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1.
Nursing ; 51(9): 44-47, 2021 Sep 01.
Article in English | MEDLINE | ID: covidwho-1462510

ABSTRACT

ABSTRACT: Substance use treatment inequities among rural populations are well documented and the COVID-19 pandemic has exacerbated these inequalities, forcing healthcare providers to be creative in the delivery of treatment. Systematic reviews on the use of telehealth to treat patients with substance use disorder indicate that it is a promising alternative to in-person services. This article examines the evidence supporting the use of telehealth in treating patients with opioid use disorder and explores other promising options that can help overcome pandemic-related barriers to treatment.


Subject(s)
COVID-19 , Health Services Accessibility/organization & administration , Opioid-Related Disorders/nursing , Rural Health Services/organization & administration , Telemedicine/organization & administration , Humans , Opioid-Related Disorders/epidemiology , Systematic Reviews as Topic , United States/epidemiology
2.
Nursing ; 51(7): 44-47, 2021 Jul 01.
Article in English | MEDLINE | ID: covidwho-1393335

ABSTRACT

ABSTRACT: Prone positioning is a recommended therapy for patients with COVID-19 who develop acute respiratory distress syndrome. This article describes the creation, operation, and evolution of the pronation therapy team at the author's Veterans Affairs facility.


Subject(s)
COVID-19/complications , Hospitals, Veterans/organization & administration , Patient Care Team/organization & administration , Patient Positioning/methods , Respiratory Distress Syndrome/therapy , COVID-19/epidemiology , Humans , New Jersey/epidemiology , Prone Position , Respiratory Distress Syndrome/virology
3.
Contemp Clin Trials ; 109: 106540, 2021 10.
Article in English | MEDLINE | ID: covidwho-1363910

ABSTRACT

There are currently no validated pharmacotherapies for posttraumatic stress disorder (PTSD)-related insomnia. The purpose of the National Adaptive Trial for PTSD-Related Insomnia (NAP Study) is to efficiently compare to placebo the effects of three insomnia medications with different mechanisms of action that are already prescribed widely to veterans diagnosed with PTSD within U.S. Department of Veterans Affairs (VA) Medical Centers. This study plans to enroll 1224 patients from 34 VA Medical Centers into a 12- week prospective, randomized placebo-controlled clinical trial comparing trazodone, eszopiclone, and gabapentin. The primary outcome measure is insomnia, assessed with the Insomnia Severity Index. A novel aspect of this study is its adaptive design. At the recruitment midpoint, an interim analysis will be conducted to inform a decision to close recruitment to any "futile" arms (i.e. arms where further recruitment is very unlikely to yield a significant result) while maintaining the overall study recruitment target. This step could result in the enrichment of the remaining study arms, enhancing statistical power for the remaining comparisons to placebo. This study will also explore clinical, actigraphic, and biochemical predictors of treatment response that may guide future biomarker development. Lastly, due to the COVID-19 pandemic, this study will allow the consenting process and follow-up visits to be conducted via video or phone contact if in-person meetings are not possible. Overall, this study aims to identify at least one effective pharmacotherapy for PTSD-related insomnia, and, perhaps, to generate definitive negative data to reduce the use of ineffective insomnia medications. NATIONAL CLINICAL TRIAL (NCT) IDENTIFIED NUMBER: NCT03668041.


Subject(s)
COVID-19 , Sleep Initiation and Maintenance Disorders , Stress Disorders, Post-Traumatic , Veterans , Humans , Pandemics , Prospective Studies , SARS-CoV-2 , Sleep Initiation and Maintenance Disorders/drug therapy , Sleep Initiation and Maintenance Disorders/etiology , Stress Disorders, Post-Traumatic/drug therapy , Stress Disorders, Post-Traumatic/epidemiology
4.
Nursing ; 51(7): 44-47, 2021 Jul 01.
Article in English | MEDLINE | ID: covidwho-1280142

ABSTRACT

ABSTRACT: Prone positioning is a recommended therapy for patients with COVID-19 who develop acute respiratory distress syndrome. This article describes the creation, operation, and evolution of the pronation therapy team at the author's Veterans Affairs facility.


Subject(s)
COVID-19/complications , Hospitals, Veterans/organization & administration , Patient Care Team/organization & administration , Patient Positioning/methods , Respiratory Distress Syndrome/therapy , COVID-19/epidemiology , Humans , New Jersey/epidemiology , Prone Position , Respiratory Distress Syndrome/virology
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