Addiction Psychiatry

Biography

Dr. Kumari, received MD Degree from Dow Medical College Karachi, Pakistan. In addition, in 2004 she received a Master's Degree in Public Health (MPH) from George Washington University, Washington DC.

Dr. Kumari has a broad solid background in clinical psychiatry research, with specific training and expertise in managing, coordinating, and collaborating on multiple clinical research projects. As a project manager Dr. Kumari gained substantial research experience on NIDA funded research project- Seek Treat, Reach, and Identify pretrial Defendants Enhancement (STRIDE) in collaboration with the Yale School of Medicine, George Mason University and Howard University Hospital. The project STRIDE is a placebo-controlled, randomized controlled trial of buprenorphine treatment for HIV-infected,-infected, opioid dependent, community-supervised defendants or offenders.

Dr. Kumari supervised project clinical and research activities involving considerable responsibilities, complexity and variety. Dr. Kumari out performed on STRIDE project which led to successful execution and completion of multiple component of STRIDE project. In addition to coordinate STRIDE project activities she contributed to the development of additional research proposals without any funding support. She actively worked on abstracts, publications, poster presentations and research proposals.Two of her publication “Illustrating and analyzing the processes of multi-institutional collaboration” published in the Journal of Internal Medicine Review.And “Factors Associated with Non-adherence to Buprenorphine Naloxone among Opioid Dependent African-Americans” published in American Journal on Addictions received substantial recognition in scientific committe.

Dr. Kumari has co-authored several publications, presented in scientific conferences on-going research projects. Her professional background merges over 10 years of clinical research experience in psychiatry from NIMH, University of Maryland, Baltimore, and Howard University Hospital. In 2012 she presented at the Stigma conference in Washington, DC; in 2013 she contributed to the posters at the APHA and APA conferences. In 2014 she presented in AAAP conference at Florida. Dr.Kumari, was featured at the GHUCCTS-e-Reporter Newsletter “Fighting Heroin Addiction One STRIDE at a Time” as their April 2014 spotlight of the month.

Abstract

Background & Objectives: Opioid use disorders are common, chronic relapsing disorders. Buprenorphine (BUP) is an FDA approved medication in the treatment of opioid use disorders, but patient adherence to this medication remains a challenge. To identify risk factors for non-adherence, this chart review study examined the association between DSM-IV Axis I psychiatric disorders, substance use, demographics, and adherence to BUP-naloxone in African–American patients.

 

Methods: Charts were selected of patients who had 5 visits and completed psychometric screens (patient health questionnaire, mood disorder questionnaire, and a posttraumatic stress disorder questionnaire) at the time of the initial visit (N ¼ 50). Urine drug screens (UDS) were also obtained. Treatment adherence was defined as BUP presence in UDS for 80% of the visits.

 

Results: A total of 48% of patients were adherent to treatment. Non-adherent patients had higher rates of use for not only opioids, but also cocaine, and alcohol. Cocaine use was associated with BUP-naloxone non-adherence even after controlling for opioid use. Attendance in cognitive behavioral group therapy sessions (CBT) was significantly associated with adherence. Patients endorsing PTSD symptoms showed higher adherence to treatment compared to those who did not endorse these symptoms.

 

Conclusions & Scientific Significance: Our results indicate that alcohol and illicit substance use is associated with non-adherence to BUP-naloxone treatment, and suggests that CBT and efforts to promote abstinence from non-opioid substance use may improve adherence among African–Americans. These findings contribute to growing literature on understanding adherence to BUP-naloxone, which is critical to reduce morbidity and mortality.