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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
821
Time for a rethink of treatment for patients with depression in primary care
Type: Journal Article
Year: 2010
Publication Place: England
Topic(s):
General Literature
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View the DOI record for Time for a rethink of treatment for patients with depression in primary care
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View the PubMed citation for Time for a rethink of treatment for patients with depression in primary care823
Towards client-centered counseling: Development and testing of the WHO Decision-Making Tool
Type: Journal Article
Year: 2010
Publication Place: Ireland
Topic(s):
General Literature
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View the DOI record for Towards client-centered counseling: Development and testing of the WHO Decision-Making Tool
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View the PubMed citation for Towards client-centered counseling: Development and testing of the WHO Decision-Making Tool824
Training peer educators to promote self-management skills in people with serious mental illness (SMI) and diabetes (DM) in a primary health care setting
Type: Journal Article
Year: 2014
Abstract: Aim To describe the training and participant experience of patients with both severe mental illness (SMI) and diabetes (DM) who were enrolled in a Peer Educator Training Program adapted to a primary health care setting. BACKGROUND: The mortality of patients with both SMI and DM is high. Illness self-management includes medications, psychosocial treatments, and healthy behaviors, yet treatment engagement is often sub-optimal with adherence rates of 52% for diabetic medications and 62% for antipsychotic medications among the SMI. To address this problem, a new behavioral intervention study targeting SMI and DM self-management used trained peer educators (PEs) with the same chronic conditions to enhance program effectiveness. A manual facilitated training on intervention topics such as SMI and DM therapies, stress management, and stigma reduction as well as training in group intervention techniques, telephone skills, and crisis management. METHODS: We assessed PE attitudes and input using in-depth face-to-face interviews. Interviews were audio-taped, transcribed, coded, and analyzed using the classic method of content analysis emphasizing dominant themes. A member check-in was conducted where participants commented on analysis results. Findings Six relevant descriptive themes emerged: (1) positive group experience; (2) success with learning manual content; (3) increased knowledge about SMI and DM; (4) improved self-management skills; (5) increased self-confidence and self-efficacy in becoming a PE; and being (6) united in purpose to help others self-manage their SMI and DM. Qualitative evidence supports structured training for SMI-DM PEs. Key components include written educational materials and the power of the group process to increase knowledge, self-management skills, confidence, and self-efficacy. Recommendations are offered to support further endeavors to mobilize peers with SMI to help other patients with complex comorbidities better manage their own health.
Topic(s):
General Literature
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825
Transdiagnostic stepped care in mental health
Type: Journal Article
Year: 2017
Publication Place: Australia
Abstract: A component of Australia's recent national reform agenda for mental health services is the directive to the Primary Health Networks to develop and implement stepped-care models of service delivery. The current guidance proposes that interventions are aligned to mild, moderate and severe illness categories. Other models in operation are tied to single disorders, such as depression. Both approaches have a number of limitations when applied to real-world, complex clinical practice, especially in primary care. This article outlines some limitations of these models and argues for the development of a transdiagnostic model, based on developments in our work in primary care youth services, which can be generalised to adult populations. Such models aim to ensure that consumers receive the right intensity of care at the right time. The adjunct use of technology within services could also improve service accessibility and outcomes monitoring, and help to improve the efficiency of resource allocation based on consumer need.
Topic(s):
General Literature
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826
Transdisciplinary care: opportunities and challenges for behavioral health providers
Type: Journal Article
Year: 2010
Publication Place: United States
Topic(s):
General Literature
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View the DOI record for Transdisciplinary care: opportunities and challenges for behavioral health providers
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View the PubMed citation for Transdisciplinary care: opportunities and challenges for behavioral health providers828
Translating the patient navigator approach to meet the needs of primary care
Type: Journal Article
Year: 2010
Publication Place: United States
Abstract: BACKGROUND: Helping patients navigate the complex and fragmented US health care system and coordinating their care are central to the patient-centered medical home. We evaluated the pilot use of a patient navigator (PN), someone who helps patients use the health care system effectively and efficiently, in primary care practices. METHODS: This study was a cross-case comparative analysis of 4 community practices that implemented patient navigation. Project meeting notes, PN activity logs and debriefings, physician interviews, and patient/family member interviews were analyzed using a grounded approach. RESULTS: Seventy-five mostly female, elderly patients received navigation services from a social worker. The PN typically helped patients obtain social services and navigate health coverage and complex referrals. Availability of workspace for PN, interaction with practice members, and processes used for selecting and referring patients affected PN collaboration with and integration into practices. Patients found PN services very helpful, and physicians viewed the PN as someone carrying out new tasks that the practice was not previously doing. CONCLUSIONS: Patient navigation in community primary care practices is useful for patients who have complex needs. Integrating such services into primary care settings will require new practice and payment models to realize the full potential of integrated patient navigation services in this setting.
Topic(s):
General Literature
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View the DOI record for Translating the patient navigator approach to meet the needs of primary care
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View the PubMed citation for Translating the patient navigator approach to meet the needs of primary care829
Treating anxiety in the presence of medical comorbidity: calmly moving forward
Type: Journal Article
Year: 2013
Publication Place: United States
Abstract: Patients with chronic medical conditions (CMCs) and a comorbid anxiety or mood disorder tend to report more symptoms and experience poorer treatment outcomes compared with those without mental health comorbidity. Although the benefits to be derived from treating depression in patients with CMCs have begun to be quantified, particularly among those with cardiovascular disease, our understanding of the benefits of treating anxiety in patients with CMCs is far less developed. Improving care for patients with CMCs is one of the major challenges facing medicine today because patients with multiple chronic diseases account for most health care costs. Emerging evidence indicates that integrated or "blended" collaborative care strategies that treat both the psychiatric and physical conditions together tend to produce greater improvements in mood symptoms and control of CMCs compared with programs that target the psychiatric condition alone. We review a new report, published in this issue of Psychosomatic Medicine, from the National Institutes of Mental Health-funded multisite Coordinated Anxiety Learning and Management trial, that shines new attention on anxiety disorders and medical comorbidity. We place their findings in context with these new blended care models that are potentially more powerful, scalable, cost-effective, and readily delivered through existing CMC programs.
Topic(s):
General Literature
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View the DOI record for Treating anxiety in the presence of medical comorbidity: calmly moving forward
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View the PubMed citation for Treating anxiety in the presence of medical comorbidity: calmly moving forward830
Treating depression in disabled, low-income elderly: a conceptual model and recommendations for care
Type: Journal Article
Year: 2010
Publication Place: England
Abstract: BACKGROUND: The treatment of depression in low-income older adults who live in poverty is complicated by several factors. Poor access to resources, disability, and mild cognitive impairment are the main factors that moderate treatment effects in this population. Interventions that not only address the depressive syndrome but also manage social adversity are sorely needed to help this patient population recover from depression. METHODS: This paper is a literature review of correlates of depression in late life. In the review we propose a treatment model that combines case management (CM) to address social adversity with problem solving treatment (PST) to address the depressive syndrome. RESULTS: We present the case of Mr Z, an older gentleman living in poverty who is also depressed and physically disabled. In this case we illustrate how the combination of CM and PST can work together to ameliorate depression. CONCLUSIONS: The combination of age, disability, and social adversity complicates the management and treatment of depression. CM and PST are interventions that work synergistically to overcome depression and manage social problems.
Topic(s):
General Literature
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View the DOI record for Treating depression in disabled, low-income elderly: a conceptual model and recommendations for care
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View the PubMed citation for Treating depression in disabled, low-income elderly: a conceptual model and recommendations for care833
Treating pain in primary care: Optimizing an integrated psychological intervention based on perspectives of psychologists, primary care providers, and patients
Type: Journal Article
Year: 2019
Publication Place: United States
Topic(s):
General Literature
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835
Treatment of co-morbid mental illness in primary care: how to minimize weight gain, diabetes, and metabolic syndrome
Type: Journal Article
Year: 2011
Publication Place: United States
Abstract: In patients with mental illness the increased risk from cardiovascular disease appears to be related to the increased incidence of obesity, hypertension, and diabetes mellitus. Barriers to the medical care in this patient population include diminished adherence to treatment and preventative recommendations, lack of willingness to engage in self-care activities, decreased access to affordable medical care, underestimation of risk by physicians, and adverse effects of commonly prescribed psychiatric medications. When managing patients with mental illness it is necessary to estimate the patient's metabolic and cardiovascular risk, monitor BMI, waist circumference, fasting glucose, and lipid profile regularly, evaluate psychiatric medications metabolic risk, and choose less "metabolically threatening" drugs. The promotion of healthy lifestyle choices among persons with serious mental illness is essential not only as part of their recovery, but as an integral part of preventing metabolic changes and weight gain linked to their illness and medication side effects. In patients with mental illness and co-morbid diabetes, metabolic syndrome, and obesity, psychiatrist and primary care clinicians should collaborate to establish a plan for healthy lifestyle habits (diet and activity regimen), encourage weight loss, and follow-up regularly using multispecialty teams to improve management.
Topic(s):
General Literature
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Reference Links: View the PubMed citation for Treatment of co-morbid mental illness in primary care: how to minimize weight gain, diabetes, and metabolic syndrome
839
Treatment selection and treatment initialization in guideline-based stepped and collaborative care for depression
Type: Journal Article
Year: 2018
Publication Place: United States
Abstract: In order to optimize patient allocation, guidelines recommend stepped and collaborative care models (SCM) including low-intensity treatments. The aim of this study is to investigate the implementation of guideline-adherent treatments in a SCM for depression in routine care. We analyzed care provider documentation data of n = 569 patients treated within a SCM. Rates of guideline-adherent treatment selections and initializations as well as accordance between selected and initialized treatment were evaluated for patients with mild, moderate and severe depression. Guideline-adherent treatment selection and initialization was highest for mild depression (91% resp. 85%). For moderate depression, guideline-adherent treatments were selected in 68% and applied in 54% of cases. Guideline adherence was lowest for severe depression (59% resp. 19%). In a multiple mixed logistic regression model a significant interaction between guideline adherence in treatment selection/initialization and severity degree was found. The differences between treatment selection and initialization were significant for moderate (OR: 1.8 [95% CI: 1.30 to 2.59; p = 0.0006]) and severe depression (OR: 6.9; [95% CI: 4.24 to 11.25; p < .0001] but not for mild depression (OR = 1.8, [95%-CI: 0.68 to 4.56; p = 0.2426]). Accordance between selected and initialized treatment was highest for mild and lowest for severe depression. We conclude that SCMs potentially improve care for mild depression and guideline adherence of treatment selections. Guideline adherence of treatment initialization and accordance between treatment selection and initialization varies with depression severity. Deficits in treating severe depression adequately may be more a problem of failed treatment initializations than of inadequate treatment selections.
Topic(s):
General Literature
See topic collection
Reference Links:
View the DOI record for Treatment selection and treatment initialization in guideline-based stepped and collaborative care for depression
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View the PubMed citation for Treatment selection and treatment initialization in guideline-based stepped and collaborative care for depression840
Treatment selection and treatment initialization in guideline-based stepped and collaborative care for depression
Type: Journal Article
Year: 2018
Publication Place: United States
Abstract: In order to optimize patient allocation, guidelines recommend stepped and collaborative care models (SCM) including low-intensity treatments. The aim of this study is to investigate the implementation of guideline-adherent treatments in a SCM for depression in routine care. We analyzed care provider documentation data of n = 569 patients treated within a SCM. Rates of guideline-adherent treatment selections and initializations as well as accordance between selected and initialized treatment were evaluated for patients with mild, moderate and severe depression. Guideline-adherent treatment selection and initialization was highest for mild depression (91% resp. 85%). For moderate depression, guideline-adherent treatments were selected in 68% and applied in 54% of cases. Guideline adherence was lowest for severe depression (59% resp. 19%). In a multiple mixed logistic regression model a significant interaction between guideline adherence in treatment selection/initialization and severity degree was found. The differences between treatment selection and initialization were significant for moderate (OR: 1.8 [95% CI: 1.30 to 2.59; p = 0.0006]) and severe depression (OR: 6.9; [95% CI: 4.24 to 11.25; p < .0001] but not for mild depression (OR = 1.8, [95%-CI: 0.68 to 4.56; p = 0.2426]). Accordance between selected and initialized treatment was highest for mild and lowest for severe depression. We conclude that SCMs potentially improve care for mild depression and guideline adherence of treatment selections. Guideline adherence of treatment initialization and accordance between treatment selection and initialization varies with depression severity. Deficits in treating severe depression adequately may be more a problem of failed treatment initializations than of inadequate treatment selections.
Topic(s):
General Literature
See topic collection
Reference Links:
View the DOI record for Treatment selection and treatment initialization in guideline-based stepped and collaborative care for depression
View DOI Record
View the PubMed citation for Treatment selection and treatment initialization in guideline-based stepped and collaborative care for depression