Report

Teaser, summary, work performed and final results

Periodic Reporting for period 1 - BEAMED (Better Addiction Medicine Education for Doctors)

Teaser

What is the problem/issue being addressed?Drug and alcohol addiction cause a significant social and economic burden globally. Adequate diagnosis and treatment by general practitioners fails, in part due to a lack of knowledge and accredited training in addiction medicine. In...

Summary

What is the problem/issue being addressed?
Drug and alcohol addiction cause a significant social and economic burden globally. Adequate diagnosis and treatment by general practitioners fails, in part due to a lack of knowledge and accredited training in addiction medicine. In Ireland, the training of general practitioners in identifying and treating addiction is lacking. Internationally, a number of initiatives to address this challenge have emerged, including a specialised training programme in Canada.

Why is it important for society?
This study improves addiction education for doctors and responds directly to the European Research Agency’s priorities “Excellent Science, Health, Demographic Change and Wellbeing”, specifically “improve ability to monitor health and to prevent, detect, treat and manage disease”.

What are the overall objectives?
To build on these initiatives, the goal of this project is to establish the feasibility and acceptability of training primary care practitioners in addiction medicine, and, in particular, how international models of addiction medicine training might inform the future development of general practice education in Ireland. Specifically, the ongoing project seeks to increase incorporation of new understandings about addictive disorders from multiple disciplines into undergraduate and postgraduate medical curricula. The disciplines include public health, general practice, psychiatry and health services research.

Work performed

Research products resulting from our work performed on this research project from the beginning to the end of the period covered by the report (September 2019) include 13 conference presentations led by the fellow or the supervised students, and 12 research manuscripts published in peer-reviewed journals (please see Publications).

Final results

Much has been learned about the process, challenges, outcomes and impacts of focused addiction medicine education through this project. In this context, previous literature has demonstrated that low rates of training among physicians in areas other than addiction are attributable to substantial debt burdens associated with medical education and inflexible training programmes that often do not accommodate specialised education in a physician’s area of focus or physicians’ concurrent and ongoing clinical activities. To this end, there is a paucity of information evaluating focused addiction education among physicians, and the subsequent evaluation of training outcomes and impact on addiction treatment. This study employed an innovative evaluation approach, with the goal of prospectively evaluating and disseminating the impacts and outcomes of focused addiction medicine education on subsequent competence and confidence.

Potential impacts: Given the state of the art in the field, this project has applied a systematic, step-wise method to create a toolkit that is informed by empirical evidence and expert opinion. Evaluating a North-American curriculum in EU was novel and has been relatively understudied. The project’s novel methodologies were: a) systematic review – there were no systematic reviews of the topic, only two previous narrative reviews; b) training needs assessment – this is a novel technology that was developed in Netherlands, piloted in Indonesia and Lithuania, but not in UK or Ireland; and c) addiction medicine fellowship – this novel training method started in early 2000 and hasn’t been used in EU.

Potential impact of the project and training on researcher’s career:
The fellowship has opened new career perspectives for the academic sector, and in a public policy or advisory role. Doing this project has advanced my skills as a methodology expert. The research training has added more value to the international work and created increased linkage with Ireland. This has expanded the scope of what I have been doing; allowed a better evaluation of training, using a pre- post- assessment of clinical rotations.

Potential impact of the researcher’s activity on European society and economy:
Addiction treatment / primary care systems: by consolidating addiction training between service providers (primary and secondary care agencies). The consolidated core competencies for addiction medicine education ease the collaboration between providers, by increasing the shared knowledge and understanding of addiction. Both British Columbia Centre on Substance Use (BCCSU) at University of British Columbia, and the Primary Mental Healthcare Research Group (PMHRG) at University College Dublin, aim to expand the role of primary care in addiction treatment, thus increasing EU citizens’ access to treatment.

Policy & education: by testing feasibility of increasing addiction training in primary care, this research contributes towards evidence-based policy and education in EU and internationally. The issue requires an international approach to save money, minimise duplication of work on addiction medicine curricula, improve adoption of best practices across continents, and to standardise addiction medicine education worldwide. Consolidated core competencies and quality standards can make it easier for doctors to move between systems within the European Higher Education Area. Here, the fellowship has facilitated such mobility when the fellow hosted two international visitors as follows:
Sponsored long–term visitors and research associates
Mar –April, 2018; Prof Gerrard Bury, University College Dublin, Ireland (Visiting Professorship from the Ireland-Canada University Foundation)
Sept –2017; Prof Dennis McCarty, Oregon Health& Sciences University, Portland, OR

Discipline of addiction medicine: the researcher develops unique competencies and links that are highly needed for the progress of addiction medicine in Eu

Website & more info

More info: http://www.ucd.ie/medicine/primaryconnections/.