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C52. Client defined recovery at Calgary iOAT

C52. Client defined recovery at Calgary iOAT

Learner category:

  • Beginning Level
  • Novice Level

Learning objectives:

  • Participants will recognize the unique needs of iOAT clients within the program and will identify strategies
    utilized to engage the most vulnerable clients, build trust, and bridge to the broader health care system.
  • Participants will appreciate unique challenges that the Calgary iOAT clients experienced. They will gain awareness
    around the improvements and barriers to clients that participate in the Calgary iOAT program.

Abstract

Objective The Calgary Injectable Opioid Agonist Treatment (iOAT) program provides specialized wrap-around care and treatment for individuals with severe opioid use disorder who inject drugs and have been unsuccessful with oral medications. Continuous learning has become an embedded component to service delivery. Early learnings include the importance of building connections with the community and health care system. Primary care providers imbedded in iOAT help create a bridge to other services that benefit the clients and facilitate holistic, wrap-around care for this vulnerable population. Methods Client feedback has been the driving force behind any adjustments made at iOAT. Using Quality of Life and Barriers surveys, program experience interviews, self-report and client letters we had the opportunity to understand the impact iOAT had on clients in the program. Results At intake, Forty-one percent of respondents found their quality of life very poor or poor, and more than half (55%) were dissatisfied or very dissatisfied with their health. After two months and longer in the program, 69% of respondents indicated their quality of life as good or very good, and 48% were satisfied with their health. Positive changes reported were reduced illicit opioid use, reduced criminal activity, and an increased ability to improve their lives. Conclusions Every client is provided with holistic, wrap-around care that supports them in their recovery. This comprehensive care has provided clients with support, encouragement, and opportunity. The clients have reported and demonstrated changed behaviors, improved functioning and a desire to improve their lives.

Authors

Stacey Whitman
RN MN, Alberta Health Services

Stacey Whitman is the Manager Calgary Injectable Opioid Agonist Treatment Program and the Calgary Opioid Dependency Program (ODP). She is a registered nurse and competed her Master of Nursing Degree in 2017. Stacey has worked in a variety of settings including acute care, outpatient programming and residential care.

Cristina Zaganelli
MN NP, Alberta Health Services

Cristina is a nurse practitioner with a practice focus in substance use, mental health, and homelessness. She graduated from the University of Calgary and Dalhousie University. Cristina works at the Injectable Opioid Agonist Therapy Clinic, Youth Substance Use and Mental Health Services, and The CUPS Health Clinic.

Comments (9)

  1. Dennis Hagarty

    Nicely done. I like that you see the patient not the disease. Question does your program use buprenorphine or methadone? Your hours are long how many staff (nurses, counselors, Social Workers, & physicians do you have?

    1. Stacey Whitman

      Our prescribers use a variety of options for OAT. Hydromorphone is the injectable medication. The long acting medication given at the last session of the day is methadone or a slow release oral morphine. We have had some clients on buprenorphine.
      As for staffing, we have a physician provide 4 hours of onsite care daily as well as to remain on-call the remainder of the day (until 1900), our baseline for nurses is 3 per shift, one admin, one Peer Support Worker per shift. In addition, we have a Social worker and Outreach worker Monday through Friday. Our Nurse practitioner is also Monday through Friday.

  2. suzannealunni@yahoo.com

    Great presentation. Your program is fabulous ! More programs such as yours is needed across countries.
    Thank you for the compassionate care your program offers to patients.

    1. Stacey Whitman

      Thank you!

  3. Niall Tamayo

    Great presentation! I’m glad to see that something like this exists in Canada…I see this as a service that is similar to a consumption site…However, most supervised consumption sites (that I know of) ask the individuals to bring their own….Are you aware of any conversations where this prescribed model can be extended to Supervised Consumption Sites?

    1. Stacey Whitman

      This is definitely a conversation that is occurring. We are located in the same building as the Supervised Consumption site and it works very well. We work closely with the team so that we are able to support our clients.

  4. Paulo Seabra

    Dear Stacey
    I congratulate you on the great job you are doing. I realized that on the last access of the day, users take a prolonged-release opioid (such as methadone). My question is, in view of the added value of methadone programs in reducing injectable consumption, how do you see the transition of your users to oral metador programs?
    Best whishes.

  5. Rachel Shuster, BSN, RN, CARN, CAAP

    Thank you so much for this presentation. Ensuring I am aware of and learning from programs like this are why being part of an international organization is so important to me. Its my hope that someday (soon, please) the US can follow in these footsteps. Thank you for bringing this knowledge to all who are attending this year’s virtual conference.

  6. Oluremi Adejumo

    Hello Stacey and Christina, I enjoyed your presentation. Indeed, your program is intense and provides the holistic care needed for improved health outcomes.

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