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KT Challenge team takes aim at stimulant use disorder

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For the third year in a row, CHÉOS is supporting a team in the Knowledge Translation Challenge, a regional initiative jointly supported by PHC, PHCRI, and VCHRI. The challenge is designed to support teams of clinicians in moving evidence into practice to improve patient care.

Dr. Eugenia Oviedo-Joekes

Dr. Eugenia Oviedo-Joekes will serve as the project mentor for a team of point-of-care workers, including a nurse practitioner, physician, and two pharmacists that will explore the use of sustained release oral dexamphetamine (Dexedrine®) in patients receiving injectable opioid agonist treatment (iOAT).
“Dexamphetamine can be used to treat stimulant use disorder among people who use stimulants, such as cocaine,” said Dr. Oviedo-Joekes “Recent evidence from the Netherlands shows that this treatment is effective and safe among people receiving iOAT.”

Despite this evidence and the reported success of the treatment from Crosstown Clinic, the site of the SALOME and NAOMI trials, dexamphetamine is not currently prescribed to patients receiving iOAT outside of Crosstown.

PhD candidate Heather Palis is supporting the team as the research coordinator for the project. She is supervised by Dr. Oviedo-Joekes.

Heather Palis

“Our previous work with care providers has identified a number of common barriers to practice change with dexamphetamine,” said Palis. “These include concerns about dosing, drug interactions, and side-effects, as well as general uncertainties about how and for whom the treatment could be offered.”

The first aim of the KT project is to shift attitudes among care providers who are hesitant to prescribe dexamphetamine. In order to do this, the team will develop a webinar for potential prescribers. The team will also hold workshops aimed at increasing awareness of this treatment among patients.

“The collaborative exchange of knowledge with patients is a key component of this project,” said Palis. “The workshops are an opportunity to share information about the treatment but also learn how it can be adapted to better suit patient needs and expectations.”

Lay summaries of the results will be produced and delivered to community organizations and other patient groups.

Ultimately, the aim of this project is to promote increased awareness about dexamphetamine and how it can be used, and to increase understanding of it as a treatment for stimulant use disorder.

Last year, Dr. Joseph Puyat mentored a KT Challenge team that implemented a clinical toolkit for monitoring people on clozapine, a medication used for treatment-resistant schizophrenia. For the inaugural KT Challenge in 2017, Dr. Martha Mackay mentored a team that implemented an intervention to screen all cardiac patients for depression and anxiety before discharge.