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Medicine resident, postdoctoral and graduate student research

Permanent URI for this collectionhttps://hdl.handle.net/10222/79406

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    Uptake of slow-release oral morphine as opioid agonist treatment among hospitalized patients with opioid use disorder
    (Wiley, 2021) Brothers, Thomas D.; Fraser, John; MacAdam, Emily; Morgan, Brendan; Webster, Duncan
    Introduction: Buprenorphine and methadone are highly effective first-line medications for opioid agonist treatment (OAT) but are not acceptable to all patients. We aimed to assess the uptake of slow-release oral morphine (SROM) as second-line OAT among medically ill, hospitalized patients who declined buprenorphine and methadone. Methods: This study included consecutive hospitalized patients with untreated moderate-to-severe opioid use disorder (OUD) referred to an inpatient addiction medicine consultation service, between June 2018 and September 2019, in Nova Scotia, Canada. We assessed the proportion of patients initiating first-line OAT (buprenorphine or methadone) in-hospital, and the proportion initiating SROM after declining first-line OAT. We compared rates of outpatient OAT continuation (filling outpatient OAT prescription or attending first outpatient OAT clinic visit) by medication type, and compared OAT selection between patients with and without chronic pain, using Chi-squared tests. Results: Thirty-four patients were offered OAT initiation in-hospital; six patients (18%) also had chronic pain. Twenty-one patients (62%) initiated first-line OAT with buprenorphine or methadone. Of the 13 patients who declined first-line OAT, seven (54%) initiated second-line OAT with SROM in-hospital. Rates of outpatient OAT continuation after hospital discharge were high (>80%) and did not differ between medications (p=0.4). Patients with co-existing chronic pain were more likely to choose SROM over buprenorphine or methadone (p=0.005). Discussion and Conclusions: The ability to offer SROM (in addition to buprenorphine or methadone) increased rates of OAT initiation among hospitalized patients. Increasing access to SROM would help narrow the OUD treatment gap of unmet need.
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    Pregnant and postpartum women's perceptions of barriers and enablers to physical activity during pregnancy: a qualitative systematic review protocol.
    (2020-07) McKeough, Regan; Piccinini-Vallis, Helena; Blanchard, Chris
    Background: Moderate physical activity throughout pregnancy has been shown to have many health benefits for the mother, including reductions in the risk of preeclampsia and gestational weight gain, as well as improvements in blood pressure regulation. Despite the health benefits, it has been shown that many pregnant women do not meet the current guidelines for physical activity throughout pregnancy. Therefore, it is important to determine what influences pregnant women’s physical activity levels during pregnancy. This qualitative systematic review will aim to determine pregnant and postpartum women’s perceptions of barriers and enablers to physical activity during pregnancy. Methods: MEDLINE, PsycINFO, CINHAL, and EMBASE will be searched systematically to identify qualitative studies investigating pregnant and/or postpartum women’s perceptions of barriers and facilitators to physical activity during pregnancy. Included studies will be limited to populations of pregnant and/or postpartum women between the ages of 18 and 40 years old (inclusive), that have been published from 1985 onward. Two reviewers will independently screen and select references that will be critically appraised using the Mixed Methods Appraisal Tool. Extracted data will be mapped on the COM-B framework and synthesized using a meta-aggregative approach. Discussion: We aim to provide information on pregnant and postpartum women’s perceptions of barriers and enablers to physical activity during pregnancy, which may assist clinicians in developing more appropriate physical activity interventions and providing counselling.