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Opioids & SU
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).
695 Results
522
State Adoption of Incentives to Promote Evidence-Based Practices in Behavioral Health Systems
Type: Journal Article
Year: 2018
Abstract: OBJECTIVE: Despite the critical role behavioral health care payers can play in creating an incentive to use evidence-based practices (EBPs), little research has examined which incentives are used in public mental health systems, the largest providers of mental health care in the United States. METHODS: The authors surveyed state mental health directors from 44 states about whether they used any of seven strategies to increase the use of EBPs. Participants also ranked attributes of each incentive on the basis of key characteristics of diffusion of innovation theory (perceived advantage, simplicity, compatibility, observability, and gradually implementable) and perceived effectiveness. RESULTS: Almost three-quarters of state directors endorsed using at least one financial incentive; most paid for training and technical assistance. Few used other incentives. Strategies perceived as simple and compatible were more readily adopted. Enhanced rates and paying for better outcomes were perceived as the most effective but were the least deployed, suggesting that simplicity and organizational compatibility may be the most decisive factors when choosing incentives. CONCLUSIONS: Payers are not using the incentives they perceive as most effective, and they are mostly using only one strategy for reasons of simplicity and compatibility. Future work should focus on barriers to measurement that likely hinder the adoption and implementation of paying for better outcomes and enhanced reimbursement rates, with the ultimate goal of measuring the effectiveness of incentives on EBP implementation efforts.
Topic(s):
Healthcare Policy
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Reference Links: 
View the DOI record for State Adoption of Incentives to Promote Evidence-Based Practices in Behavioral Health Systems
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View the PubMed citation for State Adoption of Incentives to Promote Evidence-Based Practices in Behavioral Health Systems527
State mental health policy: mending Missouri's safety net: transforming systems of care by integrating primary and behavioral health care
Type: Journal Article
Year: 2009
Publication Place: United States
Abstract: Missouri has begun a three-year pilot program across the state to integrate the primary care services provided by federally qualified health centers (FQHCs) and the behavioral health services provided by community mental health centers (CMHCs). This column describes the integration initiative, in which start-up funds were provided in 2008 to seven FQHC-CMHC partnerships (a total of $700,000 to each pair over 3.5 years). It reviews lessons learned during the first year of the project in bringing these two very different public systems of care together to mend the public health safety net.
Topic(s):
Healthcare Policy
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535
State-level and system-level opioid prescribing policies: The impact on provider practices and overdose deaths, a systematic review
Type: Journal Article
Year: 2016
Publication Place: United States
Abstract: OBJECTIVE: In response to persistent public health concerns regarding prescription opioids, many states and healthcare systems have implemented legislation and policies intended to regulate or guide opioid prescribing. The overall impact of these policies is still uncertain. The aim of this systematic review was to examine the existing evidence of provider-level and patient-level outcomes preimplementation and postimplementation of policies and legislation constructed to impact provider prescribing practices around opioid analgesics. DESIGN: A systematic search of MEDLINE, EMBASE, the Web of Science, and the Cochrane Database of Systematic Reviews was conducted to identify studies evaluating the impact of opioid prescribing policies on provider-level and patient-level outcomes. The systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: Eleven studies were included in the review. A meta-analysis was not possible due to between-study heterogeneity. Six of the studies assessed state-level policies, and five were at the level of the healthcare system or hospital. Studies showed temporal associations between policy implementation and reductions in opioid prescribing, as well as opioid-related overdoses. Results were mixed regarding the impact of policies on misuse. The majority of the studies were judged to be of low quality based on the GRADE criteria. CONCLUSIONS: There is low to moderate quality evidence suggesting that the presence of opioid prescribing policy will reduce the amount and strength of opioid prescribed. The presence of these policies may impact the number of overdoses, but there is no clear evidence to suggest that it reduces opioid misuse.
Topic(s):
Opioids & Substance Use
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, Healthcare Policy
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537
Strategies for Reducing Opioid-Overdose Deaths - Lessons from Canada
Type: Journal Article
Year: 2018
Abstract: This article explores lessons the United States can learn from Canada, which has taken bold action on a number of fronts with the aim of reducing deaths related to fentanyl, fentanyl analogues, and other opioids.
Topic(s):
Healthcare Policy
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, Opioids & Substance Use
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Reference Links:
View the DOI record for Strategies for Reducing Opioid-Overdose Deaths - Lessons from Canada
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View the PubMed citation for Strategies for Reducing Opioid-Overdose Deaths - Lessons from Canada540
Structural barriers in the context of opiate substitution treatment in Germany--A survey among physicians in primary care
Type: Journal Article
Year: 2013
Publication Place: England
Abstract: BACKGROUND: Opiate substitution treatment (OST) is the most widely used treatment for opioid dependence in Germany with substantial long-term benefits for the patient and for society. Due to lessened restrictive admission criteria, the number of registered OST patients in Germany has increased continuously in the recent years, whereas the number of physicians providing OST has remained constant. Previous data already indicated a deteriorating situation in the availability or quality of OST delivered and that structural barriers impede physicians in actively providing OST. The present survey among a sample of primary care physicians in Germany aimed to identify and assess potential structural barriers for the provision of health care in the context of OST. METHODS: An anonymous written questionnaire was sent out to a sample of 2,332 physicians across Germany providing OST. Physicians contacted were identified through databases of the Federal State Chambers of Physicians and/or of the Federal Associations of Statutory Health Insurance Physicians. Data obtained were analysed descriptively. RESULTS: The response rate was 25.5% and the majority of 596 physicians sampled viewed substantial problems in terms of the regulatory framework of OST care in the German context. Furthermore, financial remuneration, insufficient qualification, as well as inadequate interdisciplinary cooperation in the treatment of comorbidities of opiate substituted patients were regarded as problematic. The number of physicians providing OST in Germany is expected to substantially decrease in the near future. CONCLUSION: Despite less restrictive admission criteria for OST in Germany, the legal regulation framework for OST is still a limiting factor through raising concerns on the provider and consumer side to be unable to adhere to the strict rules. To avoid future shortages in the provision of OST care on the system level in Germany, revisions to the legal framework seem to be necessary. In regards to adequate care for drug use-related infectious diseases and psychiatric comorbidities commonly found in opiate substituted patients, efforts are required to improve professional qualifications of physicians providing OST as well as respective interdisciplinary collaboration.
Topic(s):
Opioids & Substance Use
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, Education & Workforce
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, Healthcare Policy
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