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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).

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11272 Results
2441
Comparing telemedicine to in-person buprenorphine treatment in U.S. veterans with opioid use disorder
Type: Journal Article
Authors: L. A. Lin, J. C. Fortney, A. S. B. Bohnert, L. N. Coughlin, L. Zhang, J. D. Piette
Year: 2022
Abstract:

BACKGROUND: Telemedicine-delivered buprenorphine (tele-buprenorphine) can potentially increase access to buprenorphine for patients with opioid use disorder (OUD), especially during the COVID-19 pandemic, but we know little about use in clinical care. METHODS: This study was a retrospective national cohort study of veterans diagnosed with opioid use disorder (OUD) receiving buprenorphine treatment from the Veterans Health Administration (VHA) in fiscal years 2012-2019. The study examined trends in use of tele-buprenorphine and compared demographic and clinical characteristics in patients who received tele-buprenorphine versus those who received in-person treatment only. RESULTS: Utilization of tele-buprenorphine increased from 2.29% of buprenorphine patients in FY2012 (n = 187) to 7.96% (n = 1352) in FY2019 in VHA veterans nationally. Compared to patients receiving only in-person care, tele-buprenorphine patients were less likely to be male (AOR = 0.85, 95% CI: 0.73-0.98) or Black (AOR = 0.54, 95% CI: 0.45-0.65). Tele-buprenorphine patients were more likely to be treated in community-based outpatient clinics rather than large medical centers (AOR = 2.91, 95% CI: 2.67-3.17) and to live in rural areas (AOR = 2.12, 95% CI:1.92-2.35). The median days supplied of buprenorphine treatment was 722 (interquartile range: 322-1459) among the tele-buprenorphine patients compared to 295 (interquartile range: 67-854) among patients who received treatment in-person. CONCLUSIONS: Use of telemedicine to deliver buprenorphine treatment in VHA increased 3.5-fold between 2012 and 2019, though overall use remained low prior to COVID-19. Tele-buprenorphine is a promising modality especially when treatment access is limited. However, we must continue to understand how practitioners and patient are using telemedicine and how these patients' outcomes compare to those using in-person care.

Topic(s):
Financing & Sustainability See topic collection
,
Healthcare Disparities See topic collection
,
HIT & Telehealth See topic collection
,
Opioids & Substance Use See topic collection
2442
Comparing the effectiveness of a brief intervention to reduce unhealthy alcohol use among adult primary care patients with and without depression: A machine learning approach with augmented inverse probability weighting
Type: Journal Article
Authors: Santiago Papini, Felicia W. Chi, Alejandro Schuler, Derek D. Satre, Vincent X. Liu, Stacy A. Sterling
Year: 2022
Topic(s):
Opioids & Substance Use See topic collection
2444
Comparing the validity of self-report and urinalysis for substance use among former inmates in the Northeastern United States
Type: Journal Article
Authors: Jacob J. van den Berg, Samuel Adeyemo, Mary B. Roberts, Beth C. Bock, L. A. R. Stein, Rosemarie A. Martin, Donna R. Parker, Jennifer G. Clarke
Year: 2018
Topic(s):
Healthcare Disparities See topic collection
,
Opioids & Substance Use See topic collection
2445
Comparison between buprenorphine provider availability and opioid deaths among US counties
Type: Journal Article
Authors: Christopher W. Jones, Zachary Christman, Christopher M. Smith, Michelle R. Safferman, Matthew Salzman, Kaitlan Baston, Rachel Haroz
Year: 2018
Publication Place: United States
Topic(s):
Education & Workforce See topic collection
,
Healthcare Disparities See topic collection
,
Opioids & Substance Use See topic collection
2446
Comparison Between Urinalysis Results and Self-Reported Heroin Use Among Patients Undergoing Methadone Maintenance Treatment in China
Type: Journal Article
Authors: L. Li, L. J. Liang, C. Lin, N. Feng, Z. Wu
Year: 2017
Publication Place: England
Abstract: BACKGROUND: The validity and concordance of two main measures of drug use behavior, self-report and urinalysis, has long been discussed. More understanding is needed about the underlying factors associated with discordance between these two methods. OBJECTIVES: Describe the pattern and associated factors of discordance between self-reported heroin use and the urinalysis results of opiate use among methadone maintenance therapy (MMT) patients in China. METHODS: A total of 2,448 MMT patients from 68 clinics in five provinces of China participated in a survey, which collected information on demographics, drug use and MMT-related factors, depressive symptoms, and drug avoidance self-efficacy. The most recent urine morphine test result was obtained from medical records and compared with self-reported heroin use. Participants who had urinalysis within 14 days of the survey were included in the analysis. RESULTS: Among the 1,092 participants, 70 (6.4%) self-reported heroin use and 195 (17.9%) had positive urinalysis results. The over-reporters group had significantly higher education, and the under-reporters had significantly higher level of drug-avoidance self-efficacy and lower level of depressive symptoms. Among the participants who either self-reported heroin use or had positive urinalysis results, being young, having higher education, and having lower level of depressive symptoms were associated with discordance between self-reports and urinalysis results. CONCLUSION: The combination of both measures in assessing drug use behavior seems necessary. The validity of self-report should be considered differently based on demographic and psychosocial characteristics.
Topic(s):
Opioids & Substance Use See topic collection
2447
Comparison of acculturation experiences of foreign educated nurses in three integrated healthcare care systems in the US
Type: Journal Article
Authors: D. F. Pacquiao, M. Sulse
Year: 2008
Publication Place: URL
Topic(s):
Education & Workforce See topic collection
2448
Comparison of behavioral treatment conditions in buprenorphine maintenance.
Type: Journal Article
Authors: Walter Ling, Maureen Hillhouse, Alfonso Ang, Jessica Jenkins, Jacqueline Fahey
Year: 2013
Topic(s):
Opioids & Substance Use See topic collection
2449
Comparison of Biological Screening and Diagnostic Indicators to Detect In Utero Opiate and Cocaine Exposure Among Mother-Infant Dyads
Type: Journal Article
Authors: M. Stabler, P. Giacobbi Jr, I. Chertok, L. Long, L. Cottrell, P. Yossuck
Year: 2017
Publication Place: United States
Abstract: BACKGROUND: Opioid and cocaine antenatal substance use can result in significant obstetric and pediatric health implications. Accurate detection of in utero-exposed neonates can improve patient care and health outcomes. Therefore, the effectiveness of mother-infant biological and diagnostic indicators collected at labor and delivery to provide accurate detection of in utero opiate and cocaine exposure was assessed. METHODS: A retrospective medical chart review included 335 mother-infant dyads exposed to antenatal substances who were delivered between January 2009 and March 2014. Mother-infant dyads were a subset of a larger retrospective cohort of 560 substance-using mothers, who had a valid meconium drug screen (MDS) and anesthesia before delivery. Alternative biological and diagnostic indicators of maternal urine drug screens (UDS), maternal substance use International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes, and neonatal exposure diagnostic ICD-9-CM codes were compared against MDS. Data were analyzed using classification accuracy measures. RESULTS: Compared with MDS, maternal UDS had the highest sensitivity [0.52, 95% confidence interval (CI), 0.39-0.65] and specificity (0.88, 95% CI, 0.79-0.97) to detect intrauterine opiate exposure. Maternal substance use diagnosis had the highest sensitivity (0.39, 95% CI, 0.16-0.61) and maternal UDS had the highest specificity (1.00, 95% CI, 0.99-1.00) to detect intrauterine cocaine exposure. Cocaine exposure had significantly higher accuracy scores across detection methods compared with opiate exposure. CONCLUSIONS: Alternative indicators collected at delivery were ineffective at identifying in utero substance exposure, especially neonatal-exposed ICD-9-CM codes. Low sensitivity scores indicate that many exposed neonates could be misdiagnosed or left untreated. Accurate antenatal exposure identification at delivery is an important form of tertiary assessment that warrants the development of improved screening methodology and standardization of hospital biological drug testing.
Topic(s):
Healthcare Disparities See topic collection
,
Opioids & Substance Use See topic collection
2450
Comparison of buprenorphine and methadone in the treatment of opiate withdrawal: Possible advantages of buprenorphine for the treatment of opiate-benzodiazepine codependent patients?
Type: Journal Article
Authors: Laurence J. Reed, Anthony Glasper, Cornelis J. de Wet, Jennifer Bearn, Michael Gossop
Year: 2007
Topic(s):
Opioids & Substance Use See topic collection
2451
Comparison of buprenorphine treatment for opioid dependence in 3 settings
Type: Journal Article
Authors: K. Miotto, M. Hillhouse, R. Donovick, J. Cunningham-Rathner, C. Charuvastra, M. Torrington, A. E. Esagoff, W. Ling
Year: 2012
Publication Place: United States
Abstract: Although use of buprenorphine in the treatment of opioid dependence is expected to continue to increase, little is known about the optimal setting for providing the medical and psychosocial care required with buprenorphine pharmacotherapy. OBJECTIVE: This study compared buprenorphine therapy delivered in 3 distinct treatment settings: an opioid treatment program (OTP) offering individual counseling, a group counseling program utilizing the manualized Matrix Model (MMM) of cognitive-behavioral treatment, and a private clinic setting mirroring standard medical management for buprenorphine treatment provided specifically at a psychiatrist's private practice (primary care setting). METHOD: Participants were inducted on buprenorphine and provided with treatment over a 52-week study duration. All participants were scheduled for weekly treatment visits for the first 6 study weeks and 2 sites reduced treatment to monthly visits for dispensing of medication and psychosocial counseling. Outcomes include opioid use, participant retention in treatment, and treatment participation. RESULTS: Participants presenting for treatment at the sites differed only by race/ethnicity and opioid use did not differ by site. Retention differed by treatment site, with the number of participants who stayed in the study until the end of 20 weeks significantly associated with treatment site. The mean number of minutes spent in each individual counseling session also differed by site. Although no difference in opioid use by treatment site was found, results document a significant association between opioid use and buprenorphine dose. DISCUSSION: These results show some differences by treatment site, although the similarity and relative ease in which the sites were able to recruit participants for treatment with buprenorphine, and minor implementation problems reported suggests the feasibility of treatment with buprenorphine across various treatment settings. CONCLUSION: Similar rates of continued opioid use across study sites and few qualitative reports of problems indicates that treatment with buprenorphine and associated psychosocial counseling are safe and relatively easy to implement in a variety of treatment settings.
Topic(s):
Opioids & Substance Use See topic collection
2452
Comparison of characteristics of opioid-using pregnant women in rural and urban settings
Type: Journal Article
Authors: S. H. Heil, S. C. Sigmon, H. E. Jones, M. Wagner
Year: 2008
Publication Place: United States
Abstract: Historically, research on opioid use during pregnancy has occurred in urban settings and it is unclear how urban and rural populations compare. We examined socio-demographic and other variables in opioid-using pregnant women seeking treatment and screened for participation in a multi-site randomized controlled trial. Women screened in rural Burlington, Vermont (n = 54), were compared to those screened in urban Baltimore, Maryland (n = 305). Rural opioid-using pregnant women appear to have some characteristics associated with better treatment outcomes (e.g., less severe drug use, greater employment). However, they may face additional barriers in accessing treatment (e.g., greater distance from treatment clinic).
Topic(s):
Opioids & Substance Use See topic collection
,
Healthcare Disparities See topic collection
2453
Comparison of Collaborative Care and Colocation Treatment for Patients With Clinically Significant Depression Symptoms in Primary Care
Type: Journal Article
Authors: M. A. Blackmore, K. E. Carleton, S. M. Ricketts, U. B. Patel, D. Stein, A. Mallow, J. P. Deluca, H. Chung
Year: 2018
Publication Place: United States
Abstract: OBJECTIVE: The study compared clinical outcomes of depression treatment in primary care with a colocation model versus a collaborative care model (CoCM). METHODS: Patients (N=240) with Patient Health Questionnaire-9 (PHQ-9) scores of >/=10 treated for clinically significant depression symptoms in primary care sites implementing the CoCM or a colocation model were compared. PHQ-9 scores were collected at baseline and 12 weeks. RESULTS: From baseline to follow-up, reductions in PHQ-9 scores were 33% for the CoCM sites and 14% for the colocation sites, with an unadjusted mean difference in scores of 2.81 (p=.001). CONCLUSIONS: More patients treated in sites that used the CoCM experienced a significantly greater reduction in depression symptoms, compared with patients in sites with the colocation model. As greater adoption of integration models in primary care occurs, it will be important to consider potential implications of these results for promoting adoption of CoCM elements. Further replication of these findings is warranted.
Topic(s):
Healthcare Disparities See topic collection
2454
Comparison of demographic and clinical characteristics between opioid-dependent individuals admitted to a community-based treatment setting and those enrolled in a research-based treatment setting
Type: Journal Article
Authors: C. P. Carroll, M. Kidorf, E. C. Strain, R. K. Brooner
Year: 2007
Publication Place: United States
Abstract: Despite the significant developments in pharmacotherapy and behavioral treatments for addiction, the dissemination of new treatment methods into the community has been slow. It has been pointed out that treatments developed in research settings may be impractical in community treatment settings, which might help explain the transition lag. Screening and recruitment of participants for research studies might partially explain this, as there is evidence that substance-abusing individuals who participate in clinical research are different on a number of measures from treatment seekers. However, no study has directly compared treatment seekers with research participants drawn from similar populations using prospective methods. This study compared the demographic characteristics, drug use and psychosocial problem severity levels, and personality traits of opioid-dependent individuals seeking help in a community setting (n = 502) with those of opioid-dependent individuals in a primarily research-based drug abuse treatment setting (n = 459); both settings offered a similar set of treatment services (opioid agonist medication and counseling). Although the overall findings revealed numerous similarities between the groups, differences were also observed. Most notably, there were significantly fewer women in the research sample than in the community-based treatment sample. Other differences included a modest but statistically significant increase in psychosocial problem severity levels in the community-based treatment sample and higher drug use problem severity levels in the research sample. Interestingly, many of these differences were strongest in women as compared with men.
Topic(s):
Opioids & Substance Use See topic collection
2455
Comparison of electronic physician prompts versus waitroom case-finding on clinical trial enrollment
Type: Journal Article
Authors: B. L. Rollman, G. S. Fischer, F. Zhu, B. H. Belnap
Year: 2008
Publication Place: United States
Abstract: BACKGROUND: Recruiting patients into clinical research protocols is challenging. Electronic medical record (EMR) systems capable of prompting clinicians may facilitate enrollment. OBJECTIVE: To compare an EMR-based clinician prompt versus a wait-room-based case-finding strategy at enrolling patients into a clinical trial. DESIGN: Cross-sectional comparison of recruitment data from two trials to treat anxiety disorders in primary care. Both studies utilized similar enrollment criteria, intervention strategies, and the same four practice sites and EMR system. PARTICIPANTS: Patients referred by their (primary care physicians) PCPs in response to an EMR prompt (recruited 1/2005-10/2006), and patients enrolled by research assistants stationed in practice waiting rooms (7/2000-4/2002). MEASUREMENTS: Referral counts, patients' baseline sociodemographic and clinical characteristics. RESULTS: Over a 22-month period, EMR-prompted PCPs referred 794 patients and 176 (22%) met study inclusion criteria and enrolled, compared to 8,095 patients approached by wait room-based recruiters of whom 193 (2.4%) enrolled. Subjects enrolled by EMR-prompted PCPs were more likely to be non-white (23% vs 5%; P < 0.001), male (28% vs 18%; P = 0.03), and have higher anxiety levels than those recruited by wait-room recruiters (P < 0.0001). CONCLUSIONS: EMR systems prompting clinicians to refer patients with specific characteristics are an efficient recruitment tool with critical implications for increasing minority participation in clinical research.
Topic(s):
HIT & Telehealth See topic collection
2456
Comparison of Health Centers and Certified Community Behavioral Health Clinics
Type: Government Report
Authors: National Association of Community Health Centers
Year: 2023
Publication Place: Bethesda, MD
Topic(s):
Healthcare Disparities See topic collection
,
Healthcare Policy See topic collection
,
Grey Literature See topic collection
Disclaimer:

This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

2457
Comparison of hope and self-efficacy of successful (without lapses) and failed (with repeated lapses) addicts under maintenance methadone therapy
Type: Journal Article
Authors: Tooraj Sepahvand
Year: 2019
Topic(s):
Measures See topic collection
,
Opioids & Substance Use See topic collection
2458
Comparison of integrated behavioral health treatment for internalizing psychiatric disorders in patients with and without Type 2 diabetes
Type: Journal Article
Authors: Arthur R. Andrews III, Debbie Gomez, Austin Larey, Hayden Pacl, Dennis Burchette Jr., Juventino Hernandez Rodriguez, Freddie A. Pastrana, Ana J. Bridges
Year: 2016
Topic(s):
General Literature See topic collection
2459
Comparison of Medicaid reimbursements for psychiatrists and primary care physicians
Type: Journal Article
Authors: Tami L. Mark, William Parish, Gary A. Zarkin, Ellen Weber
Year: 2020
Topic(s):
Education & Workforce See topic collection
,
Financing & Sustainability See topic collection
2460
Comparison of Methods for Alcohol and Drug Screening in Primary Care Clinics
Type: Journal Article
Authors: J. McNeely, A. Adam, J. Rotrosen, S. E. Wakeman, T. E. Wilens, J. Kannry, R. N. Rosenthal, A. Wahle, S. Pitts, S. Farkas, C. Rosa, L. Peccoralo, E. Waite, A. Vega, J. Kent, C. K. Craven, T. A. Kaminski, E. Firmin, B. Isenberg, M. Harris, A. Kushniruk, L. Hamilton
Year: 2021
Abstract:

IMPORTANCE: Guidelines recommend that adult patients receive screening for alcohol and drug use during primary care visits, but the adoption of screening in routine practice remains low. Clinics frequently struggle to choose a screening approach that is best suited to their resources, workflows, and patient populations. OBJECTIVE: To evaluate how to best implement electronic health record (EHR)-integrated screening for substance use by comparing commonly used screening methods and examining their association with implementation outcomes. DESIGN, SETTING, AND PARTICIPANTS: This article presents the outcomes of phases 3 and 4 of a 4-phase quality improvement, implementation feasibility study in which researchers worked with stakeholders at 6 primary care clinics in 2 large urban academic health care systems to define and implement their optimal screening approach. Site A was located in New York City and comprised 2 clinics, and site B was located in Boston, Massachusetts, and comprised 4 clinics. Clinics initiated screening between January 2017 and October 2018, and 93 114 patients were eligible for screening for alcohol and drug use. Data used in the analysis were collected between January 2017 and October 2019, and analysis was performed from July 13, 2018, to March 23, 2021. INTERVENTIONS: Clinics integrated validated screening questions and a brief counseling script into the EHR, with implementation supported by the use of clinical champions (ie, clinicians who advocate for change, motivate others, and use their expertise to facilitate the adoption of an intervention) and the training of clinic staff. Clinics varied in their screening approaches, including the type of visit targeted for screening (any visit vs annual examinations only), the mode of administration (staff-administered vs self-administered by the patient), and the extent to which they used practice facilitation and EHR usability testing. MAIN OUTCOMES AND MEASURES: Data from the EHRs were extracted quarterly for 12 months to measure implementation outcomes. The primary outcome was screening rate for alcohol and drug use. Secondary outcomes were the prevalence of unhealthy alcohol and drug use detected via screening, and clinician adoption of a brief counseling script. RESULTS: Patients of the 6 clinics had a mean (SD) age ranging from 48.9 (17.3) years at clinic B2 to 59.1 (16.7) years at clinic B3, were predominantly female (52.4% at clinic A1 to 64.6% at clinic A2), and were English speaking. Racial diversity varied by location. Of the 93,114 patients with primary care visits, 71.8% received screening for alcohol use, and 70.5% received screening for drug use. Screening at any visit (implemented at site A) in comparison with screening at annual examinations only (implemented at site B) was associated with higher screening rates for alcohol use (90.3%-94.7% vs 24.2%-72.0%, respectively) and drug use (89.6%-93.9% vs 24.6%-69.8%). The 5 clinics that used a self-administered screening approach had a higher detection rate for moderate- to high-risk alcohol use (14.7%-36.6%) compared with the 1 clinic that used a staff-administered screening approach (1.6%). The detection of moderate- to high-risk drug use was low across all clinics (0.5%-1.0%). Clinics with more robust practice facilitation and EHR usability testing had somewhat greater adoption of the counseling script for patients with moderate-high risk alcohol or drug use (1.4%-12.5% vs 0.1%-1.1%). CONCLUSIONS AND RELEVANCE: In this quality improvement study, EHR-integrated screening was feasible to implement in all clinics and unhealthy alcohol use was detected more frequently when self-administered screening was used at any primary care visit. The detection of drug use was low at all clinics, as was clinician adoption of counseling. These findings can be used to inform the decision-making of health care systems that are seeking to implement screening for substance use. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02963948.

Topic(s):
HIT & Telehealth See topic collection
,
Opioids & Substance Use See topic collection