Nurse led care in addictions; physical screening with help of the USS in patients with severe substance use disorders

Background:

There has been a great deal of research in the addictions field in recent years, particularly on the roles and responsibilities of different levels of care. There has been a great deal of research into nurse-led care in addiction services. The findings are that in settings where MANP MHC are in clinical leadership, nursing interventions lead to good patient-related outcomes. Reduced absenteeism, satisfied staff, improved patient-related routine outcome measures, increased patient satisfaction and, finally, care has become cheaper due to improved use of professionals. In collaboration with IntNSA, the Dutch nurse specialists (MANP) have initiated innovations aimed at nurse-led care for addicted patients. Early somatic screening was developed by the MANP’s, and the workshop will focus on the background, implementation and outcomes at patient and staff level. The main cause of reduced life expectancy in people with severe substance use disorders (SUDs) is the presence of somatic comorbidities. Addiction nurses are responsible for coordinating somatic screening and implementing follow-up according to the results. Assessing patients' physical well-being is an essential component of recovery-focused care. 

Methods
Given the limited availability of empirical research on the physical health and lifestyle of people with severe substance use disorders (SUDs), this study provides comprehensive data on their vulnerability to physical complaints. The Utrecht Somatic Screening (USS) was established to perform somatic screening and to promote a healthy lifestyle. A cross sectional study: the research cohort consisted of 136 patients with severe SUDs receiving outpatient treatment in three specific treatment programmes: 1) Flexible Assertive Community Treatment (FACT), 2) Heroin Assisted Treatment (HAT) and 3) Opiate Replacement Treatment (ORT).

Results
Evidence suggests that a significant proportion of patients, up to 50%, have deficits in their ability to self-manage their physical health. Given their position at the frontline of healthcare, addiction nurses are well placed to conduct health and lifestyle screening, facilitate care coordination, and promote patient self-management skills. The USS is a clinically effective tool for somatic screening and promotion of healthy lifestyle behaviours.

References

De Hert M, Vancampfort D, Detraux J. Somatic problems, and dual disorder patients. In: Dom G, Moggi, F, editors. Co-occurring addictive and psychiatric disorders: A practice-based handbook from a European perspective. Berlin: Springer; 2015, p. 349–61. 

Firth J, Siddiqi N, Koyanagi A, Siskind D, Rosenbaum S, Galletly C, et al. The Lancet Psychiatry Commission: A blueprint for protecting physical health in people with mental illness. Lancet Psych. 2019 Aug; 6(8):675–712. Available from: https://doi.org/10.1016/S2215-0366(19)30132-4