Policy settings for successful commissioning 17 6 Question 3 20 Key Findings 20 Requirements for effective commissioning 20 Potential impacts, risks and unintended consequences of commissioning 22 Considerations for implementation in Australia 23 7 Conclusions 27 8 Researchers’ reflections 28 9 References 30 10 Appendices 35 Appendix 1: Methods 35 (...) relationships and implementation of suggested strategies (Naylor, 2011) Added value GPs bring to commissioning include increased capacity for service redesign, involvement with local people, improved uptake of quality based referrals; focus on improving quality of primary medical care (Perkins, 2014) Limited use of priority setting tools (decision support) for resource allocation related to perceived lack of value, lack of skill &data, lack of suitable tools for public health (Marks, 2012) Pharmacy

2015 Sax Institute Evidence Check

16. Guidance on the clinical management of depressive and bipolar disorders, specifically focusing on diagnosis and treatment strategies

impairment No MDD e Depression 2 Weeks Marked Impairment N/A N/A Yes PDD d Depression 2 Weeks Clinically significant impairment N/A N/A No DMDD f* Chronic irritability and temper outbursts >12 mths with no more than 3 mths symptom- free =3 Temper outbursts per week. Present in =2 settings N/A N/A No PMDD g * Depression Final week before menses to a few days after. Causes distress or interference with functioning N/A N/A No Note: For full criteria for manic, hypomanic and depressive episodes, refer to DSM (...) in clinical settings (APA, 2013). In individuals with bipolar disorder, the initial presentation is usually that of depression and therefore the correct diagnosis cannot be made until an episode of hypomania/mania occurs. This inevitable delay that can sometimes last up to a decade results in a period of inadvertent suboptimal management. Diagnosis is also hindered by the fact that bipolar disorder has very high rates of comorbidity with anxiety, substance misuse and personality disorders (particularly

2015 Royal Australian and New Zealand College of Psychiatrists

17. Management of Substance Use Disorder

A. Screening 29 VA/DoD Clinical Practice Guideline for the Management of Substance Use Disorders December 2015 Page 4 of 169 B. Brief Alcohol Intervention 31 C. Determination of Treatment Setting 32 D. Treatment 33 a. Alcohol Use Disorder 33 b. Opioid Use Disorder 38 c. Cannabis Use Disorder 47 d. Stimulant Use Disorder 48 E. Promoting Group Mutual Help Involvement 50 F. Co-occurring Mental Health Conditions and Psychosocial Problems 52 G. Follow-up 52 H. Stabilization and Withdrawal 55 a. Assessment 55 b (...) . Alcohol Use Disorder Stabilization and Withdrawal 58 c. Opioid Use Disorder Stabilization and Withdrawal 60 d. Sedative Hypnotic Use Disorder Stabilization and Withdrawal 62 VII. Knowledge Gaps and Recommended Research 63 A. Determination of Treatment Setting 63 B. Pharmacotherapy 63 a. Opioid Use Disorder 63 b. Stimulant Use Disorder 63 C. Psychosocial Interventions 64 a. Substance Use Disorders 64 b. Opioid Use Disorder 64 D. Follow-up 64 E. Stabilization and Withdrawal 64 F. Telehealth 64 Appendix

2015 VA/DoD Clinical Practice Guidelines

18. Acute Pain Management: Scientific Evidence

are acknowledged as well. The third edition has created demand from healthcare professionals across the globe. It is widely used in western Europe, and in North America and South America. It has set the standard in acute pain medicine, and is recognised as probably the finest text on this subject in the world. Both the Australian and New Zealand College of Anaesthetists and its Faculty of Pain Medicine are immensely proud of its prestige. In its milestone report Crossing the Quality Chasm, the United States (...) ]); • Reviews that overtly state that the review conformed with an evidence-based minimum set of items for reporting referred to as Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) (Liberati 2009 GL) are identified as PRISMA eg ( Moore 2014 Level I [PRISMA]); • Reviews that overtly state that the review conformed with standards previously published as Quality of Reporting of Meta-analyses (QUOROM) ( Moher 1999 GL), a precursor of PRISMA, are identified as QUOROM eg ( Macedo 2006

2015 Clinical Practice Guidelines Portal

19. Guidelines for identification and management of substance use and substance use disorders in pregnancy

and disorders 2 Who should use these guidelines 3 Objectives and scope of the document 3 Individuals and partners involved in development of the guidelines 3 How the guidelines were developed 4 Evidence search and retrieval 4 Evidence to recommendations 6 Recommendations 6 Overarching principles 6 Screening and brief interventions for hazardous and harmful substance use during pregnancy 8 Psychosocial interventions for substance use disorders in pregnancy 9 Detoxification or quitting programmes for alcohol (...) : Detoxification or quitting programmes for alcohol and other substance dependence in pregnancy 93 Evidence question 93 Selection criteria for the systematic review 93 Evidence to recommendations table 94 Evidence Profile 4: Pharmacological treatment (maintenance and relapse prevention) for alcohol and other substance dependence in pregnancy 100 Evidence question 100 Selection criteria for the systematic review 100 Evidence to recommendations table 100 Summary of findings and GRADE tables 104 Evidence Profile

2014 World Health Organisation Guidelines

20. Guidelines for Responsible Opioid Prescribing in Chronic Non-Cancer Pain

in specific circumstances with severe intractable pain that is not amenable to short-acting or moderate doses of long-acting opioids, as there is no significant difference between long-acting and short-acting opioids for their effectiveness or adverse effects. (Evidence: fair) B) The relative and absolute contraindications to opioid use in chronic non-cancer pain must be evaluated including respiratory instability, acute psychiatric instability, uncontrolled suicide risk, active or history of alcohol (...) use, at least in the United Sates (118-121). It has been alleged, however, that these positions are largely based on poor science and misinformation in relation to the safety and effec- tiveness of opioids when prescribed by a physician and taken appropriately (51,60,62-65,118-132). Opioid use for non-therapeutic purposes and also for chronic pain has increased over the years (63,66- 68,70,76-79,85,106,127-176). It has been shown that 90% of patients present to pain management settings with prior

2012 American Society of Interventional Pain Physicians

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