Year of Publication

2020

College

Public Health

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Dr. Angela Carman

Committee Member

Dr. Mark Swanson

Committee Member

Dr. Corrine M. Williams

Committee Member

Dr. Anne Ray

Abstract

Kentucky is a disparate state, ranking as one of the top states in incidence, prevalence, and mortality for both opioid use disorders (OUD) and cancer. Due to the high volume of both diseases in the state, there is a rising concern about the overlap of these two populations. Cancer and its’ treatment are known to cause chronic pain, defined as daily pain lasting 3 months or longer. Generally, chronic pain patients of any type are known to experience higher rates of opioid misuse (21-28%) and opioid dependence (8-12%) than the general population (4.1%, 0.9% respectively). The risk of OUD must be considered when initiating long-term opioid treatment for chronic pain, since a substance use disorder may result in poor pain control, dysimmune effects, and tumor proliferative effects. This program will utilize a transdisciplinary team approach to implement Screening, Brief Intervention, and Referral to Treatment (SBIRT) at the University of Kentucky Markey Cancer Center (UK MCC) in Lexington, KY to assess cancer survivors’ risk for developing OUD, monitor opioid use during the first 12-months of survivorship, and refer patients to alternative therapies to reduce reliance on opioids and improve pain management. The implementation of the program will be evaluated with a process evaluation and an outcome evaluation. Process evaluation metrics for the provider include: performance on trainings; administration of assessments, opioid monitoring measures, and pain scales; and rate of opioid prescriptions. Outcome evaluation metrics for the participant include: ability to manage pain; satisfaction with pain treatment plans; rate of completed referrals to specialists; change in OUD monitoring measure scores and number completed; and rate of opioid prescriptions. The program will utilize existing resources through UK Healthcare, the MCC Affiliate Network, and the MCC Research Network to implement the program to scale and disseminate findings across the state and to stakeholders.

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