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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).
883 Results
101
Association between posttraumatic stress disorder and primary care provider-diagnosed disease among Iraq and Afghanistan veterans
Type: Journal Article
Year: 2010
Publication Place: United States
Abstract: OBJECTIVE: To determine if a diagnosis of posttraumatic stress disorder (PTSD) was associated with primary care provider-diagnosed physical disease in the first 5 years post deployment. METHODS: An examination of medical records of 4416 veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) was conducted. Participants were veterans who served between September 11, 2001 and December 31, 2007, without prior combat exposure, and who utilized primary care services within the VA Healthcare Network of Upstate New York. Primary care provider-diagnosed International Statistical Classification of Diseases and Related Health Problems, Revision 9 (ICD-9) physical diseases were examined. RESULTS: Adjusting for demographic characteristics and clinical factors (e.g., age, gender, depression, and substance use), PTSD was significantly associated with an almost two-fold increase of developing nervous system (odds ratio [OR], 1.98), musculoskeletal disease (OR, 1.84), and signs and ill-defined conditions of disease (OR, 1.78). A diagnosis of PTSD was significantly associated with increased odds of developing circulatory (OR, 1.29), hypertensive (OR, 1.38), and digestive system disease (OR, 1.34). Survival analyses showed that veterans with PTSD experienced early onset disease compared with veterans without PTSD; hypertensive (hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.19-2.04), circulatory, (HR, 1.36; 95% CI, 1.11-1.67), digestive (HR, 1.24; 95% CI, 1.08-1.43), nervous (HR, 1.81; 95% CI, 1.59-2.06), musculoskeletal disease (HR, 1.49; 95% CI, 1.32-1.67), and signs and ill-defined disease (HR, 1.70; 95% CI, 1.51-1.92). CONCLUSIONS: PTSD is associated with increased prevalence and onset of physical disease among OEF/OIF veterans within the early years post military service. Rising rates of PTSD may foreshadow an increase in lifespan morbidity and healthcare utilization in the coming years among OEF/OIF veterans.
Topic(s):
General Literature
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102
Association of anxiety and depression with all-cause mortality in individuals with coronary heart disease
Type: Journal Article
Year: 2013
Publication Place: England
Abstract: BACKGROUND: Depression has been related to mortality in coronary heart disease (CHD) patients, but few studies have evaluated the role of anxiety or the role of the co-occurrence of depression and anxiety. We examined whether anxiety is associated with increased risk of mortality after accounting for depression in individuals with established CHD. METHODS AND RESULTS: The cohort was composed of 934 men and women with confirmed CHD (mean age, 62+/-11 years) who completed the Hospital Anxiety and Depression scale (HADS) during hospitalization for coronary angiography. Over the 3-year follow-up period, there were 133 deaths. Elevated scores on the HADS anxiety subscale (HADS-A>/=8) were associated with increased risk of mortality after accounting for established risk factors including age, congestive heart failure, left ventricular ejection fraction, 3-vessel disease, and renal disease (hazard ratio [HR], 2.27; 95% CI, 1.55 to 3.33; P/=8) were also associated with increased risk of mortality (HR, 2.18; 95% CI, 1.47 to 3.22; P<0.001). When both psychosocial factors were included in the model, each maintained an association with mortality (anxiety, HR, 1.83; 95% CI, 1.18 to 2.83; P=0.006; depression, HR, 1.66; 95% CI, 1.06 to 2.58; P=0.025). Estimation of the HR for patients with both anxiety and depression versus those with neither revealed a larger HR than for patients with either factor alone (HR, 3.10; 95% CI, 1.95 to 4.94; P<0.001). CONCLUSIONS: Anxiety is associated with increased risk of mortality in CHD patients, particularly when comorbid with depression. Future studies should focus on the co-occurrence of these psychosocial factors as markers of increased mortality risk.
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View the DOI record for Association of anxiety and depression with all-cause mortality in individuals with coronary heart disease
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View the PubMed citation for Association of anxiety and depression with all-cause mortality in individuals with coronary heart disease103
Association of change in depression and anxiety symptoms with functional outcomes in pulmonary rehabilitation patients
Type: Journal Article
Year: 2011
Publication Place: England
Abstract: OBJECTIVE: Pulmonary rehabilitation (PR) has emerged over the last decade as an essential component of an integrated approach to managing patients with chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD). We sought to examine how depression and anxiety symptom changes relate to disease-specific quality of life outcomes following PR. METHODS: We performed a cohort study of 81 patients with COPD who completed PR at a Veterans Administration Medical Center. Pulmonary rehabilitation consisted of supervised exercise training and education twice weekly for 8 weeks. Beck Depression and Anxiety Inventories (BDI and BAI) assessed symptom burden at baseline and completion of PR. We measured change in disease-specific quality of life using the dyspnea, mastery, emotion and fatigue domains of the Chronic Respiratory Questionnaire Self-Reported (CRQ-SR) from baseline to completion of PR. RESULTS: Participants were 69.8+/-9.1 years old and all male. Forced expiratory volume in 1 s (FEV1) was 1.23+/-0.39 L. The CRQ-SR scores improved significantly: dyspnea (P<.0001), mastery (P=.015) and fatigue (P=.017). The BDI scores improved significantly (13.1+/-10.5 to 10.8+/-9.9, P=.003; BAI: 13.1+/-10.1 to 12.1+/-11.7). Multivariate regression models controlling for age, FEV1, depression treatment and anxiety treatment showed that improvement in depressive symptoms were associated with improvement in fatigue (P=.003), emotion (P=.003) and mastery (P=.01). Anxiety symptom change was not significantly associated with change in disease-specific quality of life domains. CONCLUSION: Addressing anxiety symptoms in PR patients may be indicated because disease-specific quality of life improvement appears to be associated with mood.
Topic(s):
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View the DOI record for Association of change in depression and anxiety symptoms with functional outcomes in pulmonary rehabilitation patients
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View the PubMed citation for Association of change in depression and anxiety symptoms with functional outcomes in pulmonary rehabilitation patients106
Attitudes towards brief interventions to reduce smoking and problem drinking behaviour in gynaecological practice
Type: Journal Article
Year: 2011
Publication Place: Netherlands
Topic(s):
General Literature
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View the DOI record for Attitudes towards brief interventions to reduce smoking and problem drinking behaviour in gynaecological practice
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View the PubMed citation for Attitudes towards brief interventions to reduce smoking and problem drinking behaviour in gynaecological practice107
Audit to identify the number of patients with multiple diagnoses in a community mental health team in Bedford, England
Type: Journal Article
Year: 2013
Publication Place: Croatia
Abstract: BACKGROUND: Patients with 'simple' mental health problems should be able to be managed exclusively in primary care. It is therefore anticipated that only the more complex cases would be referred to secondary care. In order to test this hypothesis, the number of patients registered with a community mental health team (CMHT) in Bedford, United Kingdom, who had received multiple psychiatric diagnoses in 2010, 2011 and 2013, was determined and analysed. METHOD: Using a secure and anonymised Microsoft Excel(R) database that contains all patient data, the proportions of patients with more than one diagnosis were audited and thus determined for the months of August 2010, June 2011 and February 2013. The total number of patients registered was also determined for comprehensiveness. We had established the basic audit standard that every patient should have only one mental health diagnosis if this was possible. RESULTS: Many patients were indeed found to have received multiple diagnoses. Furthermore, an increase in the proportion of patients with multiple diagnoses was observed; from 23.2% in 2010 to 25.2% in 2011 to 34.3% in 2013. DISCUSSION: Several psychiatric conditions have been shown to be associated with particular psychiatric co-morbidities, which may be one reason why many of the Bedford CMHT's patients receive multiple diagnoses. Furthermore, the trend observed may reflect improving mental healthcare in primary care and therefore fewer referrals of patients with 'simple' mental health conditions to secondary care, thus causing the CMHT's caseload to become increasingly complex. It may also reflect improving communication between primary and secondary care, which may also lead to fewer referrals. Finally, the trend may merely reflect better use of the available database. CONCLUSION: We have found that numerous patients received multiple diagnoses. We have also observed an increase in the proportion of such patients over three years, which may reflect improved management of mental health problems in primary care. Our results may therefore provide an incentive to establish formal shared care of psychiatric patients between primary and secondary care to improve patient management even further. Furthermore, our results reflect the complexity of the cases referred to secondary care, which are far more difficult to treat than those exclusively managed in primary care.
Topic(s):
General Literature
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108
Availability of Integrated Primary Care Services in Community Mental Health Care Settings
Type: Journal Article
Year: 2019
Publication Place: United States
Topic(s):
General Literature
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View the DOI record for Availability of Integrated Primary Care Services in Community Mental Health Care Settings
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View the PubMed citation for Availability of Integrated Primary Care Services in Community Mental Health Care Settings110
Barriers and facilitators of accessing perinatal mental health services: The perspectives of women receiving continuity of care midwifery
Type: Journal Article
Year: 2018
Publication Place: Scotland
Topic(s):
General Literature
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112
Barriers to access to treatment for mothers with postpartum depression in primary health care centers: a predictive model
Type: Journal Article
Year: 2016
Publication Place: Brazil
Abstract: OBJECTIVE: to develop a predictive model to evaluate the factors that modify the access to treatment for Postpartum Depression (PPD). METHODS: prospective study with mothers who participated in the monitoring of child health in primary care centers. For the initial assessment and during 3 months, it was considered: sociodemographic data, gyneco-obstetric data, data on the services provided, depressive symptoms according to the Edinburgh Postpartum Depression Scale (EPDS) and quality of life according to the Short Form-36 Health Status Questionnaire (SF-36). The diagnosis of depression was made based on MINI. Mothers diagnosed with PPD in the initial evaluation, were followed-up. RESULTS: a statistical model was constructed to determine the factors that prevented access to treatment, which consisted of: item 2 of EPDS (OR 0.43, 95%CI: 0.20-0.93) and item 5 (OR 0.48, 95%CI: 0.21-1.09), and previous history of depression treatment (OR 0.26, 95%CI: 0.61-1.06). Area under the ROC curve for the model=0.79; p-value for the Hosmer-Lemershow=0.73. CONCLUSION: it was elaborated a simple, well standardized and accurate profile, which advises that nurses should pay attention to those mothers diagnosed with PPD, presenting low/no anhedonia (item 2 of EPDS), scarce/no panic/fear (item 5 of EPDS), and no history of depression, as it is likely that these women do not initiate treatment.
Topic(s):
General Literature
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113
Barriers to implementing screening and brief interventions in general practice: findings from a qualitative study in Norway
Type: Journal Article
Year: 2011
Publication Place: England
Abstract: AIMS: The qualitative component of this mixed methods study aimed at obtaining more in-depth information about the barriers of implementation of screening and brief interventions (SBI) in general practice identified in the quantitative component by giving general practitioners (GPs) the opportunity to discuss and report on the particular difficulties they experience in relation to identification and treatment of alcohol problems in their daily work. METHODS: Focus-group interviews were performed with seven groups of GPs in different parts of Norway, encompassing 40 participants. The interviews were transcribed and analyzed using the QDA Miner software. RESULTS: The analysis revealed five major groups of factors influencing GPs' reluctance to use SBI for alcohol problems: (a) perception of alcohol problems, (b) integration of SBI into existing routines, (c) prevention vs. treatment, (d) structural issues and (e) the relationship between practitioner and patient. Discussion: The analysis showed that problems of implementing SBI in general practice are a complex issue. The quantitative part of the project revealed a strong association between knowledge/self-efficacy and the use of SBI. However, in the qualitative study, we were able to look in more detail at some of the findings from the first part. Even if the lack of knowledge of SBI was still significant, the five factors identified in this study appeared important for the GPs' decisions to use SBI in individual cases.
Topic(s):
General Literature
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116
Behavioral Counseling for Cardiovascular Disease Prevention in Primary Care Settings: A Systematic Review of Practice and Associated Factors
Type: Journal Article
Year: 2012
Abstract: Cardiovascular disease carries a substantial public health burden. Physician advice on modifying behavioral risk factors is effective, yet the practice of and factors associated with behavioral counseling in primary care have not been systematically investigated. The authors conducted a systematic review that identified 18 studies providing data on 6,338 physicians. The provision of preventive services differed by patients' individual risk. Physicians' counseling on smoking cessation was most commonly reported. The proportions of physicians counseling about nutrition and physical activity were notably lower and few physicians took further action by using more intensive counseling approaches. As studies were mainly based on self-reports, current delivery of preventive services may be overestimated. There is a need to increase the frequency of behavioral counseling in primary care settings, particularly for nutrition and physical activity, and to emphasize that counseling may also benefit individuals without cardiovascular disease risk factors.
Topic(s):
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118
Behavioral Health Integration and Outcomes that Matter to Patients: a Longitudinal Mixed-Methods Observational Study
Type: Journal Article
Year: 2020
Publication Place: United States
Abstract: Research on behavioral health integration (BHI) often explores outcomes for quality and cost, but less is known about impacts of integration work on key patient experience outcomes. A mixed-methods longitudinal study of BHI was conducted in 12 primary care clinics in Oregon to assess how adoption of key integration practices including integrated staffing models, integrated care trainings for providers, and integrated data sharing impacted a set of patient experience outcomes selected and prioritized by an advisory panel of active patients. Results showed that adopting key aspects of integration was not associated with improved patient experience outcomes over time. Patient interviews highlighted several potential reasons why, including an overemphasis by health systems on the structural aspects of integration versus the experiential components and potential concerns among patients about stigma and discrimination in the primary care settings where integration is focused.
Topic(s):
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View the DOI record for Behavioral Health Integration and Outcomes that Matter to Patients: a Longitudinal Mixed-Methods Observational Study
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View the PubMed citation for Behavioral Health Integration and Outcomes that Matter to Patients: a Longitudinal Mixed-Methods Observational Study119
Behavioral Health Integration and Outcomes that Matter to Patients: a Longitudinal Mixed-Methods Observational Study
Type: Journal Article
Year: 2020
Publication Place: United States
Abstract: Research on behavioral health integration (BHI) often explores outcomes for quality and cost, but less is known about impacts of integration work on key patient experience outcomes. A mixed-methods longitudinal study of BHI was conducted in 12 primary care clinics in Oregon to assess how adoption of key integration practices including integrated staffing models, integrated care trainings for providers, and integrated data sharing impacted a set of patient experience outcomes selected and prioritized by an advisory panel of active patients. Results showed that adopting key aspects of integration was not associated with improved patient experience outcomes over time. Patient interviews highlighted several potential reasons why, including an overemphasis by health systems on the structural aspects of integration versus the experiential components and potential concerns among patients about stigma and discrimination in the primary care settings where integration is focused.
Topic(s):
General Literature
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Reference Links:
View the DOI record for Behavioral Health Integration and Outcomes that Matter to Patients: a Longitudinal Mixed-Methods Observational Study
View DOI Record
View the PubMed citation for Behavioral Health Integration and Outcomes that Matter to Patients: a Longitudinal Mixed-Methods Observational Study