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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).
11202 Results
2562
Coordinated care in the management of patients with unexplained physical symptoms: depression is a key issue
Type: Journal Article
Year: 2008
Publication Place: Australia
Abstract: OBJECTIVE: To evaluate the diagnosis of patients with somatisation disorders in primary care, and the effectiveness of coordinated care and evidence-based care planning on psychiatric symptoms and quality of life for these patients. DESIGN, SETTING AND PARTICIPANTS: This was a project of the SA HealthPlus Coordinated Care Trial, comprising a randomised controlled trial of 124 subjects recruited by general practitioners in southern Adelaide. Eligible patients had a GP diagnosis of somatisation, including unexplained physical symptoms as part of anxiety, chronic pain or somatoform disorders. Diagnoses were checked using the Composite International Diagnostic Interview (CIDI). The study was conducted from December 1997 to December 1999. INTERVENTION: A care plan including treatment for depression and anxiety disorders, a containment strategy for somatisation, and service coordinator-assisted self-management. Control patients received standard treatment. MAIN OUTCOME MEASURES: Psychiatric symptoms; quality of life; medication use; and depression, anxiety and hostility scores. RESULTS: Compared with CIDI diagnoses, mood disorders in patients were underdiagnosed by GPs (64 v 31), particularly major depression (46 v 1). At 12 months, the intervention group showed reductions in depression (P = 0.002), guilt (P = 0.006) and anxiety (state, P = 0.043; trait, P = 0.001). Compared with the control group, physical role functioning improved for the intervention group (P = 0.006), and their medication use decreased by 8.9%. CONCLUSIONS: Conservative management, treatment of depression, and case management by service coordinators is effective in managing somatising patients in primary care. GPs require training in the diagnosis of depression and how to say "no" to patients with unexplained physical symptoms who request further unnecessary investigations or referrals.
Topic(s):
Medically Unexplained Symptoms
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Reference Links: View the PubMed citation for Coordinated care in the management of patients with unexplained physical symptoms: depression is a key issue
2565
Coordinating care across diseases, settings, and clinicians: A key role for the generalist in practice
Type: Journal Article
Year: 2005
Publication Place: United States
Abstract: Coordinated care is a defining principle of primary care, but it is becoming increasingly difficult to provide as the health care delivery system in the United States becomes more complex. To guide recommendations for research and practice, the evidence about implementation of coordinated care and its benefits must be considered. On the basis of review of the published literature this article makes recommendations concerning needs for a better-developed evidence base to substantiate the value of care coordination, generalist practices to be the hub of care coordination for most patients, improved communication among clinicians, a team approach to achieve coordination, integration of patients and families as partners, and incorporation of medical informatics. Although coordination of care is central to generalist practice, it requires far more effort than physicians alone can deliver. To make policy recommendations, further work is needed to identify essential elements of care coordination and prove its effectiveness at improving health outcomes.
Topic(s):
Education & Workforce
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, HIT & Telehealth
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, Healthcare Policy
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Reference Links: View the PubMed citation for Coordinating care across diseases, settings, and clinicians: A key role for the generalist in practice
2567
Coordinating Mental Health Care Across Primary Care and Schools: ADHD as a Case Example
Type: Journal Article
Year: 2013
Abstract: Although primary care practices and schools are major venues for the delivery of mental health services to children, these systems are disconnected, contributing to fragmentation in service delivery. This paper describes barriers to collaboration across the primary care and school systems, including administrative and fiscal pressures, conceptual and linguistic differences between healthcare and educational professionals, role restrictions among professionals, and privacy laws. Strategies for overcoming these barriers that can be applied in both primary care and school settings are described. The paper has a primary focus on children with ADHD, but the principles and strategies described are applicable to children with a range of mental health and health conditions.
Topic(s):
Education & Workforce
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, Healthcare Disparities
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Reference Links:
View the DOI record for Coordinating Mental Health Care Across Primary Care and Schools: ADHD as a Case Example
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View the PubMed citation for Coordinating Mental Health Care Across Primary Care and Schools: ADHD as a Case Example2570
Coordination of health behavior counseling in primary care
Type: Journal Article
Year: 2011
Publication Place: United States
Abstract: PURPOSE: We wanted to examine how coordinated care is implemented in primary care practices to address patients' health behavior change needs. METHODS: Site visit notes, documents, interviews, and online implementation diaries were collected from July 2005 to September 2007 from practice-based research networks (PBRNs) participating in Prescription for Health: Promoting Healthy Behaviors in Primary Care Research Networks (P4H). An iterative group process was used to conduct a cross-case comparative analysis of 9 interventions. Published patient outcomes reports from P4H interventions were referenced to provide information on intervention effectiveness. RESULTS: In-practice health risk assessment (HRA) and brief counseling, coupled with referral and outreach to a valued and known counseling resource, emerged as the best way to consistently coordinate and encourage follow-through for health behavior counseling. Findings from published P4H outcomes suggest that this approach led to improvement in health behaviors. Automated prompts and decision support tools for HRA, brief counseling and referral, training in brief counseling strategies, and co-location of referral with outreach facilitated implementation. Interventions that attempted to minimize practice or clinician burden through telephone and Web-based counseling systems or by expanding the medical assistant role in coordination of health behavior counseling experienced difficulties in implementation and require more study to determine how to optimize integration in practices. CONCLUSIONS: Easy-to-use system-level solutions that have point-of-delivery reminders and decision support facilitate coordination of health behavior counseling for primary care patients. Infrastructure is needed if broader integration of health behavior counseling is to be achieved in primary care.
Topic(s):
HIT & Telehealth
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, Education & Workforce
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Reference Links: View the PubMed citation for Coordination of health behavior counseling in primary care
2571
Coordination of services for people with serious mental illness and general medical conditions: Perspectives from rural northeastern United States
Type: Journal Article
Year: 2020
Publication Place: United States
Abstract: OBJECTIVE: The objective of the study was to investigate providers' perspectives on how medical, mental health, and social services are coordinated for people with serious mental illnesses and general medical conditions in 2 predominantly rural states. METHOD: To achieve multiple perspectives on service coordination, this study includes perspectives from providers employed in community mental health centers, social service agencies, and primary care settings in 2 northern rural New England states with contrasting approaches to financing and organizing services. We conducted 29 individual semistructured interviews and 1 focus group, which included administrative leaders, team leaders, primary care providers, social workers, and case managers who provide services for people with serious mental illness. Data were analyzed using qualitative thematic content analysis. RESULTS: We identified key themes at 3 levels: (a) provider-level coordination: bridging across services; managing interprofessional communications; and contrasting perspectives on the locus of responsibility for coordination; (b) individual-level coordination: support for self-management and care navigation; trusting and continuous relationships; and the right to individual choice and autonomy; (c) system-level coordination: linking appropriate residential and care provision services, funding, recruiting and retaining staff, policy enablers, and integration solutions. CONCLUSIONS: Three levels of provider-reported coordination themes are described for the 2 states, reflecting efforts to coordinate and integrate service delivery across medical, mental health, and social services. IMPLICATIONS: Improvements in patient outcomes will need additional actions that target key social determinants of health. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Topic(s):
Healthcare Disparities
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2572
Coordination of services for people with serious mental illness and general medical conditions: Perspectives from rural northeastern United States
Type: Journal Article
Year: 2020
Publication Place: United States
Abstract: OBJECTIVE: The objective of the study was to investigate providers' perspectives on how medical, mental health, and social services are coordinated for people with serious mental illnesses and general medical conditions in 2 predominantly rural states. METHOD: To achieve multiple perspectives on service coordination, this study includes perspectives from providers employed in community mental health centers, social service agencies, and primary care settings in 2 northern rural New England states with contrasting approaches to financing and organizing services. We conducted 29 individual semistructured interviews and 1 focus group, which included administrative leaders, team leaders, primary care providers, social workers, and case managers who provide services for people with serious mental illness. Data were analyzed using qualitative thematic content analysis. RESULTS: We identified key themes at 3 levels: (a) provider-level coordination: bridging across services; managing interprofessional communications; and contrasting perspectives on the locus of responsibility for coordination; (b) individual-level coordination: support for self-management and care navigation; trusting and continuous relationships; and the right to individual choice and autonomy; (c) system-level coordination: linking appropriate residential and care provision services, funding, recruiting and retaining staff, policy enablers, and integration solutions. CONCLUSIONS: Three levels of provider-reported coordination themes are described for the 2 states, reflecting efforts to coordinate and integrate service delivery across medical, mental health, and social services. IMPLICATIONS: Improvements in patient outcomes will need additional actions that target key social determinants of health. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Topic(s):
Healthcare Disparities
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2574
COPD and asthma in patients with opioid dependency: a cross-sectional study in primary care
Type: Journal Article
Year: 2020
Abstract:
Patients treated for drug addiction have high asthma and COPD prevalence rates. The relative contributions of cigarette smoking, smoking intensity and possible smoking of other substances has not been described. We aimed to describe the prevalence and determinants of asthma and COPD in patients prescribed methadone as opioid substitution therapy (OST). In a cross-sectional study of an anonymised patient-level primary care dataset of UK inner-city general practices (n = 46), 321,395 patients aged ≥18 years were identified. A total of 676 (0.21%) had a record of a methadone ever issued in primary care. The association between respiratory disease and methadone prescribing was examined using logistic regression. Models were adjusted for potential effects of clustering by practice. A total of 97.3% of patients prescribed methadone were cigarette smokers, either current (81.2%) or ex-smokers (16.1%). The prevalences of asthma and COPD were higher in methadone patients (14.2% and 12.4%, respectively) compared to non-methadone patients (4.4% and 1.1%, respectively). Methadone was an independent determinant of asthma, adjusting for smoking status (OR 3.21; 95% CI: 2.52, 4.10) or for smoking intensity (3.08; 2.27, 4.19), and of COPD, adjusting for smoking status (6.00; 4.61, 7.80) or for smoking intensity (5.80; 4.12, 8.17). COPD and asthma prevalence were substantially higher in those prescribed methadone compared to those never prescribed methadone. Prescription of methadone was an independent predictor for both COPD and asthma, even after adjustment for smoking status and smoking intensity. Possible explanations include confounding by association with smoking of heroin or crack cocaine, both of which may have a causal association with COPD and asthma.
Topic(s):
Healthcare Disparities
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, Opioids & Substance Use
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Reference Links:
View the DOI record for COPD and asthma in patients with opioid dependency: a cross-sectional study in primary care
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View the PubMed citation for COPD and asthma in patients with opioid dependency: a cross-sectional study in primary care2578
Copy/paste documentation of lifestyle counseling and glycemic control in patients with diabetes: true to form?
Type: Journal Article
Year: 2011
Publication Place: United States
Topic(s):
HIT & Telehealth
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Reference Links:
View the DOI record for Copy/paste documentation of lifestyle counseling and glycemic control in patients with diabetes: true to form?
View DOI Record
View the PubMed citation for Copy/paste documentation of lifestyle counseling and glycemic control in patients with diabetes: true to form?