From Clinicaltools.com

Alcohol Pharmacotherapy Framework

8/28/09 - we pulled Pharmacotherapy out of the Pharmacology course for MS Alcohol - it needs to be it's own separate course with real explanations of how to prescribe appropriate pharmacotherpaies and following up with patients

Project Framework

Contents 1 Description 2 URL 3 Need 4 Needs Analysis 5 Mission 6 Goal 7 Learning Objectives 8 Case Study 2: George 9 Case Study 3: Pauline 10 Module Evaluation and Review 10.1 Student Assessments

Description

(Steve draft) Since the physician is able to prescribe medications, are there any pharmacological interventions they can administer to their patient to help them halt their negative alcohol use which effects their health?

Different pharmacotherapy options are presented, with an explanation of how each drug affects the reward mechanisms to deter patients from consuming alcohol.

URL

Need

Choosing the appropriate pharmacotherapy for a patient addicted or dependent on alcohol requires that the physician understand the pharmacological effects of alcohol and pharmacotherapies, and how each drug affects reward mechanisms.

Needs Analysis

In the spring of 2008, we conducted a focus group with 13 medical school faculty and addiction consultants. The results are summarized below:

Brief Summary: The focus group shaped our module outline and content. With a rating scale of 1-5, the importance of Pharmacology as a course was rated 4.38. The belief that the average medical student would benefit from additional instruction in this topic was rated 4.42, a rating of 4.33 was deemed for encouragement of students to learn more about the topic, and the belief that the topic aligned with recommended physician competencies in the area of substance abuse was rated 4.40. Faculty thought that the module would fit easily into their institution's curriculum, with a rating of 4.17, and that they would include this module in their current teachings, with a rating of 4.25. The most respondents (8) thought the topic area should have 1 hours of lecture time devoted to it. Also, multiple areas of concentration were suggested in the topic area and these were taken into consideration when constructing the course.

Mission

To learn what pharmacotherapy drugs are available, how they work and when they are appropriate to be prescribed.

Goal

After taking this course, medical students will be able to prescribe appropriate pharmacotherapies for alcohol abuse or dependence.

Learning Objectives

1. Appropriately prescribe a pharmacological treatment based on how the drug will affect the patient's reward systems.

Case Study 2: George

Case Focus: George is presented in 1 pages, immediately following a discussion on Pharmacotherapies.

Case Goal: Physicians-in-training should be able to identify medications currently available to treat alcohol dependence and choose the best prescription for the patient.

Course Objectives Met: 3, 4

Patient: George - 23YOWM

• Chief Complaint: He is seeking pharmacological treatment for his alcohol addiction
• Narrative: George is 23 years old and has been in treatment previously.
• Alcohol Use: Known alcohol addiction
• AUD Diagnosis: George is in need of pharmacological treatment for his alcohol addiction and the best choice for him would be injectable Naltrexone as it has a 30 day duration and a higher treatment adherence because the patient cannot miss doses.
• Relevant Past Medical, Psychosocial, Family History: Unknown
• Take Home Message: Previous treatment failure leads to a need for medication that has a higher treatment adherence
• Practice Tip: Injectable Naltrexone has a 30 day duration and has a higher treatment adherence because the patient cannot miss doses.
• URL's: Meet George

Case Study 3: Pauline

Case Focus: Pauline is presented in 1 page, immediately following a discussion on different pharmacological treatment choices.

Case Goal: Physicians-in-training should be able to identify medications currently available to treat alcohol dependence and choose the best prescription for the patient.

Course Objectives Met: 3, 4

Patient: Pauline - 36YOHF

• Chief Complaint: Pauline has come into your office seeking pharmacological treatment for her alcohol addiction.
• Narrative: Pauline is a 36 year old secretary who is married with 2 children. She needs pharmacological treatment for her alcohol addiction. Complicating matters is that she has hepatic impairment, so selecting her therapy should take that into account.
• Alcohol Use: Known alcohol use problems
• AUD Diagnosis: Pauline is in need of pharmacological treatment for her alcohol addiction and the best choice for her would be Acamprosate as it does not have any noted contraindications for hepatic impairment.
• Relevant Past Medical, Psychosocial, Family History: 2 children, husband, hepatic impairment
• Take Home Message: Acamprosate is the best choice for Pauline as does not have any noted contraindications for hepatic impairment.
• Practice Tip: Co-occurring physical issues must be taken into account when prescribing medication
• URL's: Meet Pauline

Module Evaluation and Review

Student Assessments

• Knowledge questions

• ASEIB questions