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Febrile #99 – StAR: Frame Shift

99 Cover Art

Summary

This StAR episode features the CID State-of-the-Art Review: Frame Shift – Focusing on Harm Reduction and Shared Decision Making for People Who Use Drugs Hospitalized with Infections.

Table of Contents

Credits

Host: Sara Dong

Guests: Kinna Thakarar, Ayesha Appa, Chasity Tuell

Content is based on the CID article featured in this episode 

Cover Art: Sara Dong

Audio Editing: Bentley Brown 

Produced by Sara Dong with support from the Infectious Diseases Society of America (IDSA)

Our Guests

Kinna Thakarar, DO, MPH

Dr. Kinna Thakarar is an Associate Professor of Medicine and infectious diseases and addiction medicine physician at MaineHealth and Tufts University School of Medicine.  Her clinical and research interests include the ID and substance use syndemic, particularly harm reduction, shared decision making, and community-based work.

Ayesha Appa, MD

Dr. Ayesha Appa is an Assistant Professor of Medicine at UCSF, where she completed ID and Addiction fellowships in 2023.  Her research and clinical priorities are on patient-centered models of care for simultaneous treatment of addiction and infections including HIV.  She also is interested in creating more robust combined training in ID/Addiction.

Chasity Tuell

Chastity Tuell is a harm reductionist and serves as the Washington County Program Director for Maine Access Points. 

Tool.  Maine Access Points (MAP) is a harm reduction organization, providing syringe access services, overdose prevention education and naloxone distribution, peer support, and advocacy throughout rural Maine. We do this through networks of community distribution and collective organizing.

Culture

Kinna shared her love of Wawa!

Ayesha recently got a chance to read Fourth Wing while on vacation

Chasity has been enjoying her time watching junior high sports

Consult Notes

Goal

Listeners will be able to understand strategies for patient-centered healthcare that incorporates the tenets of shared decision making, harm reduction, and health equity to care for people who use drug hospitalized with infection

Learning Objectives

After listening to this episode, listeners will be able to:

  • Discuss how to approach clinical encounters with the overarching principles of harm reduction, health equity, shared decision-making, and no wrong door
  • Identify a structured conversation guide as a resource for shared decision making
  • Understand importance not creating scenarios where patient must choose use of buprenorphine and methadone vs antibiotics and avoiding MOUD (medication for opioid use disorder) discontinuation
  • Discuss safer use practices to prevent secondary infection

Disclosures

Febrile podcast reports no relevant financial disclosures

Potential conflicts of interest are noted in the CID article as well as reproduced below:

Kinna Thakarar: reports grants or contracts from SAMHSA and the National Institutes of Health and unpaid roles for the Maine Medical Center Board of Directors, AMERSA Advocacy Task Force, Infectious Diseases Society of America advocacy liaison, and Maine Recovery Council. 

Chasity Tuell: reports grants or contracts from SAMHSA and MaineHealth; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from States Recovery in Maine; and a role as Maine Recovery Council member. 

Jacinda Abdul Mutakabbir (co-author, not on podcast) reports serving on advisory boards and receiving an honorarium for Shionogi, Entasis Therapeutics, CSL Sequiris, Innoviva Specialty Therapeutics, and AbbVie; grants or contracts from CSL Sequiris; and consulting fees from Shionogi. 

All remaining authors: No reported conflicts of interest

Citation

Appa, A., Tuell, C., Thakarar, K., Dong, S. “#99: StAR: Frame Shift”. Febrile: A Cultured Podcast. https://player.captivate.fm/episode/58d9ac63-5d2c-4d7a-afde-d261d15b3fc7

Transcript

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