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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).
1012 Results
122
Automated screening for at-risk drinking in a primary care office using interactive voice response
Type: Journal Article
Year: 2010
Publication Place: United States
Abstract: OBJECTIVE: Screening for alcohol misuse in primary care settings is strongly recommended but grossly underused. Using interactive voice response (IVR), we developed an automated screening tool (IVR Screen) for identifying alcohol misuse in outpatient primary care offices and evaluated its use rate and acceptability for both patients and providers. METHOD: Patients (N = 101) presenting to a primary care clinic for scheduled, nonemergent health care visits called the IVR Screen by using a dedicated telephone in the waiting room and answered five questions about their health. Results were printed immediately for patient and provider to review during the visit. Medical assistants interviewed patients about the IVR Screen in the examination room. RESULTS: Ninety-six percent of patients who were invited to participate in the study consented to do so. Of those, 26% met criteria for alcohol misuse. Feedback from patients and providers was positive and included constructive suggestions for revisions to the IVR Screen for future use. CONCLUSIONS: IVR-based screening for at-risk drinking was feasible and did not interfere with the provider-patient interaction. The proportion of heavy drinkers identified by the IVR Screen was comparable to that of published reports of screening with written questionnaires. Implications for behavioral health screening, treatment, and clinical research are considerable because IVR-based screening assessments can be customized and targeted to different populations. Results suggest that continued development of IVR as a tool for health and alcohol screening in primary care settings is warranted.
Topic(s):
HIT & Telehealth
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Reference Links: View the PubMed citation for Automated screening for at-risk drinking in a primary care office using interactive voice response
125
Avoiding Adverse Events Secondary to Opioid-Induced Respiratory Depression: Implications for Nurse Executives and Patient Safety
Type: Journal Article
Year: 2016
Publication Place: United States
Abstract: BACKGROUND: Guidelines with recommendations for monitoring type and timing of hospitalized patients for opioid-induced respiratory depression have been published, yet adverse events continue to occur. OBJECTIVE: This study reports on the monitoring practices of 8 hospitals that volunteered to pilot test a Centers for Medicare & Medicaid Services e-quality measure that was under development. Recommendations for nurse executives are provided to support patient safety. METHODS: Data on monitoring practices were collected retrospectively from the electronic medical records at 8 hospitals on all patients receiving intravenous (IV) opioids for more than 2.5 continuous hours via patient-controlled analgesia (PCA). Analysis included the percentage of patients who were monitored according to specific standards developed by a panel of technical experts with comparisons of naloxone use to monitoring practices. RESULTS: Recommended patient assessments occurred in only 8.3% of the patients. No patients who were assessed at least every 2.5 hours received naloxone. CONCLUSIONS: Care for patients receiving IV PCA is lacking in adherence to latest safety standards. Nurse executives must implement structures and processes to promote vigilance with evidence-based monitoring practices.
Topic(s):
Opioids & Substance Use
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, Education & Workforce
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, HIT & Telehealth
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126
Barriers and drivers of health information technology use for the elderly, chronically ill, and underserved
Type: Journal Article
Year: 2008
Publication Place: United States
Abstract: OBJECTIVES: We reviewed the evidence on the barriers and drivers to the use of interactive consumer health information technology (health IT) by specific populations, namely the elderly, those with chronic conditions or disabilities, and the underserved. DATA SOURCES: We searched MEDLINE, CINHAHL, PsycINFO the Cochrane Controlled Trials Register and Database of Systematic Reviews, ERIC, and the American Association of Retired Persons (AARP) AgeLine databases. We focused on literature 1990 to present. METHODS: We included studies of all designs that described the direct use of interactive consumer health IT by at least one of the populations of interest. We then assessed the quality and abstracted and summarized data from these studies with regard to the level of use, the usefulness and usability, the barriers and drivers of use, and the effectiveness of the interactive consumer health IT applications. RESULTS: We identified and reviewed 563 full-text articles and included 129 articles for abstraction. Few of the studies were specifically designed to compare the elderly, chronically ill, or underserved with the general population. We did find that several types of interactive consumer health IT were usable and effective in multiple settings and with all of our populations of interest. Of the studies that reported the impact of interactive consumer health IT on health outcomes, a consistent finding of our review was that these systems tended to have a positive effect when they provided a complete feedback loop that included: Monitoring of current patient status. Interpretation of this data in light of established, often individualized, treatment goals. Adjustment of the management plan as needed. Communication back to the patient with tailored recommendations or advice. Repetition of this cycle at appropriate intervals. Systems that provided only one or a subset of these functions were less consistently effective. The barriers and drivers to use were most often reported as secondary outcomes. Many studies were hampered by usability problems and unreliable technology, primarily due to the research being performed on early stage system prototypes. However, the most common factor influencing the successful use of the interactive technology by these specific populations was that the consumers' perceived a benefit from using the system. Convenience was an important factor. It was critical that data entry not be cumbersome and that the intervention fit into the user's daily routine. Usage was more successful if the intervention could be delivered on technology consumers used every day for other purposes. Finally, rapid and frequent interactions from a clinician improved use and user satisfaction. CONCLUSIONS: The systems described in the studies we examined depended on the active engagement of consumers and patients and the involvement of health professionals, supported by the specific technology interventions. Questions remain as to: The optimal frequency of use of the system by the patient, which is likely to be condition-specific. The optimal frequency of use or degree of involvement by health professionals. Whether the success depends on repeated modification of the patient's treatment regimen or simply ongoing assistance with applying a static treatment plan. However, it is clear that the consumer's perception of benefit, convenience, and integration into daily activities will serve to facilitate the successful use of the interactive technologies for the elderly, chronically ill, and underserved.
Topic(s):
Healthcare Disparities
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, HIT & Telehealth
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Reference Links: View the PubMed citation for Barriers and drivers of health information technology use for the elderly, chronically ill, and underserved
127
Barriers and perceived usefulness of an ECHO intervention for office-based buprenorphine treatment for opioid use disorder in North Carolina: A qualitative study
Type: Journal Article
Year: 2021
Abstract:
Medication treatment for opioid use disorder (M-OUD) is underutilized, despite research demonstrating its effectiveness in treating opioid use disorder (OUD). The UNC Extension for Community Healthcare Outcomes for Rural Primary Care Medication Assisted Treatment (UNC ECHO for MAT) project was designed to evaluate interventions for reducing barriers to delivery of M-OUD by rural primary care providers in North Carolina. A key element was tele-conferenced sessions based on the University of New Mexico Project ECHO model, comprised of case discussions and didactic presentations using a "hub and spoke" model, with expert team members at the hub site and community-based providers participating from their offices (i.e., spoke sites). Although federal funders have promoted use of the model, barriers for providers to participate in ECHO sessions are not well documented. Methods: UNC ECHO for MAT included ECHO sessions, provider-to-provider consultations, and practice coaching. We conducted 20 semi-structured interviews to assess perceived usefulness of the UNC ECHO for MAT intervention, barriers to participation in the intervention, and persistent barriers to prescribing M-OUD. Results: Participants were generally satisfied with ECHO sessions and provider-to-provider consultations; however, perceived value of practice support was less clear. Primary barriers to participating in ECHO sessions were timing and length of sessions. Participants recommended recording ECHO sessions for viewing later, and some thought incentives for either the practice or provider could facilitate participation. Providers who had participated in ECHO sessions valued the expertise on the expert team; the team's ability to develop a supportive, collegial environment; and the value of a community of providers interested in learning from each other, particularly through case discussions. Conclusions: Despite the perceived value of ECHO, barriers may prevent consistent participation. Also, barriers to M-OUD delivery remain, including some that ECHO alone cannot address, such as Medicaid and private-insurer policies and availability of psychosocial resources.
Topic(s):
Education & Workforce
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, Financing & Sustainability
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, Opioids & Substance Use
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, HIT & Telehealth
See topic collection
128
Barriers and poor telephone counseling experiences among patients receiving medication for opioid use disorders
Type: Journal Article
Year: 2022
Publication Place: Ireland
Topic(s):
Education & Workforce
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, Healthcare Disparities
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, HIT & Telehealth
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, Opioids & Substance Use
See topic collection
Reference Links:
View the DOI record for Barriers and poor telephone counseling experiences among patients receiving medication for opioid use disorders
View DOI Record
View the PubMed citation for Barriers and poor telephone counseling experiences among patients receiving medication for opioid use disorders132
Behavioral health: setting the rural health research agenda
Type: Journal Article
Year: 2002
Publication Place: United States
Abstract: This article seeks to identify current research priorities in the area of rural behavioral health. The method for accomplishing this task begins by identifying several domains where policy has a potential to effect improvements in access or quality but has been hampered by lack of empirical knowledge. In each domain a synthesis of current research summarizes what is known and draws attention to knowledge gaps. Research questions in each domain are proposed. The policy domains are theoretically based, using a conceptual model of access to health care, with a focus on illness level (prevalence), enabling factors (the delivery system, organization and financing, the promise of telemedicine), and predisposing factors (special populations, beliefs, values, stigma).
Topic(s):
HIT & Telehealth
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Reference Links: View the PubMed citation for Behavioral health: setting the rural health research agenda
133
Benefits of telephone care over primary care for smoking cessation: a randomized trial
Type: Journal Article
Year: 2006
Publication Place: United States
Abstract: BACKGROUND: Brief clinician intervention and telephone counseling are both effective aids for smoking cessation. However, the potential benefit of telephone care above and beyond routine clinician intervention has not been examined previously. The objective of this study is to determine if telephone care increases smoking cessation compared with brief clinician intervention as part of routine health care. METHODS: This 2-group, prospective, randomized controlled trial enrolled 837 daily smokers from 5 Veterans Affairs medical centers in the upper Midwest. The telephone care group (n = 417) received behavioral counseling with mailing of smoking cessation medications as clinically indicated. The standard care group (n = 420) received intervention as part of routine health care. The primary outcome was self-reported 6-month duration of abstinence 12 months after enrollment. Secondary outcomes were 7-day point prevalence abstinence at 3 and 12 months, participation in counseling programs, and use of smoking cessation medications. RESULTS: Using intention-to-treat procedures, we found that the rate of 6-month abstinence at the 12-month follow-up was 13.0% in the telephone care group and 4.1% in the standard care group (odds ratio [OR], 3.50; 95% confidence interval [CI], 1.99-6.15). The rate of 7-day point prevalence abstinence at 3 months was 39.6% in the telephone care group and 10.1% in the standard care group (OR, 5.84; 95% CI, 4.02-8.50). Telephone care compared with standard care increased the rates of participation in counseling programs (97.1% vs 24.0%; OR, 96.22; 95% CI, 52.57-176.11) and use of smoking cessation medications (89.6% vs 52.3%; OR, 7.85; 95% CI, 5.34-11.53). CONCLUSION: Telephone care increases the use of behavioral and pharmacologic assistance and leads to higher smoking cessation rates compared with routine health care provider intervention.
Topic(s):
HIT & Telehealth
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Reference Links:
View the DOI record for Benefits of telephone care over primary care for smoking cessation: a randomized trial
View DOI Record
View the PubMed citation for Benefits of telephone care over primary care for smoking cessation: a randomized trial138
Bridging Community Mental Health and Primary Care to Improve Medication Monitoring and Outcomes for Patients With Mental Illness Taking Second-Generation Antipsychotics-HDC/DFMC Bridge Project, Phase 1: Group Concept Mapping
Type: Journal Article
Year: 2019
Publication Place: United States
Topic(s):
Healthcare Disparities
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, HIT & Telehealth
See topic collection
139
Bridging the divide between child psychiatry and primary care: the use of telephone consultation within a population-based collaborative system
Type: Journal Article
Year: 2011
Publication Place: United States
Topic(s):
HIT & Telehealth
See topic collection