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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).
12769 Results
2721
Community correctional agents' views of medication-assisted treatment: Examining their influence on treatment referrals and community supervision practices
Type:
Journal Article
Year:
2016
Publication Place:
United States
Abstract:
BACKGROUND: Alcohol and opioid use disorders are common among adults under community supervision. Although several medications (medication-assisted treatment or MAT) are Food and Drug Administration (FDA)-approved to treat such disorders, they are underutilized with this population despite established effectiveness at decreasing substance use. This paper examines how community correctional agents' understanding of addiction and views of MAT influence their professional actions regarding addiction medications. METHODS: A total of 118 semistructured qualitative interviews were conducted with community correctional agents taking part in the CJ-DATS MATICCE implementation study across 20 parole/probation offices in 9 US states. Using grounded theory methodology and an iterative analytic approach, issues of role perception, views of MAT, current treatment referral, and community supervision practices were explored. RESULTS: Agents often had limited autonomy to make direct treatment referrals, regardless of their views of MAT, as they were required to follow court orders and their organization's policies and procedures. Within some organizations, community correctional agents held sufficient autonomy to make direct treatment referrals, with agents struggling to reconcile their desire to support their clients who needed MAT with concerns about the abuse potential of opioid agonist medications. Viewing MAT as a "treatment of last resort" was counterbalanced by the view that it was an effective evidence-based practice. Agents described how MAT impacted their ability to supervise clients and how their knowledge and understanding of MAT was directly influenced by watching their clients who were successful or unsuccessful on MAT. Even those agents who were more accepting of MAT were largely unsupportive of it long-term use. CONCLUSIONS: Community correctional agents' views of MAT were influenced by their understanding of addiction as well as their experiences supervising clients receiving treatment with medications, but whether or not MAT referrals were made was not always within their control.
Topic(s):
Opioids & Substance Use
See topic collection
, Healthcare Disparities
See topic collection
2722
Community Engagement in a complex intervention to improve access to primary mental health care for hard-to-reach groups
Type:
Journal Article
Year:
2014
Topic(s):
Healthcare Disparities
See topic collection
Reference Links:
View the DOI record for Community Engagement in a complex intervention to improve access to primary mental health care for hard-to-reach groups
View DOI Record
View the PubMed citation for Community Engagement in a complex intervention to improve access to primary mental health care for hard-to-reach groups
2726
Community Health Workers Bring Cost Savings to Patient-Centered Medical Homes
Type:
Journal Article
Year:
2018
Publication Place:
Netherlands
Abstract:
The Patient-Centered Medical Home (PCMH) model demonstrated that processes of care can be improved while unnecessary care, such as preventable emergency department utilization, can be reduced through better care coordination. A complementary model, the Integrated Primary Care and Community Support (I-PaCS) model, which integrates community health workers (CHWs) into primary care settings, functions beyond improved coordination of primary medical care to include management of the social determinants of health. However, the PCMH model puts downward pressure on the panel sizes of primary care providers, increasing the average fixed costs of care at the practice level. While the I-PaCS model layers an additional cost of the CHWs into the primary care cost structure, that additional costs is relatively small. The purpose of this study is to simulate the effects of the PCMH and I-PaCS models over a 3-year period to account for program initiation to maturity. The costs and cost offsets of the model were estimated at the clinic practice level. The studies which find the largest cost savings are for high-risk, paneled patients and therefore do not represent the effects of the PCMH model on moderate-utilizing patients or practice-level effects. We modeled a 12.6% decrease in the inpatient hospital, outpatient hospital and emergency department costs of high and moderate risk patients. The PCMH is expected to realize a 1.7% annual savings by year three while the I-PaCS program is expected to a 7.1% savings in the third year. The two models are complementary, the I-PaCS program enhancing the cost reduction capability of the PCMH.
Topic(s):
Financing & Sustainability
See topic collection
, Medical Home
See topic collection
Reference Links:
View the DOI record for Community Health Workers Bring Cost Savings to Patient-Centered Medical Homes
View DOI Record
View the PubMed citation for Community Health Workers Bring Cost Savings to Patient-Centered Medical Homes
2727
Community Health Workers Bring Cost Savings to Patient-Centered Medical Homes
Type:
Journal Article
Year:
2018
Publication Place:
Netherlands
Abstract:
The Patient-Centered Medical Home (PCMH) model demonstrated that processes of care can be improved while unnecessary care, such as preventable emergency department utilization, can be reduced through better care coordination. A complementary model, the Integrated Primary Care and Community Support (I-PaCS) model, which integrates community health workers (CHWs) into primary care settings, functions beyond improved coordination of primary medical care to include management of the social determinants of health. However, the PCMH model puts downward pressure on the panel sizes of primary care providers, increasing the average fixed costs of care at the practice level. While the I-PaCS model layers an additional cost of the CHWs into the primary care cost structure, that additional costs is relatively small. The purpose of this study is to simulate the effects of the PCMH and I-PaCS models over a 3-year period to account for program initiation to maturity. The costs and cost offsets of the model were estimated at the clinic practice level. The studies which find the largest cost savings are for high-risk, paneled patients and therefore do not represent the effects of the PCMH model on moderate-utilizing patients or practice-level effects. We modeled a 12.6% decrease in the inpatient hospital, outpatient hospital and emergency department costs of high and moderate risk patients. The PCMH is expected to realize a 1.7% annual savings by year three while the I-PaCS program is expected to a 7.1% savings in the third year. The two models are complementary, the I-PaCS program enhancing the cost reduction capability of the PCMH.
Topic(s):
Financing & Sustainability
See topic collection
, Medical Home
See topic collection
Reference Links:
View the DOI record for Community Health Workers Bring Cost Savings to Patient-Centered Medical Homes
View DOI Record
View the PubMed citation for Community Health Workers Bring Cost Savings to Patient-Centered Medical Homes
2728
Community integration of transition-age individuals: views of young with mental health disorders
Type:
Journal Article
Year:
2008
Publication Place:
United States
Abstract:
This qualitative study examines the perceptions of young adults with mental health disorders of community integration. Fifty-nine young men and women participated in 12 focus groups whose aim was to gain understanding of what community integration means to them. Focus group questions also explored barriers and supports for their community integration, as well as their goals for the future and advice to others facing similar challenges. Themes that emerged were reported within the multiple domains that participants used to describe their experiences of community integration (or the lack thereof). This study highlights the desires of these young people to achieve goals in education and employment and to have friendships. Participants identified a pervasive lack of understanding of mental health and prevalent stigmatizing attitudes as resulting in challenges to their community integration. Implications of the study discuss roles for behavioral health services in encouraging empowerment, choices, and connections so that young people with mental health disorders may achieve their preferred levels of community integration.
Topic(s):
HIT & Telehealth
See topic collection
Reference Links:
View the DOI record for Community integration of transition-age individuals: views of young with mental health disorders
View DOI Record
View the PubMed citation for Community integration of transition-age individuals: views of young with mental health disorders
2729
Community interventions against depression
Type:
Journal Article
Year:
2007
Publication Place:
India
Abstract:
Depression appears to be the common psychiatric dosorder in any given community. Depression in different forms may affect 10% of the population at any given time. The paucity of mental health power has made people to ignore the presence of depression and its impact on individual's capacity of functioning. If we have to plan community based interventions some strategies are to be adopted. In primary healthcare systems short training of all categories of personnel in PHC and regular supply of free medicines are essential. With the experiences of general practitioners and their involvement, patients with depression can be approached for help. So also school and college teachers, trained counselors, religious and spiritual leaders can be involved in the processes. Family members can take care of patients. Stress management techniques, helpline, crisis intervention can be other methods to help the patients suffering from depression.
Topic(s):
Education & Workforce
See topic collection
2731
Community Mental Health Center Integrated Care Outcomes
Type:
Journal Article
Year:
2018
Publication Place:
United States
Topic(s):
General Literature
See topic collection
Reference Links:
View the PubMed citation for Community Mental Health Center Integrated Care Outcomes
2732
Community mental health nursing: Keeping pace with care delivery?
Type:
Journal Article
Year:
2008
Publication Place:
Australia
Abstract:
The National Mental Health Strategy has been associated with the movement of service delivery into the community, creating greater demand for community services. The literature suggests that the closure of psychiatric beds and earlier discharge from inpatient services, have contributed to an intensification of the workload of community mental health nurses. This paper reports findings from the first stage of an action research project to develop a workload equalization tool for community mental health nurses. The study presents data from focus groups conducted with South Australian community mental health nurses to identify issues that impact upon their workload. Four themes were identified, relating to staffing and workforce issues, clients' characteristics or needs, regional issues, and the impact of the health-care system. The data show that the workload of community mental health nurses is increased by the greater complexity of needs of community mental health clients. Service change has also resulted in poor integration between inpatient and community services and tension between generic case management and specialist roles resulting in nurses undertaking tasks for other case managers. These issues, along with difficulties in recruiting and retaining staff, have led to the intensification of community mental health work and a crisis response to care with less time for targeted interventions.
Topic(s):
Education & Workforce
See topic collection
Reference Links:
View the DOI record for Community mental health nursing: Keeping pace with care delivery?
View DOI Record
View the PubMed citation for Community mental health nursing: Keeping pace with care delivery?
2737
Community perspectives on supervised consumption sites: Insights from four U.S. counties deeply affected by opioids
Type:
Journal Article
Year:
2021
Publication Place:
United States
Topic(s):
Education & Workforce
See topic collection
, Opioids & Substance Use
See topic collection
Reference Links:
View the DOI record for Community perspectives on supervised consumption sites: Insights from four U.S. counties deeply affected by opioids
View DOI Record
View the PubMed citation for Community perspectives on supervised consumption sites: Insights from four U.S. counties deeply affected by opioids
2738
Community pharmacists in Virginia dispensing naloxone under a standing order: A qualitative study
Type:
Journal Article
Year:
2021
Publication Place:
United States
Topic(s):
Education & Workforce
See topic collection
, Opioids & Substance Use
See topic collection
Reference Links:
View the DOI record for Community pharmacists in Virginia dispensing naloxone under a standing order: A qualitative study
View DOI Record
View the PubMed citation for Community pharmacists in Virginia dispensing naloxone under a standing order: A qualitative study
2740
Community pharmacists' preparedness to intervene with concerns around prescription opioids: findings from a nationally representative survey
Type:
Journal Article
Year:
2021
Publication Place:
Netherlands
Abstract:
Background Prescription opioid use and related harms have dramatically increased in many countries. Objective To investigate pharmacists' preparedness and confidence to intervene when concerned about supplying prescription opioids and strategies used when concerned about supplying these opioids. Setting Online survey among a representative sample of Australian community pharmacists. Method Pharmacists completed an online survey about their concerns, comfort and strategies used when supplying prescription opioids. Correlates of comfort to intervene and active intervention strategies were explored using multivariable ordered logistic regression and adjusted odd ratios (aOR) and 95% confidence intervals were reported. Main outcome measures Comfort to intervene when concerned about supplying prescription opioids and pharmacists' discussing these concerns with the patient, and the prescriber. Results Most pharmacists were concerned about supplying prescription opioids to patients in the past week. Being female [adjusted odds ratio (aOR) 0.63; 95% confidence interval (CI) 0.47-0.85] was associated with reduced comfort, while practicing within a large chain pharmacy (aOR 1.52, 95% CI 1.08-2.15) was associated with greater comfort to intervene when concerned about prescription opioid supply. Pharmacists practicing in rural areas were significantly less likely than those in capital cities to discuss concerns with patients (aOR 0.66, 95% CI 0.45-0.97). Post-graduate education about substance use disorders was associated with increased likelihood of discussing concerns with patients (aOR 1.54, 95% CI 1.12-2.13). Pharmacists that indicated greater comfort in intervening when concerned about prescription opioids were more likely to discuss concerns with both patients and prescribers. Females were significantly more likely to discuss concerns with prescribers (aOR 1.67, 95% CI 1.22-2.29), whereas years of practice reduced the odds of discussing concerns with prescribers (aOR 0.98, 95% CI 0.97-0.99). Conclusion Considering specific factors such as gender and years of practice to help target pharmacist training may lead to increased comfort in discussing concerns related to prescription opioids, which in turn may improve communication with prescribers and patients.
Topic(s):
Education & Workforce
See topic collection
, Opioids & Substance Use
See topic collection