TY - JOUR
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Alcohol
KW - Alcoholism/diagnosis
KW - Analgesics, Opioid/therapeutic use
KW - Female
KW - hospice
KW - Hospice Care/statistics & numerical data
KW - Humans
KW - Male
KW - Middle Aged
KW - Opioid
KW - Pain/drug therapy
KW - palliative care
KW - Palliative Care/statistics & numerical data
KW - Substance Abuse
KW - Substance Abuse Detection/methods
KW - Substance-Related Disorders/diagnosis
KW - United States
AU - P. Sacco
AU - J. G. Cagle
AU - M. L. Moreland
AU - E. A. S. Camlin
A1 - 
AB - BACKGROUND: Quality of care provided by hospice and palliative care agencies depends on a thorough understanding of the patient, the family, their history, and current risk factors. It is therefore imperative for social workers and other providers in these settings to assess patients and caregivers for substance use disorders and potential for substance misuse. OBJECTIVE: We aimed to examine how hospice social workers in the United States screen and assess for alcohol and substance use and risk of medication diversion among patients and family caregivers. DESIGN/MEASUREMENTS: Using a cluster random sample of U.S. Medicare-certified hospices, we reviewed blank copies of psychosocial assessments used by hospice social workers from 105 agencies. We conducted systematic content analyses of these assessments, identifying and examining all items related to substance use or addiction. RESULTS: Over two-thirds (68%) of agencies assessed substance use by patient and/or family members. Assessments tended to focus broadly on whether substance misuse was a current problem for the patient or his/her primary caregivers. Assessments were not standardized instruments and did not differentiate between drug types. No assessments directly addressed potential diversion of pain medications. Larger hospices serving more patients per day were more likely to include substance use content in their assessments. CONCLUSIONS: We recommend that hospice care providers implement structured substance use screening focused on both the patients and family. To stem the public health impact of prescription opioid misuse, we recommend adoption of structured screening instruments to evaluate drug diversion risk.
BT - Journal of palliative medicine
C5 - Opioids & Substance Use
CP - 8
CY - United States
DO - 10.1089/jpm.2016.0538
IS - 8
JF - Journal of palliative medicine
N2 - BACKGROUND: Quality of care provided by hospice and palliative care agencies depends on a thorough understanding of the patient, the family, their history, and current risk factors. It is therefore imperative for social workers and other providers in these settings to assess patients and caregivers for substance use disorders and potential for substance misuse. OBJECTIVE: We aimed to examine how hospice social workers in the United States screen and assess for alcohol and substance use and risk of medication diversion among patients and family caregivers. DESIGN/MEASUREMENTS: Using a cluster random sample of U.S. Medicare-certified hospices, we reviewed blank copies of psychosocial assessments used by hospice social workers from 105 agencies. We conducted systematic content analyses of these assessments, identifying and examining all items related to substance use or addiction. RESULTS: Over two-thirds (68%) of agencies assessed substance use by patient and/or family members. Assessments tended to focus broadly on whether substance misuse was a current problem for the patient or his/her primary caregivers. Assessments were not standardized instruments and did not differentiate between drug types. No assessments directly addressed potential diversion of pain medications. Larger hospices serving more patients per day were more likely to include substance use content in their assessments. CONCLUSIONS: We recommend that hospice care providers implement structured substance use screening focused on both the patients and family. To stem the public health impact of prescription opioid misuse, we recommend adoption of structured screening instruments to evaluate drug diversion risk.
PP - United States
PY - 2017
SN - 1557-7740; 1557-7740
SP - 850
EP - 856
EP - 
T1 - Screening and Assessment of Substance Use in Hospice Care: Examining Content from a National Sample of Psychosocial Assessments
T2 - Journal of palliative medicine
TI - Screening and Assessment of Substance Use in Hospice Care: Examining Content from a National Sample of Psychosocial Assessments
U1 - Opioids & Substance Use
U2 - 28333571
U3 - 10.1089/jpm.2016.0538
VL - 20
VO - 1557-7740; 1557-7740
Y1 - 2017
ER -