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The Literature Collection contains over 10,000 references for published and grey literature on the integration of behavioral health and primary care. Learn More
Use the Search feature below to find references for your terms across the entire Literature Collection, or limit your searches by Authors, Keywords, or Titles and by Year, Type, or Topic. View your search results as displayed, or use the options to: Show more references per page; Sort references by Title or Date; and Refine your search criteria. Expand an individual reference to View Details. Full-text access to the literature may be available through a link to PubMed, a DOI, or a URL. References may also be exported for use in bibliographic software (e.g., EndNote, RefWorks, Zotero).
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341
Homeopathic medical practice for anxiety and depression in primary care: the EPI3 cohort study
Type: Journal Article
Year: 2016
Publication Place: England
Abstract: BACKGROUND: The purpose of the study was to compare utilization of conventional psychotropic drugs among patients seeking care for anxiety and depression disorders (ADDs) from general practitioners (GPs) who strictly prescribe conventional medicines (GP-CM), regularly prescribe homeopathy in a mixed practice (GP-Mx), or are certified homeopathic GPs (GP-Ho). METHODS: This was one of three epidemiological cohort studies (EPI3) on general practice in France, which included GPs and their patients consulting for ADDs (scoring 9 or more in the Hospital Anxiety and Depression Scale, HADS). Information on all medication utilization was obtained by a standardised telephone interview at inclusion, 1, 3 and 12 months. RESULTS: Of 1562 eligible patients consulting for ADDs, 710 (45.5 %) agreed to participate. Adjusted multivariate analyses showed that GP-Ho and GP-Mx patients were less likely to use psychotropic drugs over 12 months, with Odds ratio (OR) = 0.29; 95 % confidence interval (CI): 0.19 to 0.44, and OR = 0.62; 95 % CI: 0.41 to 0.94 respectively, compared to GP-CM patients. The rate of clinical improvement (HADS <9) was marginally superior for the GP-Ho group as compared to the GP-CM group (OR = 1.70; 95 % CI: 1.00 to 2.87), but not for the GP-Mx group (OR = 1.49; 95 % CI: 0.89 to 2.50). CONCLUSIONS: Patients with ADD, who chose to consult GPs prescribing homeopathy reported less use of psychotropic drugs, and were marginally more likely to experience clinical improvement, than patients managed with conventional care. Results may reflect differences in physicians' management and patients' preferences as well as statistical regression to the mean.
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View the DOI record for Homeopathic medical practice for anxiety and depression in primary care: the EPI3 cohort study
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View the PubMed citation for Homeopathic medical practice for anxiety and depression in primary care: the EPI3 cohort study342
Hospitals struggle to integrate physical and mental healthcare, inquiry finds
Type: Journal Article
Year: 2017
Publication Place: England
Topic(s):
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View the DOI record for Hospitals struggle to integrate physical and mental healthcare, inquiry finds
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View the PubMed citation for Hospitals struggle to integrate physical and mental healthcare, inquiry finds344
How much shared decision making occurs in usual primary care of depression?
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: BACKGROUND: Shared decision making (SDM) is an important component of patient-centered care, but there is little information about its use in the primary care of depression, so we sought to study its frequency in usual care as reported by patients. METHODS: Telephone interview of 1168 depressed patients taking antidepressants in 88 Minnesota primary care clinics who were identified from pharmacy claims data soon after a prescription for an antidepressant. We measured depression severity with the 9-item Patient Health Questionnaire and used a composite measure of SDM that reflected patient involvement in treatment decisions. RESULTS: These patients reported an average score for SDM of 50.7 (standard deviation, 32.8) on a scale of 0 to 100, where higher scores equate with greater SDM. In univariate analyses, the largest differences among scores were for age (scores of 58, 53, 45, and 33 for those aged 18-34, 35-49, 50-64, and >64 years, respectively; P < .0001); duration of treatment (a score of 56.6 on treatment <6 weeks vs 45.5 if longer; P < .001); and other treatments in the past 6 months (60.5 if yes vs. 46.0 if no; P = .001). SDM was not associated with any clinic characteristics, but it was correlated with patient-reported quality of care (r = 0.48; P < .001). Multivariate analyses confirmed some of these findings while showing a more complex set of relationships. CONCLUSIONS: Older patients with depression and those who have been in treatment longer report much less SDM in their care. Improving SDM, especially for these groups, may be an important target for improving patient experience and perceived quality.
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View the DOI record for How much shared decision making occurs in usual primary care of depression?
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View the PubMed citation for How much shared decision making occurs in usual primary care of depression?345
How primary care can contribute to good mental health in adults
Type: Journal Article
Year: 2017
Publication Place: England
Abstract: The need for support for good mental health is enormous. General support for good mental health is needed for 100% of the population, and at all stages of life, from early childhood to end of life. Focused support is needed for the 17.6% of adults who have a mental disorder at any time, including those who also have a mental health problem amongst the 30% who report having a long-term condition of some kind. All sectors of society and all parts of the NHS need to play their part. Primary care cannot do this on its own. This paper describes how primary care practitioners can help stimulate such a grand alliance for health, by operating at four different levels - as individual practitioners, as organisations, as geographic clusters of organisations and as policy-makers.
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View the DOI record for How primary care can contribute to good mental health in adults
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View the PubMed citation for How primary care can contribute to good mental health in adults346
How primary care can contribute to good mental health in adults
Type: Journal Article
Year: 2017
Publication Place: England
Abstract: The need for support for good mental health is enormous. General support for good mental health is needed for 100% of the population, and at all stages of life, from early childhood to end of life. Focused support is needed for the 17.6% of adults who have a mental disorder at any time, including those who also have a mental health problem amongst the 30% who report having a long-term condition of some kind. All sectors of society and all parts of the NHS need to play their part. Primary care cannot do this on its own. This paper describes how primary care practitioners can help stimulate such a grand alliance for health, by operating at four different levels - as individual practitioners, as organisations, as geographic clusters of organisations and as policy-makers.
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View the DOI record for How primary care can contribute to good mental health in adults
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View the PubMed citation for How primary care can contribute to good mental health in adults348
Identification and Management of Adolescent Depression in a Large Pediatric Care Network
Type: Journal Article
Year: 2020
Publication Place: United States
Abstract: OBJECTIVE: Primary care has been promoted as a setting to identify and manage adolescent depression. This study examined primary care-based adolescent depression identification and follow-up care when elevated symptoms were identified. METHODS: Data came from a large pediatric care network with an organizational recommendation to screen for depression at age 16 well-visits using an electronic health record (EHR)-integrated standardized measure. Analyses examined rates of screening and elevated symptoms, pediatricians' initial responses to elevated scores, and types of follow-up care received over 1 year using retrospective EHR data extraction and manual chart reviews. RESULTS: Across program sites, 76.3% (n = 6981) of patients attending their age 16 well-visits were screened. About one-quarter had an elevated score (6.7% mild and 19.2% moderate-to-severe), many of whom received active follow-up on their well-visit date. Over 1 year, three-fourths of patients with scores in the moderate-to-severe range and 40.0% of patients with scores in the mild range received follow-up care (e.g., antidepressant prescriptions) as per EHR extraction. Follow-up rates were higher as per manual chart reviews. CONCLUSION: Routine adolescent depression screening is feasible across diverse primary care sites. Most patients with elevated scores were not already receiving behavioral health services, suggesting screening identified previously undetected concerns. In turn, many adolescents with elevated scores initiated treatment after screening, which indicates providing screen results at the point of care may facilitate pediatrician actions. Still, gaps in follow-up care demonstrate the need for greater investment in primary care-based behavioral health services to support high-quality treatment and ultimately decrease the burden of adolescent depression.
Topic(s):
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View the DOI record for Identification and Management of Adolescent Depression in a Large Pediatric Care Network
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View the PubMed citation for Identification and Management of Adolescent Depression in a Large Pediatric Care Network349
Identification and Management of Adolescent Depression in a Large Pediatric Care Network
Type: Journal Article
Year: 2020
Publication Place: United States
Abstract: OBJECTIVE: Primary care has been promoted as a setting to identify and manage adolescent depression. This study examined primary care-based adolescent depression identification and follow-up care when elevated symptoms were identified. METHODS: Data came from a large pediatric care network with an organizational recommendation to screen for depression at age 16 well-visits using an electronic health record (EHR)-integrated standardized measure. Analyses examined rates of screening and elevated symptoms, pediatricians' initial responses to elevated scores, and types of follow-up care received over 1 year using retrospective EHR data extraction and manual chart reviews. RESULTS: Across program sites, 76.3% (n = 6981) of patients attending their age 16 well-visits were screened. About one-quarter had an elevated score (6.7% mild and 19.2% moderate-to-severe), many of whom received active follow-up on their well-visit date. Over 1 year, three-fourths of patients with scores in the moderate-to-severe range and 40.0% of patients with scores in the mild range received follow-up care (e.g., antidepressant prescriptions) as per EHR extraction. Follow-up rates were higher as per manual chart reviews. CONCLUSION: Routine adolescent depression screening is feasible across diverse primary care sites. Most patients with elevated scores were not already receiving behavioral health services, suggesting screening identified previously undetected concerns. In turn, many adolescents with elevated scores initiated treatment after screening, which indicates providing screen results at the point of care may facilitate pediatrician actions. Still, gaps in follow-up care demonstrate the need for greater investment in primary care-based behavioral health services to support high-quality treatment and ultimately decrease the burden of adolescent depression.
Topic(s):
General Literature
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View the DOI record for Identification and Management of Adolescent Depression in a Large Pediatric Care Network
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View the PubMed citation for Identification and Management of Adolescent Depression in a Large Pediatric Care Network350
Identification and management of depression in Australian primary care and access to specialist mental health care
Type: Journal Article
Year: 2012
Publication Place: United States
Abstract: OBJECTIVE: The authors evaluated management of illness, including access to specialist mental health care, among people identified by general practitioners as clinically depressed. METHODS: Australian primary care practitioners recruited in 2009 completed case reports and collected self-report assessments from five to seven consecutively presenting patients whom they identified as having clinical depression. RESULTS: Among 735 patients with clinical depression, 55% met criteria for major depressive syndrome, 86% reported clinically significant sleep disturbance, and 47% had been depressed for more than 12 months. Most (77%) were prescribed antidepressants, and 30% were prescribed anxiolytics or hypnotics. Patients under shared care with specialist mental health care providers (42%) had more severe, chronic, and recurrent conditions but no demographic advantages. CONCLUSIONS: Depressed patients of general practitioners often had chronic, recurrent, and moderately to severely disabling conditions, but fewer than half received specialist care. Access to specialist care, however, appeared to be based on clinical need, with little inequity in sociodemographic characteristics observed.
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View the DOI record for Identification and management of depression in Australian primary care and access to specialist mental health care
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View the PubMed citation for Identification and management of depression in Australian primary care and access to specialist mental health care351
Identification of developmental-behavioral problems in primary care: a systematic review
Type: Journal Article
Year: 2011
Publication Place: United States
Abstract: CONTEXT: Recent mandates and recommendations for formal screening programs are based on the claim that pediatric care providers underidentify children with developmental-behavioral disorders, yet the research to support this claim has not been systematically reviewed. OBJECTIVE: To review research literature for studies regarding pediatric primary care providers' identification of developmental-behavioral problems in children. METHODS: On the basis of a Medline search conducted on September 22, 2010, using relevant key words, we identified 539 articles for review. We included studies that (1) were conducted in the United States, (2) were published in peer-reviewed journals, (3) included data that addressed pediatric care providers' identification of developmental-behavioral problems in individual patients, (4) included an independent assessment of patients' developmental-behavioral problems, such as diagnostic interviews or validated screening instruments, and (5) reported data sufficient to calculate sensitivity and specificity. Studies were not limited by sample size. Eleven articles met these criteria. We used Quality Assessment of Diagnostic Accuracy Studies (QUADAS) criteria to evaluate study quality. Although the studies were similar in many ways, heterogeneous methodology precluded a meta-analysis. RESULTS: Sensitivities for pediatric care providers ranged from 14% to 54%, and specificities ranged from 69% to 100%. The authors of 1 outlier study reported a sensitivity of 85% and a specificity of 61%. CONCLUSIONS: Pediatricians are often the first point of entry into developmental and mental health systems. Knowing their accuracy in identifying children with developmental-behavioral disabilities is essential for implementing optimal evaluation programs and achieving timely identification. Moreover, these statistics are important to consider when planning large-scale screening programs.
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View the DOI record for Identification of developmental-behavioral problems in primary care: a systematic review
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View the PubMed citation for Identification of developmental-behavioral problems in primary care: a systematic review355
If Integration Is the Answer, What Was the Question? What next for English Health and Social Care Partnerships?
Type: Journal Article
Year: 2016
Publication Place: England
Topic(s):
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View the DOI record for If Integration Is the Answer, What Was the Question? What next for English Health and Social Care Partnerships?
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View the PubMed citation for If Integration Is the Answer, What Was the Question? What next for English Health and Social Care Partnerships?357
Impact of a mental health based primary care program on emergency department visits and inpatient stays
Type: Journal Article
Year: 2018
Publication Place: United States
Topic(s):
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View the DOI record for Impact of a mental health based primary care program on emergency department visits and inpatient stays
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View the PubMed citation for Impact of a mental health based primary care program on emergency department visits and inpatient stays358
Impact of a Mental Health Based Primary Care Program on Quality of Physical Health Care
Type: Journal Article
Year: 2018
Publication Place: United States
Topic(s):
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View the DOI record for Impact of a Mental Health Based Primary Care Program on Quality of Physical Health Care
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View the PubMed citation for Impact of a Mental Health Based Primary Care Program on Quality of Physical Health Care360
Impact of Collaborative Care on Absenteeism for Depressed Employees Seen in Primary Care Practices: A Retrospective Cohort Study
Type: Journal Article
Year: 2018
Publication Place: United States
Abstract: OBJECTIVE: The impact of "real world" collaborative care on depression and absenteeism for depressed employees seen in primary care practices using objective employer absence data. METHODS: A retrospective cohort study comparing depressed employees seen in primary care practices who enrolled for a "real world" collaborative care program to practice as usual (PAU) on objective absence days and depression response and remission at 6, and 12-month time periods. RESULTS: Absence days were more in the collaborative care group compared with the PAU group at 3 and 6 months but at 12 months the difference was no longer statistically significant. Collaborative care led to better response and remission depression scores compared with PAU at 12 months. CONCLUSIONS: Collaborative care led to faster improvement in depression symptoms but did not translate to less time away from work.
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