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Med/psych residents earn second place at research forum

Julie Leber, DO, and Jacob Cohn, MD, won 2nd place at 2019 residents, postdocs, fellows research forum

Two Department of Psychiatry and Behavioral Sciences residents earned second place in the poster presentation category at the University of Kansas Medical Center's 10th annual Residents, Postdocs and Fellows Research Forum.

Julie Leber, D.O., and Jacob Cohn, M.D., PGY-5 internal medicine/psychiatry residents, presented a poster outlining their novel research study, "Opioid reversal agents: a prescription for improvement," during the May 1-3 forum on the KU Medical Center campus.

The study by Leber and Cohn focused on increasing the prescription rate of opioid reversal agents such as naloxone by 15% to eligible patients on hospital discharge and assessing inpatient and outpatient provider knowledge and prescribing practices.

"We wanted to invest our time and energy in a high-impact, generalizable improvement to our current practice," Cohn said. "This type of system-based research is a pragmatic approach to change that we don't get exposed to at the resident level. It showed me how to approach quality improvement goals in a measurable, patient-centered manner."

Results of the quality improvement project showed naloxone prescriptions were provided to less than 0.05% of eligible patients, though the practice has been shown to significantly decrease morbidity and mortality in at-risk patients.

Meanwhile, through survey data, the residents found providers linked low prescription rates to their lack of understanding about who should receive reversal agents as well as feeling like it wasn't their responsibility.

"We suspected anecdotally that we could identify an area of improvement in the provision of opioid reversal agents, but I don't think either Dr. Cohn or I suspected our results would be this profound," Leber said.

Leber and Cohn worked with The University of Kansas Health System's Opioid Stewardship Committee to explore ways to get naloxone prescriptions to more eligible patients. Next steps include developing a discharge toolkit to help identify patients at risk, or individuals statistically more likely to benefit from naloxone on discharge, and to provide additional comprehensive patient-centered education.

"No one specialty has taken ownership for making sure that naloxone is available to patients that meet the U.S. Centers for Disease Control criteria," Leber said. "While I believe that it should be our collective responsibility, and that increasing provider education and familiarity with naloxone would be helpful, I also think it is an area that psychiatry could take the lead on."

The research forum was sponsored by the KU Medical Center Office of the Vice Chancellor for Research and organized by the Office of Graduate Medical Education and Office of Postdoctoral Affairs. It is designed to give participants experience presenting their research; highlight the strong research being done by residents, postdocs and fellows; and showcase the wide variety of research being conducted at KU Medical Center.

Psychiatry and Behavioral Sciences

University of Kansas Medical Center
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