Addictions program that reduces emergency room visits for opioid overdose and improves patient experience is spreading across Ontario

Thursday, July 6, 2017 General News
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TORONTO, July 6, 2017 /CNW/ - A program providing better and faster care to people living with opioid and alcohol addictions

has spread to seven communities across Ontario. Early results show that hospitals in these communities are seeing fewer emergency room visits and hospitalizations, and patients are having significantly improved experiences
because of new follow-up treatment programs and expanded community supports.

There were 3,200 opioid-related emergency department visits in Ontario in 2014 alone, according to The Ontario Drug Policy Research Network, with about half of those patients being admitted into hospital. Also, according to a recent report from the Canadian Institute for Health Information, Ontario had over 24,200 alcohol-related hospitalizations in 2015-2016.  

A first-of-its-kind project, Mentoring, Education, and Clinical Tools for Addiction: Primary Care-Hospital Integration (META:PHI) is addressing these issues by developing rapid-access addiction medicine clinics that integrate care received in emergency departments and hospitals, primary care, and front-line community services such as withdrawal management centres and shelters. Patients can now seamlessly transition from emergency departments to a rapid-access clinic and then, once stable, to a primary care provider.

Patients reported an improved experience in their care, that their addiction was addressed, and that they felt less stigma when receiving care – something patients living with addiction report often feeling.  

"Rapid-access addiction medicine clinics that open as part of the META:PHI project provide immediate access to lifesaving treatment," says Dr. Meldon Kahan, META:PHI Project Lead and Medical Director of Substance Use Service, Women's College Hospital. "We are now in the midst of an opiate crisis across the country, and this treatment model offers us a realistic and effective response to this crisis."

Developed by Dr. Kahan, along with his team and the leadership at Women's College Hospital, META:PHI was born out of the necessity for more accessible, evidence-based addiction care. With support from Adopting Research to Improve Care (ARTIC), META:PHI has extended its reach to 861 patients, who have received treatment in rapid-access clinics and benefited from improved care in hospitals and primary care clinics in Ottawa, Sudbury, London, Owen Sound, Sarnia, St. Catharines and Newmarket. 

ARTIC is a joint program of the Council of Academic Hospitals of Ontario (CAHO) and Health Quality Ontario. Its mandate is to accelerate the spread of proven care.

"META:PHI is having a real impact on the lives of patients and their families," says Karen Michell, Executive Director of CAHO. "An integrated, more supportive approach is helping to change the way Ontario's health system treats people living with addictions and ARTIC has played a key role in spreading the program's success across the province."

Reducing emergency department visits

People struggling with opioid or alcohol addiction often don't have a coordinated plan for recovery. Their fragmented care finds many in and out of treatment centres or in an emergency department following an overdose. Once discharged, people are not always referred to ongoing treatment, or may wait months to begin a program.

Results from META:PHI show that by providing patients with faster access to more supportive treatment, delivered in a more integrated way, hospital emergency visits related to opioid or alcohol addictions decrease.

At Health Sciences North in Sudbury, for example, clinicians measured the number of times patients supported through META:PHI visited the emergency department 90 days before and after their first rapid-access clinic appointment and found a 63 per cent reduction in emergency department visits. Measuring the same way, Sarnia's rapid-access clinic saw a 45 per cent reduction in emergency department visits.

According to 9 Million Opioid Prescriptions, a report by Health Quality Ontario, nearly two million people in Ontario fill prescriptions for opioids every year — translating into one in every seven Ontarians, or 14 per cent of the province's population.

"Opioid use is on the rise in Ontario and addiction is a very serious concern," says Dr. Joshua Tepper, President and CEO of Health Quality Ontario. "META:PHI aims to provide access to quality care while reducing the pressure on hospital emergency departments that are seeing more opioid-related overdoses."

By early 2018, the ARTIC-supported META:PHI clinics estimate that they will have treated more than 2,000 patients. Each year, that number should continue to grow as the clinics build capacity and continue to spread. With funding from the Toronto Central LHIN, META:PHI will expand two existing rapid access clinics and open five new ones in the Toronto area in the next 18 months.

ARTICARTIC's proven model brings evidence-based care faster and more consistently to more people in Ontario. Supported by the Ministry of Health and Long-Term Care, ARTIC provides project teams with funding and active support over approximately two years to ensure successful implementation and sustainability of health care interventions across more Ontario health care providers.

Another example of an ARTIC spread project is Depression and Alcoholism – Validation of an Integrated Care Initiative (DA VINCI). While depression and alcohol use often go hand in hand, they are traditionally screened and treated separately. DA VINCI, originally established at the Centre for Addiction and Mental Health, is the first program in Canada to implement a way to systematically screen and treat both together. Successfully implemented across eight additional health care organizations, the program saw reductions in depression and drinking in those who completed the program.

To learn more about ARTIC and its programs and how it's improving quality of care across Ontario, please visit the websites of the Council of Academic Hospitals of Ontario or Health Quality Ontario.

About CAHO The Council of Academic Hospitals of Ontario represents Ontario's 23 research hospitals that play a unique and vital role in the province's health care system. Collectively, we provide advanced patient care services, train the next generation of health care professionals, and conduct leading-edge research to discover tomorrow's care today. On the foundation of this work, we generate the expertise and evidence to drive change as system leaders, building a healthier, wealthier, smarter Ontario. For more information, visit www.caho-hospitals.com.

About Health Quality Ontario Health Quality Ontario is the provincial advisor on the quality of health care. With the goal of excellent care for all Ontarians, Health Quality Ontario reports to the public on how the system is performing, develops standards for what quality care looks like, evaluates the effectiveness of new health care technologies and services, and promotes quality improvement aimed at substantial and sustainable positive change. Visit www.hqontario.ca for more information.

SOURCE Health Quality Ontario



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