Literature Collection

2801

Decreasing Role Strain for Caregivers of Veterans with Dependence in Performing Activities of Daily Living

Type: Journal Article

Authors: Colleen L. Campbell, Sean McCoy, Nannette Hoffman, Patricia O'Neil

Year: 2014

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2802

Decreasing Stigma Involving Addiction Begins With the Medical Profession

Type: Web Resource

Authors: Ayana Jordan

Year: 2018

Topic(s):

,

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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 Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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2803

Deep brain stimulation of the nucleus accumbens/ventral capsule for severe and intractable opioid and benzodiazepine use disorder

Type: Journal Article

Authors: J. J. Mahoney, M. W. Haut, S. L. Hodder, W. Zheng, L. R. Lander, J. H. Berry, D. L. Farmer, J. L. Marton, M. Ranjan, N. J. Brandmeir, V. S. Finomore, J. L. Hensley, W. M. Aklin, G. J. Wang, D. Tomasi, E. Shokri-Kojori, A. R. Rezai

Year: 2021

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2804

Deficiencies in suicide training in primary care specialties: A survey of training directors

Type: Journal Article

Authors: Donna Sudak, Alec Roy, Howard Sudak, Alan Lipschitz, John Maltsberger, Herbert Hendin

Year: 2007

Publication Place: US: American Psychiatric Assn

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2805

Defining and measuring core processes and structures in integrated behavioral health in primary care: a cross-model framework

Type: Journal Article

Authors: K. A. Stephens, C. van Eeghen, B. Mollis, M. Au, S. A. Brennhofer, M. Martin, J. Clifton, E. Witwer, A. Hansen, J. Monkman, G. Buchanan, R. Kessler

Year: 2020

Publication Place: England

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2806

Defining and measuring the patient-centered medical home

Type: Journal Article

Authors: K. C. Stange, P. A. Nutting, W. L. Miller, C. R. Jaen, B. F. Crabtree, S. A. Flocke, J. M. Gill

Year: 2010

Publication Place: United States

Abstract: The patient-centered medical home (PCMH) is four things: 1) the fundamental tenets of primary care: first contact access, comprehensiveness, integration/coordination, and relationships involving sustained partnership; 2) new ways of organizing practice; 3) development of practices' internal capabilities, and 4) related health care system and reimbursement changes. All of these are focused on improving the health of whole people, families, communities and populations, and on increasing the value of healthcare. The value of the fundamental tenets of primary care is well established. This value includes higher health care quality, better whole-person and population health, lower cost and reduced inequalities compared to healthcare systems not based on primary care. The needed practice organizational and health care system change aspects of the PCMH are still evolving in highly related ways. The PCMH will continue to evolve as evidence comes in from hundreds of demonstrations and experiments ongoing around the country, and as the local and larger healthcare systems change. Measuring the PCMH involves the following: Giving primacy to the core tenets of primary care. Assessing practice and system changes that are hypothesized to provide added value Assessing development of practices' core processes and adaptive reserve. Assessing integration with more functional healthcare system and community resources. Evaluating the potential for unintended negative consequences from valuing the more easily measured instrumental features of the PCMH over the fundamental relationship and whole system aspects. Recognizing that since a fundamental benefit of primary care is its adaptability to diverse people, populations and systems, functional PCMHs will look different in different settings. Efforts to transform practice to patient-centered medical homes must recognize, assess and value the fundamental features of primary care that provide personalized, equitable health care and foster individual and population health.

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2807

Defining and Predicting Opioid and Cocaine Treatment Response

Type: Journal Article

Authors: Robert A. Gardner, David H. Epstein, Kenzie L. Preston, Karran A. Phillips

Year: 2019

Publication Place: Philadelphia, Pennsylvania

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2808

Defining key health information technology terms

Type: Government Report

Authors: National Alliance for Health Information Technology

Year: 2008

Publication Place: Washington, D.C.

Topic(s):

,

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.

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2809

Defining Peer Roles and Status Among Community Health Workers and Peer Support Specialists in Integrated Systems of Care

Type: Journal Article

Authors: A. S. Daniels, S. Bergeson, K. J. Myrick

Year: 2017

Publication Place: United States

Abstract: Current strategies for integrating general medical and behavioral health services focus primarily on improving the coordination of care and expanding team-based services. Absent from most discussion has been a focus on the workforces that provide the bulk of community-based outreach, engagement, activation, motivational support, and self-management: community health workers (CHWs) and peer support specialists (PSSs). CHWs have primarily been deployed in general medical care and PSSs in behavioral health care. Understanding the unique contributions that CHWs and PSS provide for health promotion and wellness and improved population health outcomes is an important challenge. This Open Forum reviews the key elements of peer status as a way to help illustrate the differences between these workforces and the best deployment strategies for each workforce. A framework is proposed that outlines key support roles provided by the CHW and PSS workforces.

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2810

Defining the psychiatric nursing role in the medical home

Type: Journal Article

Authors: Geraldine S. Pearson

Year: 2016

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2811

Defining the State Role in Primary Care Reform

Type: Government Report

Authors: Lauryn Walker, Lisa Dulsky Watkins, Christopher F. Koller

Year: 2024

Publication Place: New York, NY

Topic(s):

,

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.

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2812

Definitive urine drug testing in office-based opioid treatment: a literature review

Type: Journal Article

Authors: A. G. Barthwell, J. Allgaier, K. Egli

Year: 2018

Publication Place: England

Abstract: Individuals who receive buprenorphine treatment for opioid use disorder in office-based settings may be at risk for, or have a history of, polysubstance use. Urine drug testing is an important clinical tool for monitoring medication adherence and patient stability; and screening for illicit drug use and dangerous drug-drug interactions. This article is intended to educate practitioners in office-based opioid treatment settings on selecting appropriate substances for a definitive drug testing panel that are known to be used concurrently, sequentially, or in combination with buprenorphine for opioid use disorder. It is also intended to educate such practitioners on selecting appropriate testing technology to reduce risks to the health and safety of patients prescribed buprenorphine for opioid use disorder. In developing this article, the author conducted a search from May 2018 through December 2017 of peer-reviewed and government-supported articles in electronic databases. The literature showed that several common substances are often abused in conjunction with certain other substances, increasing the risk of serious adverse events, including death. Whether used on their own, concurrently, sequentially, or in combination, substances of abuse carry significant health risks. Definitive urine drug testing, given its high specificity and sensitivity, can accurately identify the use of specific prescription medications and illicit substances that, especially when taken with buprenorphine or other substances, may cause harm to a patient. When testing for buprenorphine and other opioids; sedatives, hypnotics, and anxiolytics; cocaine; amphetamines; and PCP and other club drugs, providers in office-based opioid treatment settings are strongly advised to use definitive urine drug tests as the primary testing methodology. In addition, practitioners must be able to identify all other substances that a patient may be consuming, taking into consideration the patient's historical and current drugs of choice, given that concurrent use with buprenorphine or other substances may cause serious adverse events. This article highlights the pressing market demand for comprehensive, definitive urine drug testing at a more reasonable cost.

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2813

Delaware health system heartened over MH integration in primary care

Type: Journal Article

Authors: Gary Enos

Year: 2016

Publication Place: Hoboken, New Jersey

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2814

Delayed villous maturation in term placentas exposed to opioid maintenance therapy: a retrospective cohort study

Type: Journal Article

Authors: A. E. Serra, L. S. Lemon, N. B. Mokhtari, W. T. Parks, J. M. Catov, R. Venkataramanan, S. N. Caritis

Year: 2017

Publication Place: United States

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2815

Delineating responsibility: Primary care provider perspective

Type: Journal Article

Authors: S. A. MacLaurin, D. C. Henderson, O. Freudenreich

Year: 2015

Publication Place: United States

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2816

Delivering On Accountable Care: Lessons From A Behavioral Health Program To Improve Access And Outcomes

Type: Journal Article

Authors: R. M. Clarke, J. Jeffrey, M. Grossman, T. Strouse, M. Gitlin, S. A. Skootsky

Year: 2016

Publication Place: United States

Abstract: Patients with behavioral health disorders often have worse health outcomes and have higher health care utilization than patients with medical diseases alone. As such, people with behavioral health conditions are important populations for accountable care organizations (ACOs) seeking to improve the efficiency of their delivery systems. However, ACOs have historically faced numerous barriers in implementing behavioral health population-based programs, including acquiring reimbursement, recruiting providers, and integrating new services. We developed an evidence-based, all-payer collaborative care program called Behavioral Health Associates (BHA), operated as part of UCLA Health, an integrated academic medical center. Building BHA required several innovations, which included using our enterprise electronic medical record for behavioral health referrals and documentation; registering BHA providers with insurance plans' mental health carve-out products; and embedding BHA providers in primary care practices throughout the UCLA Health system. Since 2012 BHA has more than tripled the number of patients receiving behavioral health services through UCLA Health. After receiving BHA treatment, patients had a 13 percent reduction in emergency department use. Our efforts can serve as a model for other ACOs seeking to integrate behavioral health care into routine practice.

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2817

Delivering opioid maintenance treatment in rural and remote settings

Type: Journal Article

Authors: L. Berends, A. Larner, D. I. Lubman

Year: 2015

Publication Place: Australia

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2818

Delivering perinatal depression care in a rural obstetric setting: a mixed methods study of feasibility, acceptability and effectiveness

Type: Journal Article

Authors: Amritha Bhat, Susan Reed, Johnny Mao, Mindy Vredevoogd, Joan Russo, Jennifer Unger, Roger Rowles, Jurgen Unutzer

Year: 2018

Publication Place: England

Abstract:

OBJECTIVES: Universal screening for depression during pregnancy and postpartum is recommended, yet mental health treatment and follow-up rates among screen-positive women in rural settings are low. We studied the feasibility, acceptability and effectiveness of perinatal depression treatment integrated into a rural obstetric setting. METHODS: We conducted an open treatment study of a screening and intervention program modified from the Depression Attention for Women Now (DAWN) Collaborative Care model in a rural obstetric clinic. Depression screen-positive pregnant and postpartum women received problem-solving therapy (PST) with or without antidepressants. A care manager coordinated communication between patient, obstetrician and psychiatric consultant. We measured change in the Patient Health Questionnaire 9 (PHQ-9) score. We used surveys and focus groups to measure patient and provider satisfaction and analyzed focus groups using qualitative analysis. RESULTS: The intervention was well accepted by providers and patients, based on survey and focus group data. Feasibility was also evidenced by recruitment (87.1%) and retention (92.6%) rates and depression outcomes (64% with >50% improvement in PHQ 9) which were comparable to clinical trials in similar urban populations. Conclusions for practice: DAWN Collaborative Care modified for treatment of perinatal depression in a rural obstetric setting is feasible and acceptable. Behavioral health services integrated into rural obstetric settings could improve care for perinatal depression.

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2819

Delivering person-centered care with an electronic health record

Type: Journal Article

Authors: V. Stanhope, E. B. Matthews

Year: 2019

Publication Place: England

Abstract: BACKGROUND: Electronic health records are now widely adopted in medical and behavioral health settings. While they have the potential to improve the quality of care, the research findings on their impact on clinical practice and outcomes have been mixed. This study explores how the electronic health record and its stage of development influenced the implementation of person-centered care planning in community mental health clinics. METHODS: The study was set in five community mental health clinics which utilized an EHR and had been trained in person-centered care planning. Using an objective quantitative measure of fidelity, the study examined fidelity to PCCP across time and by stage of EHR development. Data from focus groups, interviews with clinic leaders and consultant reports was analyzed to explore the process of implementation and the role of the electronic health record. RESULTS: All clinics demonstrated an overall increase in PCCP fidelity at the conclusion of the study period but there were significant differences in PCCP fidelity among clinics with EHRs in different stages of development. Electronic health records emerged as a significant implementation factor in the qualitative data with clinics being unable to individualize service plans and encountering technical difficulties. Barriers to person-centered care included drop-down boxes and pre-determined outcomes. Clinic responses included customizing their record or developing workarounds. CONCLUSIONS: The study demonstrated the need to align the electronic health record with a person-centered approach which includes individualizing information and orienting service plans to personal life goals. The ability of clinics to be able to customize their records and balance the need for unique and aggregate information in the record is critical to improve both the provider experience and the quality of care. TRIAL REGISTRATION: Clinicaltrials.gov , NCT02299492 , registered on November 24, 2014.

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2820

Delivering person-centered care with an electronic health record

Type: Journal Article

Authors: V. Stanhope, E. B. Matthews

Year: 2019

Publication Place: England

Abstract: BACKGROUND: Electronic health records are now widely adopted in medical and behavioral health settings. While they have the potential to improve the quality of care, the research findings on their impact on clinical practice and outcomes have been mixed. This study explores how the electronic health record and its stage of development influenced the implementation of person-centered care planning in community mental health clinics. METHODS: The study was set in five community mental health clinics which utilized an EHR and had been trained in person-centered care planning. Using an objective quantitative measure of fidelity, the study examined fidelity to PCCP across time and by stage of EHR development. Data from focus groups, interviews with clinic leaders and consultant reports was analyzed to explore the process of implementation and the role of the electronic health record. RESULTS: All clinics demonstrated an overall increase in PCCP fidelity at the conclusion of the study period but there were significant differences in PCCP fidelity among clinics with EHRs in different stages of development. Electronic health records emerged as a significant implementation factor in the qualitative data with clinics being unable to individualize service plans and encountering technical difficulties. Barriers to person-centered care included drop-down boxes and pre-determined outcomes. Clinic responses included customizing their record or developing workarounds. CONCLUSIONS: The study demonstrated the need to align the electronic health record with a person-centered approach which includes individualizing information and orienting service plans to personal life goals. The ability of clinics to be able to customize their records and balance the need for unique and aggregate information in the record is critical to improve both the provider experience and the quality of care. TRIAL REGISTRATION: Clinicaltrials.gov , NCT02299492 , registered on November 24, 2014.

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