Literature Collection

321

Effectiveness of transdiagnostic internet cognitive behavioural treatment for mixed anxiety and depression in primary care

Type: Journal Article

Authors: Jill M. Newby, Louise Mewton, Alishia D. Williams, Gavin Andrews

Year: 2014

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322

Effects of a telephone counseling intervention on psychosocial adjustment in women following a cardiac event

Type: Journal Article

Authors: R. Gallagher, S. McKinley, K. Dracup

Year: 2003

Publication Place: United States

Abstract: OBJECTIVE: The purpose of this study was to test the effect of a post-discharge telephone counseling intervention on women's psychosocial adjustment following a cardiac event. DESIGN: The study was a prospective, randomized, controlled trial. PATIENTS: Women (n = 196) were recruited from 4 hospitals in Sydney, Australia, who were hospitalized for coronary artery disease: myocardial infarction, coronary artery bypass grafts, coronary angioplasty, or stable angina. Women were randomized to usual care (n = 103) or telephone counseling (n = 93) and were 67 years of age (range 34-92). The majority had not completed high school (92%) and were not employed (84%). OUTCOMES: Psychosocial adjustment was measured by the Psychosocial Adjustment to Illness Scale and the Hospital Anxiety and Depression Scale the day before hospital discharge and 12 weeks postdischarge. INTERVENTION: Individualized information and support, was designed to promote self-managed recovery and psychosocial adjustment, and began with an evaluation during admission and was followed up by telephone counseling at 1, 2, 3, and 6 weeks after discharge. RESULTS: The intervention had no effect on psychosocial adjustment (F[1,182] = 0.06, P =.8), anxiety (F[1,182] = 0.15, P =.69) or depression (F[1,182] = 0.11, P =.74) at 12 weeks after discharge. Women made significant improvements during the 12 weeks on mean scores for psychosocial adjustment (F[1,182] = 58.37, P =.00), anxiety (F [1,182] = 74.58, P =.00) and depression (F[1,182] = 14.11, P =.00). The predictors of poor psychosocial outcomes for women included being less than 55 years of age, being unemployed or retired, having poor psychosocial adjustment to illness at baseline, having readmission, or experiencing a stressful, personal event during follow-up. CONCLUSIONS: Women at risk for poor outcomes following hospitalization for a cardiac event can be identified (ie, women less than 55 years of age, unemployed or retired, poorly adjusted to their cardiac illness, or readmitted to hospital within 12 weeks of a previous cardiac admission), but an effective intervention to enhance psychosocial outcomes remains to be established.

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323

Effects of automated smartphone mobile recovery support and telephone continuing care in the treatment of alcohol use disorder: study protocol for a randomized controlled trial

Type: Journal Article

Authors: J. R. McKay, D. H. Gustafson, M. Ivey, F. McTavish, K. Pe-Romashko, B. Curtis, D. A. Oslin, D. Polsky, A. Quanbeck, K. G. Lynch

Year: 2018

Publication Place: England

Abstract: BACKGROUND: New smartphone communication technology provides a novel way to provide personalized continuing care support following alcohol treatment. One such system is the Addiction version of the Comprehensive Health Enhancement Support System (A-CHESS), which provides a range of automated functions that support patients. A-CHESS improved drinking outcomes over standard continuing care when provided to patients leaving inpatient treatment. Effective continuing care can also be delivered via telephone calls with a counselor. Telephone Monitoring and Counseling (TMC) has demonstrated efficacy in two randomized trials with alcohol-dependent patients. A-CHESS and TMC have complementary strengths. A-CHESS provides automated 24/7 recovery support services and frequent assessment of symptoms and status, but does not involve regular contact with a counselor. TMC provides regular and sustained contact with the same counselor, but no ongoing support between calls. The future of continuing care for alcohol use disorders is likely to involve automated mobile technology and counselor contact, but little is known about how best to integrate these services. METHODS/DESIGN: To address this question, the study will feature a 2 x 2 design (A-CHESS for 12 months [yes/no] x TMC for 12 months [yes/no]), in which 280 alcohol-dependent patients in intensive outpatient programs (IOPs) will be randomized to one of the four conditions and followed for 18 months. We will determine whether adding TMC to A-CHESS produces fewer heavy drinking days than TMC or A-CHESS alone and test for TMC and A-CHESS main effects. We will determine the costs of each of the four conditions and the incremental cost-effectiveness of the three active conditions. Analyses will also examine secondary outcomes, including a biological measure of alcohol use, and hypothesized moderation and mediation effects. DISCUSSION: The results of the study will yield important information on improving patient alcohol use outcomes by integrating mobile automated recovery support and counselor contact. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02681406 . Registered on 2 September 2016.

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324

Effects of automated smartphone mobile recovery support and telephone continuing care in the treatment of alcohol use disorder: study protocol for a randomized controlled trial

Type: Journal Article

Authors: J. R. McKay, D. H. Gustafson, M. Ivey, F. McTavish, K. Pe-Romashko, B. Curtis, D. A. Oslin, D. Polsky, A. Quanbeck, K. G. Lynch

Year: 2018

Publication Place: England

Abstract: BACKGROUND: New smartphone communication technology provides a novel way to provide personalized continuing care support following alcohol treatment. One such system is the Addiction version of the Comprehensive Health Enhancement Support System (A-CHESS), which provides a range of automated functions that support patients. A-CHESS improved drinking outcomes over standard continuing care when provided to patients leaving inpatient treatment. Effective continuing care can also be delivered via telephone calls with a counselor. Telephone Monitoring and Counseling (TMC) has demonstrated efficacy in two randomized trials with alcohol-dependent patients. A-CHESS and TMC have complementary strengths. A-CHESS provides automated 24/7 recovery support services and frequent assessment of symptoms and status, but does not involve regular contact with a counselor. TMC provides regular and sustained contact with the same counselor, but no ongoing support between calls. The future of continuing care for alcohol use disorders is likely to involve automated mobile technology and counselor contact, but little is known about how best to integrate these services. METHODS/DESIGN: To address this question, the study will feature a 2 x 2 design (A-CHESS for 12 months [yes/no] x TMC for 12 months [yes/no]), in which 280 alcohol-dependent patients in intensive outpatient programs (IOPs) will be randomized to one of the four conditions and followed for 18 months. We will determine whether adding TMC to A-CHESS produces fewer heavy drinking days than TMC or A-CHESS alone and test for TMC and A-CHESS main effects. We will determine the costs of each of the four conditions and the incremental cost-effectiveness of the three active conditions. Analyses will also examine secondary outcomes, including a biological measure of alcohol use, and hypothesized moderation and mediation effects. DISCUSSION: The results of the study will yield important information on improving patient alcohol use outcomes by integrating mobile automated recovery support and counselor contact. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02681406 . Registered on 2 September 2016.

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325

Effects of electronic psychiatric consultations on primary care provider perceptions of mental health care: Survey results from a randomized evaluation

Type: Journal Article

Authors: E. Golberstein, S. Kolvenbach, H. Carruthers, B. Druss, P. Goering

Year: 2018

Publication Place: Netherlands

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326

Effects of Telephone-Based Peer Support in Patients With Type 2 Diabetes Mellitus Receiving Integrated Care: A Randomized Clinical Trial

Type: Journal Article

Authors: J. C. Chan, Y. Sui, B. Oldenburg, Y. Zhang, H. H. Chung, W. Goggins, S. Au, N. Brown, R. Ozaki, R . Y. Wong, G. T. Ko, E. Fisher

Year: 2014

Abstract: IMPORTANCE In type 2 diabetes mellitus (T2DM), team management using protocols with regular feedback improves clinical outcomes, although suboptimal self-management and psychological distress remain significant challenges. OBJECTIVE To investigate if frequent contacts through a telephone-based peer support program (Peer Support, Empowerment, and Remote Communication Linked by Information Technology [PEARL]) would improve cardiometabolic risk and health outcomes by enhancing psychological well-being and self-care in patients receiving integrated care implemented through a web-based multicomponent quality improvement program (JADE [Joint Asia Diabetes Evaluation]). DESIGN, SETTING, AND PARTICIPANTS Between 2009 and 2010, 628 of 2766 Hong Kong Chinese patients with T2DM from 3 publicly funded hospital-based diabetes centers were randomized to the JADE + PEARL (n = 312) or JADE (n = 316) groups, with comprehensive assessment at 0 and 12 months. INTERVENTIONS Thirty-three motivated patients with well-controlled T2DM received 32 hours of training (four 8-hour workshops) to become peer supporters, with 10 patients assigned to each. Peer supporters called their peers at least 12 times, guided by a checklist. MAIN OUTCOMES AND MEASURES Changes in hemoglobin A1c (HbA1c) level (primary), proportions of patients with attained treatment targets (HbA1c <7%; blood pressure <130/80 mm Hg; low-density lipoprotein cholesterol <2.6 mmol/L [to convert to milligrams per deciliter, divide by 0.0256]) (secondary), and other health outcomes at month 12. RESULTS Both groups had similar baseline characteristics (mean [SD] age, 54.7 [9.3] years; 57% men; disease duration, 9.4 [7.7] years; HbA1c level, 8.2% [1.6%]; systolic blood pressure, 136 [19] mm Hg; low-density lipoprotein cholesterol level, 2.89 [0.82] mmol/L; 17.4% cardiovascular-renal complications; and 34.9% insulin treated). After a mean (SD) follow-up period of 414 (55) days, 5 patients had died, 144 had at least 1 hospitalization, and 586 had repeated comprehensive assessments. On intention-to-treat analysis, both groups had similar reductions in HbA1c (JADE + PEARL, 0.30% [95% CI, 0.12%-0.47%], vs JADE, 0.29% [95% CI, 0.12%-0.47%] [P = .97]) and improvements in treatment targets and psychological-behavioral measures. In the JADE + PEARL group, 90% of patients maintained contacts with their peer supporters, with a median of 20 calls per patient. Most of the discussion items were related to self-management. CONCLUSIONS AND RELEVANCE In patients with T2DM receiving integrated care, peer support did not improve cardiometabolic risks or psychological well-being. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00950716.

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327

Effects of Virtual Care and Same-Day Access to Integrated Care on Specialty Mental Health Engagement in the Veterans Health Administration

Type: Journal Article

Authors: Taona P. Haderlein, Aram Dobalian, Pushpa V. Raja, Claudia Der-Martirosian

Year: 2023

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328

Efficacy of nurse telehealth care and peer support in augmenting treatment of depression in primary care

Type: Journal Article

Authors: E. M. Hunkeler, J. F. Meresman, W. A. Hargreaves, B. Fireman, W. H. Berman, A. J. Kirsch, J. Groebe, S. W. Hurt, P. Braden, M. Getzell, P. A. Feigenbaum, T. Peng, M. Salzer

Year: 2000

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329

Efficacy, tolerability, and preference of mirtazapine orally disintegrating tablets in depressed patients: a 17-week naturalistic study in Lithuania

Type: Journal Article

Authors: V. Danileviciute, A. Sveikata, V. Adomaitiene, G. Gumbrevicius, V. Fokas, R. Sveikatiene

Year: 2009

Publication Place: Lithuania

Abstract: Mirtazapine is an established antidepressant with well-documented efficacy demonstrated in controlled clinical trials. However, the gap between the results obtained in controlled clinical trials and everyday clinical practice exists. Therefore, the importance of naturalistic studies in psychiatry is becoming recognized. The aim of present naturalistic study was to acquire data on efficacy, safety, and preference of mirtazapine orally disintegrating tablets during a 17-week treatment of depression. This prospective, open-label, multicenter study in patients with mild to severe depression was conducted at 47 mental health centers of Lithuania by 78 psychiatrists. Patients were initially given 15 mg or 30 mg of mirtazapine orally disintegrating tablets; the maximum allowed dose was 45 mg per day. The primary efficacy measure was the total score on the Hamilton Depression Rating Scale-17 (HAMD-17), the Clinical Global Impression-Severity (CGI-S), and Clinical Global Impression-Improvement (CGI-I) scales. Tolerability was primarily measured by assessing the incidence of treatment-emergent adverse events. Patients were evaluated at baseline, at weeks 1, 5, 9, 13, and 17. A total of 779 patients (595 women [76.4%] with a mean [SD] age of 50.2 [13.65] and 184 men [23.6%] with a mean [SD] age of 52.4 [14.6] years) were enrolled into the study; 687 (88.2%) patients completed the study. The mean (SD) daily dose of mirtazapine orally disintegrating tablets was 29.0 (3.8) mg. The mean total (SD) HAMD-17 score improved significantly from 25.7 (4.6) to 7.3 (4.3) (P<0.005). At each visit, the mean HAMD-17 score was significantly lower than that at the preceding visit. At week 17, remission (HAMD-17 score < or =7) was observed in 436 (56%) patients. The mean (SD) CGI-S score improved significantly from 4.9 (1.0) at baseline to 1.5 (0.6) at endpoint (P<0.001). According to the CGI-I assessments, 621 patients (89.4%) improved and improved very much. The vast majority of patients (80%) preferred the new formulation of mirtazapine - mirtazapine orally disintegrating tablet. Treatment-emergent adverse events occurred in 106 patients (13.6%). The most frequent adverse events were weight gain, sedation, dizziness, and dry mouth. In this study conducted in Lithuania with depressed patients, a significant improvement was shown in all efficacy measures. In addition, mirtazapine orally disintegrating tablet was a well-tolerated and preferable formulation for the treatment of depressed patients.

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330

Electronic harm reduction interventions for drug overdose monitoring and prevention: A scoping review

Type: Journal Article

Authors: A. Loverock, T. Marshall, D. Viste, F. Safi, W. Rioux, N. Sedaghat, M. Kennedy, S. M. Ghosh

Year: 2023

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331

Electronic health record functionality needed to better support primary care

Type: Journal Article

Authors: A. H. Krist, J. W. Beasley, J. C. Crosson, D. C. Kibbe, M. S. Klinkman, C. U. Lehmann, C. H. Fox, J. M. Mitchell, J. W. Mold, W. D. Pace, K. A. Peterson, R. L. Phillips, R. Post, J. Puro, M. Raddock, R. Simkus, S. E. Waldren

Year: 2014

Abstract: Electronic health records (EHRs) must support primary care clinicians and patients, yet many clinicians remain dissatisfied with their system. This article presents a consensus statement about gaps in current EHR functionality and needed enhancements to support primary care. The Institute of Medicine primary care attributes were used to define needs and meaningful use (MU) objectives to define EHR functionality. Current objectives remain focused on disease rather than the whole person, ignoring factors such as personal risks, behaviors, family structure, and occupational and environmental influences. Primary care needs EHRs to move beyond documentation to interpreting and tracking information over time, as well as patient-partnering activities, support for team-based care, population-management tools that deliver care, and reduced documentation burden. While stage 3 MU's focus on outcomes is laudable, enhanced functionality is still needed, including EHR modifications, expanded use of patient portals, seamless integration with external applications, and advancement of national infrastructure and policies.

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332

Electronic Health Record Impact on Work Burden in Small, Unaffiliated, Community-Based Primary Care Practices

Type: Journal Article

Authors: Jenna Howard, Elizabeth C. Clark, Asia Friedman, Jesse C. Crosson, Maria Pellerano, Benjamin F. Crabtree, Ben-Tzion Karsh, Carlos R. Jaen, Douglas S. Bell, Deborah J. Cohen

Year: 2012

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333

Electronic health record-based monitoring of primary care patients at risk of medication-related toxicity

Type: Journal Article

Authors: D. G. Bundy, J. A. Marsteller, A. W. Wu, L. D. Engineer, S. M. Berenholtz, A. H. Caughey, D. Silver, J. Tian, R. E. Thompson, M. R. Miller, C. U. Lehmann

Year: 2012

Publication Place: United States

Abstract: BACKGROUND: Timely laboratory monitoring may reduce the potential harm associated with chronic medication use. A study was conducted to determine the proportion of patients receiving National Committee for Quality Assurance (NCQA)-recommended laboratory medication monitoring in a primary care setting and to assess the effect of electronic health record (EHR)-derived, paper-based, provider-specific feedback bulletins on subsequent patient receipt of medication monitoring. METHODS: In a single-arm, pre-post intervention in two federally qualified community health centers in Baltimore, patients targeted were adults prescribed at least 6 months (in the preceding year) for at least one index medication (digoxin, statins, diuretics, angiotensin-converting enzyme inhibitors/ angiotensin II-receptor blockers) in a 12-month period (August 2008-July 2009). RESULTS: Among the 2,013 patients for whom medication monitoring was recommended, 42% were overdue for monitoring at some point during the study. As the number of index medications the patient was prescribed increased, the likelihood of ever being overdue for monitoring decreased. Being listed on the provider-specific monitoring bulletin doubled the odds of a patient receiving recommended laboratory monitoring before the next measurement period (1-2 months). Limiting the intervention to the most overdue patients, however, mitigated its overall impact. CONCLUSIONS: Recommended laboratory monitoring of chronic medications appears to be inconsistent in primary care, resulting in potential harm for individuals at risk for medication-related toxicity. EHRs may be an important component of systems designed to improve medication monitoring, but multimodal interventions will likely be needed to achieve high reliability.

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334

Electronic health records and support for primary care teamwork

Type: Journal Article

Authors: A. S. O'Malley, K. Draper, R. Gourevitch, D. A. Cross, S. H. Scholle

Year: 2015

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335

Electronic medical records to increase the clinical treatment of tobacco dependence: a systematic review

Type: Journal Article

Authors: R. G. Boyle, L. I. Solberg, M. C. Fiore

Year: 2010

Publication Place: Netherlands

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336

Electronic screening for mental health in rural primary care: feasibility and user testing

Type: Journal Article

Authors: S. P. Farrell, L. M. Zerull, I. H. Mahone, S. Guerlain, D. Akan, E. Hauenstein, J. Schorling

Year: 2009

Publication Place: United States

Abstract: Despite attention to prevention and screening for depression and alcohol use, Healthy People 2010 objectives continue to include goals to increase the detection of depression and decrease the rates of alcohol abuse. These problems remain significant. The overall goal of this study was to develop a computer-based electronic screening (eScreening) tool and determine the feasibility of implementing computer-based eScreening technology for rural visitors to a primary care clinic. The study called specifically for an electronic touch screen with voice prompts. This tool, called the eScreening tool, screens for alcohol abuse and depression among rural patients in a primary care setting. The screening was offered to rural adults who are not in acute distress and not at end of life, regardless of their stated reason for seeking medical care. Phase 1 of the pilot was used to determine the perceptions of nurses, other providers, and consumers regarding the acceptability and perceived usefulness of an eScreening tool. Phase 2 involved user testing of the eScreening tool. The longer term goals of the research program are to work with rural nurses to improve patient outcomes and develop interventions and for educational, consultation, and/or direct clinical care.

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337

Electronic screening for mental health in rural primary care: implementation

Type: Journal Article

Authors: S. P. Farrell, I. H. Mahone, L. M. Zerull, S. Guerlain, D. Akan, E. Hauenstein, J. Schorling

Year: 2009

Publication Place: United States

Abstract: The goals of this study were to develop a computer-based electronic screening tool (eScreening) and determine the feasibility of implementing eScreening for rural users of primary care. This descriptive pilot adapted existing screening measures for depression and alcohol abuse to a portable computer-based format and examined the feasibility of its adoption and use. This was a three-step design using convenience samples for (1) a focus group with providers, (2) usability testing with selected rural patients using the computerized touch screen, and (3) implementing the touch screen platform with a small sample in primary care to determine feasibility. This paper reports on Phase III, which assessed consumer response to eScreening.

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338

Emergency response community effectiveness: A simulation modeler for comparing emergency medical services with smartphone-based samaritan response

Type: Journal Article

Authors: Michael Khalemsky, David G. Schwartz

Year: 2017

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339

Employing telehealth strategies for opioid addiction during COVID-19: implications for social work health care

Type: Journal Article

Authors: S. H. Kim, O. Tesmer

Year: 2021

Publication Place: United States

Abstract:

As the COVID-19 global pandemic continues, more than 40 states have reported increases in opioid-related mortality. The issue of service access and delivery poses a major concern for those struggling with mental illness and substance use disorders in the United States. To ensure the continuity of health care during the pandemic and the co-occurring opioid crisis, the United States continues to adapt its healthcare delivery strategies, which include the introduction of telehealth. Telehealth is a relatively new concept and requires rapid systems changes as well as adjustments from both service providers and recipients. The proper adaptation to the new service delivery method could result in process optimization and improved outcomes for those struggling with opioid dependency. This study aims to bring attention to the opioid crisis that may be overlooked in light of the global pandemic and encourage social workers and other mental health professionals to utilize modern technological advancements to improve service delivery to their clients. This paper offers a literature review with four themes: (1) a retrospect on pain and opioids, (2) current telehealth models and practical strategies, (3) social work roles and functions in telehealth care, and (4) next steps and implications of telehealth for social work as a much-needed health-care delivery tool at the clinical and community social work practice level.

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340

EMRs bring all of healthcare together

Type: Journal Article

Authors: Bradley Steinfeld, Barbara Ekorenrud, Clayton Gillett, Michael Quirk, Ted Eytan

Year: 2006

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