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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).
11199 Results
3061
Diagnostic accuracy and adequacy of treatment of depressive and anxiety disorders: A comparison of primary care and specialized care patients
Type: Journal Article
Year: 2014
Topic(s):
General Literature
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3062
Diagnostic accuracy of a two-item Drug Abuse Screening Test (DAST-2)
Type: Journal Article
Year: 2017
Publication Place: England
Abstract: OBJECTIVE: Drug use is prevalent and costly to society, but individuals with drug use disorders (DUDs) are under-diagnosed and under-treated, particularly in primary care (PC) settings. Drug screening instruments have been developed to identify patients with DUDs and facilitate treatment. The Drug Abuse Screening Test (DAST) is one of the most well-known drug screening instruments. However, similar to many such instruments, it is too long for routine use in busy PC settings. This study developed and validated a briefer and more practical DAST for busy PC settings. METHOD: We recruited 1300 PC patients in two Department of Veterans Affairs (VA) clinics. Participants responded to a structured diagnostic interview. We randomly selected half of the sample to develop and the other half to validate the new instrument. We employed signal detection techniques to select the best DAST items to identify DUDs (based on the MINI) and negative consequences of drug use (measured by the Inventory of Drug Use Consequences). Performance indicators were calculated. RESULTS: The two-item DAST (DAST-2) was 97% sensitive and 91% specific for DUDs in the development sample and 95% sensitive and 89% specific in the validation sample. It was highly sensitive and specific for DUD and negative consequences of drug use in subgroups of patients, including gender, age, race/ethnicity, marital status, educational level, and posttraumatic stress disorder status. CONCLUSIONS: The DAST-2 is an appropriate drug screening instrument for routine use in PC settings in the VA and may be applicable in broader range of PC clinics.
Topic(s):
Measures
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, Opioids & Substance Use
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Reference Links: View the PubMed citation for Diagnostic accuracy of a two-item Drug Abuse Screening Test (DAST-2)
3067
Differences between soldiers, with and without emotional distress, in number of primary care medical visits and type of presenting complaints
Type: Journal Article
Year: 2007
Publication Place: Israel
Abstract: BACKGROUND: In 2003 a total of 43 soldiers in the Israel Defense Forces committed suicide; only 20% of them were known to the IDF mental health services. Somatic symptoms are often the only presentation of emotional distress during the primary care visit and may be the key to early identification and treatment. OBJECTIVES: To examine whether the information in the medical records of soldiers can be used to identify those suffering from anxiety, affective or somatoform disorder. METHODS: We conducted a case-control study using the information in the electronic medical records of soldiers who during their 3 year service developed affective disorder, anxiety, or somatoform disorder. A control group was matched for recruitment date, type of unit and occupation in the service, and the Performance Prediction Score. The number and reasons for physician visits were collated. RESULTS: The files of 285 soldiers were examined: 155 cases and 130 controls. The numbers of visits (mean +/- SD) during the 3 and 6 month periods in the case and control groups were 4.7 +/- 3.3 and 7.1 +/- 5.0, and 4.1 +/- 2.9 and 5.9 +/- 4.6 respectively. The difference was statistically significant only for the 6 month period (P < 0.05). The variables that remained significant, after stepwise multivariate regression were the Performance Prediction Score and the presenting complaints of back pain and diarrhea. CONCLUSIONS: These findings may spur the development of a computer-generated warning for the primary care physician who will then be able to interview his or her patient appropriately and identify mental distress earlier.
Topic(s):
HIT & Telehealth
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3070
Differences in medical care expenditures for adults with depression compared to adults with major chronic conditions
Type: Journal Article
Year: 2009
Publication Place: Italy
Abstract: BACKGROUND: Approximately 17.1 million adults report having a major depressive episode in 2004 which represents 8% of the adult population in the U.S. Of these, more than one-third did not seek treatment. In spite of the large and extensive literature on the cost of mental health, we know very little about the differences in out-of-pocket expenditures between adults with depression and adults with other major chronic disease and the sources of those expenditures. AIMS: For persons under age 65, compare total and out-of-pocket expenditures of those with depression to non-depressed individuals who have another major chronic disease. METHODS: This study uses two linked, nationally representative surveys, the 1999 National Health Interview Survey (NHIS) and the 2000 Medical Expenditure Panel Survey (MEPS), to identify the population of interest. Depression was systematically assessed using a short form of the World Health Organization's (WHO) Composite International Diagnostic Interview--Short Form (CIDI-SF). To control for differences from potentially confounding factors, we matched depressed cases to controls using propensity score matching. RESULTS: We estimate that persons with depression have about the same out-of-pocket expenditures while having 11.8% less total medical expenditures (not a statistically significant difference) compared to non-depressed individuals with at least one chronic disease. DISCUSSION: High out-of-pocket expenditures are a concern for individuals with chronic diseases. Our study shows that those with depression have comparable out-of-pocket expenses to those with other chronic diseases, but given their lower income levels, this may result in a more substantial financial burden. IMPLICATION FOR POLICY: High out-of-pocket expenditures are a concern for individuals with depression and other chronic diseases. For both depressed individuals and non-depressed individuals with other chronic diseases, prescription drug expenditures contribute most to out-of-pocket expenses. Given the important role medications play in treatment of depression, high copayment rates are a concern for limiting compliance with appropriate treatment.
Topic(s):
Financing & Sustainability
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, Key & Foundational
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Reference Links: View the PubMed citation for Differences in medical care expenditures for adults with depression compared to adults with major chronic conditions
3071
Differences in patients' perceived helpfulness of depression treatment provided by general medical providers and specialty mental health providers
Type: Journal Article
Year: 2015
Publication Place: United States
Abstract: OBJECTIVE: This study examined the differences in the level of perceived helpfulness of treatments received for a major depressive episode (MDE) from a general medical provider only, a specialty mental health provider only or both. METHOD: This study examined a sample of 8900 respondents from the 2008-2012 National Survey on Drug Use and Health aged 18-64 who had past 12-month MDE (based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, Fourth edition) and received treatment for depression. Generalized ordered logistic regression analyses were conducted to estimate the association between the type of treatment providers and perceived helpfulness of depression treatment. RESULTS: Adults who received depression treatment from either specialty mental health providers alone or from both specialty mental health providers and general medical providers in the past year were more likely to report that treatment helped them. The differences persisted after adjusting for sociodemographic characteristics, comorbid health conditions, receipt of depression medication and severity of depression (adjusted odds ratios across level of perceived helpfulness ranged from 1.63 to 3.96). CONCLUSIONS: This finding calls for greater attention to factors associated with provider type and organizational context that may contribute to differences in perceived helpfulness of depression treatment.
Topic(s):
Education & Workforce
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, Healthcare Disparities
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3072
Differences in perceived clinical knowledge uptake among health profession students and licensed clinicians receiving buprenorphine waiver training in Oregon
Type: Journal Article
Year: 2022
Publication Place: United States
Abstract:
Background: Addressing the opioid crisis requires an understanding of how to train both health professional students and practicing clinicians on medications for opioid use disorder (mOUD). We designed a robust evaluation instrument to assess the impact of training on perceived clinical knowledge in these different categories of learners. Methods: We enrolled 3rd and 4th year medical, physician assistant (PA), and nurse practitioner (NP) students, as well as practicing PAs, NPs, and physicians to undertake the Drug Addiction Treatment Act (DATA) Waiver Training for mOUD. We designed and implemented a cross-sectional survey to assess perceived change in clinical knowledge as a result of training in opioid use disorder and satisfaction with training. Results: Twenty-one MD/DO and 45 NP/PA students, and 24 practicing MD/DO and 27 NP/PAs completed the survey. Among health professional students (n = 66) and practicing clinicians (n =51), perceived clinical knowledge scores increased significantly (p < 0.001) for all 13 variables. Program evaluation scores for the buprenorphine waiver training were high with no statistical differences between students and practicing clinicians. Overall, the majority of participants indicated they would recommend the training to a colleague (Students' score = 4.84; practicing clinician scores = 4.53; scale = strongly disagree = 1 to strongly agree = 5). Conclusions: Our novel instrument allowed us to determine that the implementation of buprenorphine waiver trainings for health professional students and practicing clinicians leads to significant increases in perceived knowledge, interest and confidence in diagnosing and treating OUD. Although the buprenorphine waiver can now be obtained without training, many waivered providers still do not prescribe buprenorphine; integrating training into medical, NP, and PA curriculum for students and offering the training to practicing clinicians may increase confidence and uptake of mOUD.
Topic(s):
Education & Workforce
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, Measures
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, Opioids & Substance Use
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3077
Differences in Team Mental Models Associated With Medical Home Transformation Success
Type: Journal Article
Year: 2019
Publication Place: United States
Topic(s):
Education & Workforce
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Reference Links:
View the DOI record for Differences in Team Mental Models Associated With Medical Home Transformation Success
View DOI Record
View the PubMed citation for Differences in Team Mental Models Associated With Medical Home Transformation Success3078
Differences in the primary care management of patients with psychosis from two ethnic groups: A population-based cross-sectional study
Type: Journal Article
Year: 2010
Publication Place: England
Abstract: BACKGROUND: Ethnicity is an important dimension in many aspects of psychosis. OBJECTIVE: To investigate ethnic differences in the primary care management of patients with psychosis. METHODS: Data were obtained from Lambeth DataNet, a database of computerized general practice case records derived from practices in an inner city London borough. We undertook a cross-sectional survey of patients with psychosis. Outcome measures: health screening, chronic disease management and prescribing data and differences between ethnic groups were expressed as odds ratios (ORs). RESULTS: One thousand six hundred and ninety-four of 165,911 (1.02%) registered patients had a diagnosis of psychosis; 1090 (64%) had ethnicity recorded; 501 were White and 403 were Black or Black British. There were no significant ethnic differences for blood pressure, cholesterol or HbA1c monitoring or control; cervical or mammography screening; treatment with hypotensives, statins, antidepressants, lithium, antipsychotics or atypical antipsychotics. Depot injectable antipsychotics were more likely to be prescribed to Black patients than other delivery modes: OR 2.10 (95% CI: 1.20-3.67). CONCLUSIONS: Measurable aspects of physical health care of patients with psychosis were similar, regardless of ethnicity. Increased use of the depot antipsychotic medication in black patients needs further exploration.
Topic(s):
Healthcare Disparities
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3080
Differences in treatment attitudes between depressed African-American and Caucasian veterans in primary care
Type: Journal Article
Year: 2011
Publication Place: United States
Abstract: OBJECTIVES: Depressive disorders are common, and it is important to understand the factors that contribute to racial disparities in depression treatment. This primary care study of veterans with subsyndromal depression examined two hypotheses: that African Americans would be less likely than Caucasians to believe that medication is beneficial in depression treatment and would be more likely to believe that counseling or psychotherapy is beneficial. METHODS: Primary care patients with subsyndromal depression were referred to the Philadelphia Department of Veterans Affairs Behavioral Health Laboratory and asked about past experiences and attitudes toward depression treatment. RESULTS: Among 111 African-American and 95 Caucasian participants, logistic regression analyses determined that African Americans were less likely to view medication as beneficial (odds ratio=.44). No racial differences were found in participants' attitude toward counseling or psychotherapy. CONCLUSIONS: The findings support the premise that clinicians treating patients with subsyndromal depressive syndromes should take into account racial differences in attitudes toward treatment.
Topic(s):
Healthcare Disparities
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Reference Links:
View the DOI record for Differences in treatment attitudes between depressed African-American and Caucasian veterans in primary care
View DOI Record
View the PubMed citation for Differences in treatment attitudes between depressed African-American and Caucasian veterans in primary care