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Opioids & SU
The Literature Collection contains over 11,000 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).
11231 Results
241
A comparison of common screening methods for predicting aberrant drug-related behavior among patients receiving opioids for chronic pain management
Type: Journal Article
Year: 2009
Publication Place: England
Abstract: OBJECTIVE: The ability to predict risk for violating opioid medication policies, known as aberrant drug-related behavior, is critical for providing optimal treatment. Many pain management centers measure risk using one of several partially validated measures: the Screener and Opioid Assessment for Patients with Pain (SOAPP), the Diagnosis, Intractability, Risk, and Efficacy inventory (DIRE), and/or the Opioid Risk Tool (ORT). However, little is known about how these measures compare with each other in predicting aberrant drug-related behavior and discontinuance of opioid pain medications. The current study aimed to address this research question. PATIENTS: Participants were 48 patients who attended a pain management center in Tennessee but were later discontinued from opioids for aberrant drug-related behavior. Patients referred for opioid medication for pain management participated in a semi-structured clinical interview with the staff psychologist and completed the aforementioned measures. Patients generally returned to the pain clinic on a monthly basis for medication management. Results. Analyses compared the sensitivity of each self-report measure and the clinical interview in predicting discontinuance for aberrant drug-related behavior. RESULTS: showed the highest sensitivity for the clinical interview (0.77) and the SOAPP (0.72), followed by the ORT (0.45) and the DIRE (0.17). Combining the clinical interview with the SOAPP increased sensitivity to 0.90. CONCLUSIONS: Among patients who were discontinued from opioids for aberrant drug-related behaviors, the clinical interview and the SOAPP were most effective at predicting risk at baseline. Implications for future research and clinical practice are discussed.
Topic(s):
Opioids & Substance Use
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, Measures
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244
A Comparison of Medication-Assisted Treatment Options for Opioid Addiction: A Review of the Literature
Type: Journal Article
Year: 2021
Publication Place: United States
Topic(s):
Opioids & Substance Use
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Reference Links: 
View the DOI record for A Comparison of Medication-Assisted Treatment Options for Opioid Addiction: A Review of the Literature
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View the PubMed citation for A Comparison of Medication-Assisted Treatment Options for Opioid Addiction: A Review of the Literature246
A comparison of methods of administering the opioid risk tool
Type: Journal Article
Year: 2011
Publication Place: United States
Abstract: Risk assessment and stratification have become important aspects for the prescription of opioids to patients with chronic pain. Recent research has shown that the Opioid Risk Tool (ORT), a widely used risk assessment tool, has poor predictive abilities when compared with other risk assessment methods. This study compares two different methods of administration of the ORT to further study this issue. Patients at a pain practice were given an ORT to complete per the usual method of administration. In addition, a separate blinded ORT was completed by a psychologist after conducting a clinical interview with the patient. The results of the patient-completed ORT (PC-ORT) and the clinician-completed ORT (CC-ORT) were compared. There were significant differences found between the two, with the psychologist usually rating the patient higher in risk. The CC-ORT demonstrated better prediction of aberrant drug-taking behavior than the PC-ORT. The items that were discrepant between the two suggest that the differences were primarily due to comprehension issues. A strategy to help maximize the usefulness of the ORT derived from this finding and clinical experience is discussed.
Topic(s):
Opioids & Substance Use
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, Measures
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Reference Links: View the PubMed citation for A comparison of methods of administering the opioid risk tool
247
A comparison of office-based buprenorphine treatment outcomes in Bronx community clinics before versus during the COVID-19 pandemic
Type: Journal Article
Year: 2022
Topic(s):
Education & Workforce
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, Healthcare Disparities
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, Opioids & Substance Use
See topic collection
249
A comparison of patient recall of smoking cessation advice with advice recorded in electronic medical records
Type: Journal Article
Year: 2011
Publication Place: England
Abstract: BACKGROUND: Brief cessation advice delivered to smokers during routine primary care consultations increases smoking cessation rates. However, in previous studies investigating recall of smoking cessation advice, smokers have reported more advice being received than is actually documented in their medical records. Recording of smoking cessation advice in UK primary care medical records has increased since the introduction of the Quality and Outcomes Framework (QOF) in 2004, and so we compare recall and recording of cessation advice since this time to assess whether or not agreement between these two data sources has improved. METHODS: For each year from 2000 to 2009, the proportion of patients in The Health Improvement Network Database (THIN) with a recording of cessation advice in their notes in the last 12 months was calculated. In 2004, 2005 and 2008, these figures were compared to rates of patients recalling having received cessation advice in the last 12 months in the Primary Care Trust (PCT) Patient Surveys, with adjustment for age, sex and regional differences between the populations. RESULTS: In 2004 there was good agreement between the proportion of THIN patients who had cessation advice recorded in their medical records and the proportion recalling advice in the Patient Survey. However, in both 2005 and 2008, more patients had cessation advice recorded in their medical records than recalled receiving advice. CONCLUSIONS: Since the introduction of the QOF, the rate of recording of cessation advice in primary care medical records has exceeded that of patient recall. Whilst both data sources have limitations, our study suggests that, in recent years, the proportion of smokers being advised to quit by primary care health professionals may not have improved as much as the improved recording rates imply.
Topic(s):
HIT & Telehealth
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Reference Links:
View the DOI record for A comparison of patient recall of smoking cessation advice with advice recorded in electronic medical records
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View the PubMed citation for A comparison of patient recall of smoking cessation advice with advice recorded in electronic medical records253
A comparison of Tier 1 and Tier 3 medical homes under Oklahoma Medicaid program
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: INTRODUCTION: The patient-centered medical home (PCMH) is a team-based model of care that seeks to improve quality of care and control costs. The Oklahoma Health Care Authority (OHCA) directs Oklahoma's Medicaid program and contracts with 861 medical home practices across the state in one of three tiers of operational capacity: Tier 1 (Basic), Tier 2 (Advanced) and Tier 3 (Optimal). Only 13.5% (n = 116) homes are at the optimal level; the majority (59%, n = 508) at the basic level. In this study, we sought to determine the barriers that prevented Tier 1 homes from advancing to Tier 3 level and the incentives that would motivate providers to advance from Tier 1 to 3. Our hypotheses were that Tier 1 medical homes were located in smaller practices with limited resources and the providers are not convinced that the expense of advancing from Tier 1 status to Tier 3 status was worth the added value. METHODS: We analyzed OHCA records to compare the 508 Tier 1 (entry-level) with 116 Tier 3 (optimal) medical homes for demographic differences with regards to location: urban or rural, duration as medical home, percentage of contracts that were group contracts, number of providers per group contract, panel age range, panel size, and member-provider ratio. We surveyed all 508 Tier 1 homes with a mail-in survey, and with focused follow up visits to identify the barriers to, and incentives for, upgrading from Tier 1 to Tier 2 or 3. RESULTS: We found that Tier 1 homes were more likely to be in rural areas, run by solo practitioners, serve exclusively adult panels, have smaller panel sizes, and have higher member-to-provider ratios in comparison with Tier 3 homes. Our survey had a 35% response rate. Results showed that the most difficult changes for Tier 1 homes to implement were providing 4 hours of after-hours care and a dedicated program for mental illness and substance abuse. The results also showed that the most compelling incentives for encouraging Tier 1 homes to upgrade their tier status were less"red tape"with prior authorizations, higher pay, and help with panel member follow-up. DISCUSSION: Multiple interventions may help medical homes in Oklahoma advance from the basic to the optimal level such as sharing of resources among nearby practices, expansion of OHCA online resources to help with preauthorizations and patient follow up, and the generation and transmission of data on the benefits of medical homes.
Topic(s):
Medical Home
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, Healthcare Disparities
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, Healthcare Policy
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Reference Links: View the PubMed citation for A comparison of Tier 1 and Tier 3 medical homes under Oklahoma Medicaid program
254
A comparison of two screening instruments in detecting psychiatric morbidity in a Nigerian pediatric primary care service: assessing clinical suitability and applicability
Type: Journal Article
Year: 2012
Publication Place: India
Abstract: BACKGROUND: To improve poor attendance and underutilization of the child and adolescent psychiatric service in the University of Ilorin Teaching Hospital, Ilorin, Nigeria, we compared a child behavior questionnaire (CBQ) with reporting questionnaire for children (RQC) for use in our primary care unit where the bulk of referrals come from to determine which is more applicable. METHODS: This was a cross-sectional two-stage study on the prevalence and pattern of psychiatric disorders in children attending the primary care unit of University of Ilorin Teaching Hospital, over a 6-month period. CBQ and RQC were completed by the mothers of 350 children aged 7-14 years in the first stage; in the second, a stratified subsample of 157 children based on scores on CBQ were interviewed using the children's version of the schedule for affective disorders and schizophrenia (Kiddie-SADS-PL). The receiver operating characteristics (ROC) analysis was carried out to determine the screening properties of CBQ and RQC. RESULTS: The optimal cutoff score for CBQ and RQC were 7 and 1, respectively. Sensitivity, specificity, and misclassification rates at the cutoff for CBQ was 0.8 (80%); 0 96 (96%); 0.083 (8.3%), and RQC was 0.90 (90%); 0.78 (78%); 0.19 (19%). The discriminating ability of CBQ indicated by the area under the curve (AUC) in the ROC was 0.93 while RQC was 0.88. CONCLUSION: Even with the evident marginal superior discriminating ability of CBQ in our study in primary care, RQC has the advantage of brevity and ease of application for workers at this level. In the child and adolescent clinic CBQ may still be preferred.
Topic(s):
Healthcare Disparities
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255
A comparison of various risk screening methods in predicting discharge from opioid treatment
Type: Journal Article
Year: 2012
Publication Place: United States
Abstract: OBJECTIVES: Risk assessment and stratification has become an important aspect of the prescribing of opioids to patients with chronic pain. There is little empirical data available on the sensitivity and specificity of commonly used risk assessment tools. This paper describes 2 studies that compare the prediction capabilities of various risk assessment tools. METHODS: The first study presents data on patients at a pain practice whose treatment with opioids was stopped due to their engaging in aberrant drug-related behavior. Patients were assessed with the Screener and Opioid Assessment for Patients with Pain-Revised (SOAPP-R), the Pain Medication Questionnaire, the Opioid Risk Tool, and a clinical interview. A second study compared the risk assessment measures, SOAPP-R, Pain Medication Questionnaire, Opioid Risk Tool, and a clinical interview. Data were gathered on whether patients had engaged in aberrant drug-related behavior at 6-month follow-up. RESULTS: Significant differences in the measures were found. Accuracy did not appear to be a function of the type of aberrant drug-related behavior that the patient engaged in for any of the measures. The clinical interview showed the best sensitivity of the 4 risk measures in predicting risk. The SOAPP-R showed the best sensitivity of the self-report measures. However, the SOAPP-R appears to overrate risk. DISCUSSION: Overall, these studies indicate that not all risk assessment tools are equal in their ability to accurately predict future aberrant drug-related behavior. It may be that written risk assessment tools that use more subtle items are better suited to certain patient populations.
Topic(s):
Opioids & Substance Use
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, Measures
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Reference Links:
View the DOI record for A comparison of various risk screening methods in predicting discharge from opioid treatment
View DOI Record
View the PubMed citation for A comparison of various risk screening methods in predicting discharge from opioid treatment256
A Comparison Study of Primary Care Utilization and Mental Health Disorder Diagnoses Among Children In and Out of Foster Care on Medicaid
Type: Journal Article
Year: 2020
Publication Place: United States
Abstract:
The purpose of this study was to compare the utilization of primary care services and presence of mental health disorder diagnoses among children in foster care to children on Medicaid not in foster care in a large health system. The data for this study were analyzed from a clinical database of a multipractice pediatric health system in Houston, Texas. The sample included more than 95 000 children covered by Medicaid who had at least one primary care visit during the 2-year study period. The results of the study demonstrated that children not in foster care had a greater number of primary care visits and the odds of having >3 visits were significantly lower for children in foster care with a mental health disorder diagnosis. Additionally, more than a quarter of children in foster care had a diagnosis of a mental health disorder, compared with 15% of children not in foster care.
Topic(s):
Financing & Sustainability
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, Healthcare Disparities
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259
A computer-assisted depression intervention in primary care
Type: Journal Article
Year: 2011
Publication Place: England
Abstract: BACKGROUND: The clinical benefit for depression of an interactive computer-assisted cognitive-behavioral program on CD-ROM, the Wellness Workshop (WW), was evaluated in a randomized controlled trial. METHOD: A total of 191 individuals referred by primary-care physicians were randomly assigned to a control group, where physician-directed treatment as usual (TAU) was provided, or to a treatment group, where TAU was supplemented with the WW CD-ROM, delivered by mail (WW+TAU). Data were collected at baseline, at 6 weeks' post-intervention, and at a 6-month follow-up assessment. Participants were given a strong incentive by a reimbursement of $75 for completion of each assessment. Measures included symptom ratings obtained via structured clinical diagnostic interviews, as well as a battery of self-report questionnaires on symptoms specifically targeted by the intervention. RESULTS: Analysis of results demonstrated evidence for skill acquisition for improving dysfunctional thinking and reducing anxiety. Among those who met diagnostic criteria for depression, WW+TAU participants were three times more likely to remit at 6 weeks' post-test than TAU participants. CONCLUSIONS: The evidence supports the conclusion that the WW intervention added benefit to traditional care for depression. No placebo comparison group was included and the WW+TAU participants received slightly more attention (a supportive telephone contact,
Topic(s):
HIT & Telehealth
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Reference Links: View the PubMed citation for A computer-assisted depression intervention in primary care