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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
2461
Competencies for engaging high-needs patients in primary care
Type: Journal Article
Year: 2018
Publication Place: Netherlands
Topic(s):
Healthcare Disparities
See topic collection
Reference Links: View the PubMed citation for Competencies for engaging high-needs patients in primary care
2462
Competencies for psychology practice in primary care
Type: Journal Article
Year: 2014
Publication Place: United States
Topic(s):
Education & Workforce
See topic collection
2467
Complex health concerns among child welfare populations and the benefit of pediatric medical homes
Type: Journal Article
Year: 2017
Publication Place: England
Topic(s):
Healthcare Disparities
See topic collection
Reference Links: View the PubMed citation for Complex health concerns among child welfare populations and the benefit of pediatric medical homes
2468
Complexity in partnerships: A qualitative examination of collaborative depression care in primary care clinics and community-based organisations in California, United States
Type: Journal Article
Year: 2020
Publication Place: England
Abstract: Partnering across health clinics and community organisations, while worthwhile for improving health and well-being, is challenging and time consuming. Even partnerships that have essential elements for success in place face inevitable challenges. To better understand how cross-organisational partnerships work in practice, this paper examines collaborations between six primary care clinics and community-based organisations in the United States that were part of an initiative to address late-life depression using an enhanced collaborative care model (Archstone Foundation Care Partners Project). As part of an evaluation of the Care Partners Project, 54 key informant interviews and 10 focus groups were conducted from 2015 to 2017. Additionally, more than 80 project-related documents were reviewed. Qualitative thematic analysis was used to code the transcripts and identify prominent themes in the data. Examining clinic and community organisation partnerships in practice highlighted their inherent complexity. The partnerships were fluid and constantly evolving, shaped by a multiplicity of perspectives and values, and vulnerable to unpredictability. Care Partners sites negotiated the complexity of their partnerships drawing upon three main strategies: adaptation (allowing for flexibility and rapid change); integration (providing opportunities for multi-level partnerships within and across organisations) and cultivation (fostering a commitment to the partnership and its value). These strategies provided opportunities for Care Partners collaborators to work with the inherent complexity of partnering. Intentionally acknowledging and embracing such complexity rather than trying to reduce or avoid it, may allow clinic and community collaborators to strengthen and sustain their partnerships.
Topic(s):
Financing & Sustainability
See topic collection
2469
Complexity in partnerships: A qualitative examination of collaborative depression care in primary care clinics and community-based organisations in California, United States
Type: Journal Article
Year: 2020
Publication Place: England
Abstract: Partnering across health clinics and community organisations, while worthwhile for improving health and well-being, is challenging and time consuming. Even partnerships that have essential elements for success in place face inevitable challenges. To better understand how cross-organisational partnerships work in practice, this paper examines collaborations between six primary care clinics and community-based organisations in the United States that were part of an initiative to address late-life depression using an enhanced collaborative care model (Archstone Foundation Care Partners Project). As part of an evaluation of the Care Partners Project, 54 key informant interviews and 10 focus groups were conducted from 2015 to 2017. Additionally, more than 80 project-related documents were reviewed. Qualitative thematic analysis was used to code the transcripts and identify prominent themes in the data. Examining clinic and community organisation partnerships in practice highlighted their inherent complexity. The partnerships were fluid and constantly evolving, shaped by a multiplicity of perspectives and values, and vulnerable to unpredictability. Care Partners sites negotiated the complexity of their partnerships drawing upon three main strategies: adaptation (allowing for flexibility and rapid change); integration (providing opportunities for multi-level partnerships within and across organisations) and cultivation (fostering a commitment to the partnership and its value). These strategies provided opportunities for Care Partners collaborators to work with the inherent complexity of partnering. Intentionally acknowledging and embracing such complexity rather than trying to reduce or avoid it, may allow clinic and community collaborators to strengthen and sustain their partnerships.
Topic(s):
Financing & Sustainability
See topic collection
2471
Complexity in practice: understanding primary care as a complex adaptive system
Type: Journal Article
Year: 2010
Publication Place: England
Abstract: BACKGROUND: This series summarises new empirical research on quality improvement through case studies of the implementation of clinical governance arrangements in two primary care organisations (PCOs). OBJECTIVE: To describe a new socio-technical model for effective quality improvement and clinical governance. METHOD: The research strategy included a literature review, survey, in-depth interviews, participant observation and purposively sampled case studies, conducted within a social constructionist ontological perspective. This approach contextualises the origins of clinical governance and the trend towards collaborative partnerships and federated models of practice, enabled by developments in primary care informatics. RESULTS: People operating within multidisciplinary networks communicate with each other to determine actions that govern their most relevant concerns. Quality improvement in two PCOs is enabled through social interactions between individuals and groups with complex relationships; and information technology (IT) systems which make some aspects of the quality of care explicit. CONCLUSIONS: The results are real-world exemplars of the emergent properties of complex adaptive systems. Improving clinical governance in primary care requires both complex social interactions and underpinning informatics. The socio-technical lessons learned from this research should inform future management approaches.
Topic(s):
HIT & Telehealth
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Reference Links: View the PubMed citation for Complexity in practice: understanding primary care as a complex adaptive system
2473
Compliance with opioid treatment guidelines for chronic non-cancer pain (CNCP) in primary care at a Veterans Affairs Medical Center (VAMC)
Type: Journal Article
Year: 2013
Publication Place: England
Abstract: OBJECTIVE: The primary objective of this study was to measure prescribing compliance with the Veterans Affairs/Department of Defense treatment guidelines for chronic non-cancer pain (CNCP) in the primary care setting. We also determined the proportion of subjects who demonstrated aberrant drug-related behaviors (ADRBs) and the patient characteristics associated with them. DESIGN: This is a retrospective chart review. SETTING: Primary care setting in Veterans Affairs Medical Center. SUBJECTS: All patients with CNCP between the ages of 18 and 87 years who received opioid prescriptions for 3 or more consecutive months during a 1-year period (July 2009 to August 2010) were eligible for inclusion. A random sample of 800 patients was selected using pharmacy prescription database. Chi-square test was utilized to analyze associations between ADRB and patient characteristics. RESULTS: About half the patients in our sample had a signed opioid pain care agreement (OPCA), and at least one urine drug test (UDT) was obtained. UDT was positive for an illicit drug/unreported opioid in 19.5% of the patients, and negative for the prescribed drug in 25.2% of the sample. About 10% of the sample population had morphine equivalent dose equal to or greater than 200 mg/day. ADRBs were identified in 22.9% of the patients. Younger age, psychiatric comorbidities, history of substance abuse, and high opioid dose were associated with high risk of ADRB, but the presence of OPCA lowered the risk of ADRB. CONCLUSION: This article studied the prescribing practices of opioids in a primary care setting and can be used to enhance provider education regarding chronic pain guidelines.
Topic(s):
Opioids & Substance Use
See topic collection
2474
Comprehending care in a medical home: A usual source of care and patient perceptions about healthcare communication
Type: Journal Article
Year: 2008
Publication Place: United States
Abstract: OBJECTIVE: To examine whether having a usual source of care (USC) is associated with positive patient perceptions of health care communication and to identify demographic factors among patients with a USC that are independently associated with differing reports of how patients perceive their involvement in health care decision making. METHODS: Cross-sectional analyses of nationally representative data from the 2002 Medical Expenditure Panel Survey. Among adults with a health care visit in the past year (n = approximately 16,700), we measured independent associations between having a USC and patient perceptions of health care communication. Second, among respondents with a USC (n = approximately 18,000), we assessed the independent association between various demographic factors and indicators of patients' perceptions of their autonomy in making health care decisions. RESULTS: Approximately 78% of adults in the United States reported having a USC. Those with a USC were more likely to report that providers always listened to them, always explained things clearly, always showed respect, and always spent enough time with them. Patients who perceived higher levels of decision-making autonomy were non-Hispanic, had health insurance coverage, lived in rural areas, and had higher incomes. CONCLUSIONS: Patients with a USC were more likely to perceive positive health care interactions. Certain demographic factors among the subgroups of Medical Expenditure Panel Survey respondents with a USC were associated with patient perceptions of greater decision-making autonomy. Efforts to ensure universal access to a USC must be partnered with broader awareness and training of USC providers to engage patients from various demographic backgrounds equally when making health care decisions at the point of care.
Topic(s):
Medical Home
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Reference Links:
View the DOI record for Comprehending care in a medical home: A usual source of care and patient perceptions about healthcare communication
View DOI Record
View the PubMed citation for Comprehending care in a medical home: A usual source of care and patient perceptions about healthcare communication2475
Comprehensibility and readability of patient self-administered opioid assessment screening tools
Type: Journal Article
Year: 2007
Publication Place: United States
Abstract: OBJECTIVE: The aims of this study were to evaluate the cognitive complexity and reading demands of patient self-administered Opioid Assessment Screening Tools (OASTs) for use in adults with nonmalignant pain. METHODS: Using comprehensive search strategies, we identified english-language OASTs with established validity and reliability for inclusion in our study. Cognitive complexity of individual OAST statements or questions were assessed using three techniques (number of items, number of words, and linguistic problems), whereas readability was measured using the Flesch-Kinkaid formula. RESULTS: Four (n=4) were identified and included in our review: Current Opioid Misuse Measure (COMM), Pain Medication Questionnaire (PMQ), Screener and Opioid Assessment for Patient with Pain, and Screening Tool for Addiction Risk (STAR). Number of total OAST statements or questions ranged from a low of 14 (STAR) to a high of 26 (PMQ), whereas number of words (length) per statement or question averaged from a low of 10.2 +/- 1.1 (STAR) to a high of 15.9 +/- 3.8 (PMQ). The STAR (1.3 +/- 1.1) had the fewest number of linguistic problems per statement or question, whereas the PMQ (3.0 +/- 1.4) had the most linguistic problems per statement or question. Although, readability of OASTs ranged from approximately sixth (STAR) to eighth (COMM, PMQ) grade, there was notable variation in readability across individual statements or questions. CONCLUSIONS: Our study demonstrates that formatting characteristics, including linguistic problems, and high readability of several OAST statements or questions may hinder many patients' ability to accurately complete and comprehend OASTs independently.
Topic(s):
Opioids & Substance Use
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, Measures
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Reference Links: View the PubMed citation for Comprehensibility and readability of patient self-administered opioid assessment screening tools
2476
Comprehensive and compassionate responses for opioid use disorder among pregnant and parenting women
Type: Journal Article
Year: 2021
Publication Place: England
Abstract:
Pregnant and parenting women with opioid use disorder face multiple challenges to recovery. Trauma histories, poverty, stigma and discrimination, and lack of access to treatment intersect to marginalise this population. It is important that pregnant and parenting women with opioid use disorder receive comprehensive care to improve their health, the health of their child(ren), and prevent the intergenerational transmission of opioid and other substance use disorders. For nearly 50 years the Maternal Addiction Treatment, Education, and Research program has provided an evolving and expanding range of comprehensive services for treating opioid and other substance use disorders in this population. In this review the rationale for, and processes by which, key components of a comprehensive approach are discussed. These components include patient navigation for access to care, low-barrier medications for opioid use disorder, effective trauma-responsive therapy, prenatal and well-child healthcare, and other support services that make it possible for pregnant and parenting women to engage in treatment and improve the health of the entire family. Additionally, a method for supporting staff to build resilience and reduce fatigue and burnout is discussed. These components comprise an effective model of care for pregnant and parenting women with opioid and other substance use disorders.
Topic(s):
Education & Workforce
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, Healthcare Disparities
See topic collection
, Opioids & Substance Use
See topic collection
Reference Links:
View the DOI record for Comprehensive and compassionate responses for opioid use disorder among pregnant and parenting women
View DOI Record
View the PubMed citation for Comprehensive and compassionate responses for opioid use disorder among pregnant and parenting women