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Opioids & SU
The Literature Collection contains over 10,000 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).
10858 Results
3881
Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication
Type: Journal Article
Year: 2005
Publication Place: United States
Abstract: CONTEXT: An understudied crucial step in the help-seeking process is making prompt initial contact with a treatment provider after first onset of a mental disorder. OBJECTIVE: To provide data on patterns and predictors of failure and delay in making initial treatment contact after first onset of a mental disorder in the United States from the recently completed National Comorbidity Survey Replication. DESIGN AND SETTING: Nationally representative face-to-face household survey carried out between February 2001 and April 2003. PARTICIPANTS: A total of 9282 respondents aged 18 years and older. MAIN OUTCOME MEASURES: Lifetime DSM-IV disorders were assessed with the World Mental Health (WMH) Survey Initiative version of the World Health Organization Composite International Diagnostic Interview (WMH-CIDI), a fully structured interview designed to be administered by trained lay interviewers. Information about age of first professional treatment contact for each lifetime DSM-IV/WMH-CIDI disorder assessed in the survey was collected and compared with age at onset of the disorder to study typical duration of delay. RESULTS: Cumulative lifetime probability curves show that the vast majority of people with lifetime disorders eventually make treatment contact, although more so for mood (88.1%-94.2%) disorders than for anxiety (27.3%-95.3%), impulse control (33.9%-51.8%), or substance (52.7%-76.9%) disorders. Delay among those who eventually make treatment contact ranges from 6 to 8 years for mood disorders and 9 to 23 years for anxiety disorders. Failure to make initial treatment contact and delay among those who eventually make treatment contact are both associated with early age of onset, being in an older cohort, and a number of socio-demographic characteristics (male, married, poorly educated, racial/ethnic minority). CONCLUSIONS: Failure to make prompt initial treatment contact is a pervasive aspect of unmet need for mental health care in the United States. Interventions to speed initial treatment contact are likely to reduce the burdens and hazards of untreated mental disorder.
Topic(s):
Education & Workforce
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3882
Fair hearing outcomes of patients recommended discharge from methadone maintenance
Type: Journal Article
Year: 2017
Publication Place: United States
Topic(s):
Opioids & Substance Use
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Reference Links: 
View the DOI record for Fair hearing outcomes of patients recommended discharge from methadone maintenance
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View the PubMed citation for Fair hearing outcomes of patients recommended discharge from methadone maintenance3883
Falling through the cracks: gaps in depression treatment among older Mexican-origin and white men
Type: Journal Article
Year: 2012
Topic(s):
Healthcare Disparities
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, Key & Foundational
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Reference Links:
View the DOI record for Falling through the cracks: gaps in depression treatment among older Mexican-origin and white men
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View the PubMed citation for Falling through the cracks: gaps in depression treatment among older Mexican-origin and white men3885
Family doctors and psychologists working together: Doctors' and patients' perspectives
Type: Journal Article
Year: 2011
Publication Place: England
Topic(s):
Financing & Sustainability
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Reference Links:
View the DOI record for Family doctors and psychologists working together: Doctors' and patients' perspectives
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View the PubMed citation for Family doctors and psychologists working together: Doctors' and patients' perspectives3886
Family doctors' problems and motivating factors in management of depression
Type: Journal Article
Year: 2006
Publication Place: England
Abstract: BACKGROUND: Depression is a frequent psychiatric disorder, and depressive patient may be more problematic for the family doctors (FD) than a patient suffering from a somatic disease. Treatment of patients with depressive disorders is a relatively new task for Estonian FDs. The aim of our study was to find out the family doctors' attitudes to depression related problems, their readiness, motivating factors and problems in the treatment of depressive patients as well as the existence of relevant knowledge. METHODS: In 2002, altogether 500 FDs in Estonia were invited to take part in a tailor-made questionnaire survey, of which 205 agreed to participate. RESULTS: Of the respondents 185(90%) considered management of depressive patients and their treatment to be the task of FDs. One hundred and eighty FDs (88%) were themselves ready to deal with depressed patients, and 200(98%) of them actually treated such patients. Commitment to the interests of the patients, better cooperation with successfully treated patients, the patients' higher confidence in FDs and disappearance of somatic complaints during the treatment of depression were the motivating factors for FDs. FDs listed several important problems interfering with their work with depressive patients: limited time for one patient, patients' attitudes towards the diagnosis of depression, doctors' difficulties to change the underlying causes of depression, discontinuation of the treatment due to high expenses and length. Although 115(56%) respondents maintained that they had sufficient knowledge for diagnostics and treatment of depression, 181(88%) were of the opinion that they needed additional training. CONCLUSION: FDs are ready to manage patients who might suffer from depression and are motivated by good doctor-patient relationship. However, majority of them feel that they need additional training.
Topic(s):
Education & Workforce
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, Medically Unexplained Symptoms
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View the DOI record for Family doctors' problems and motivating factors in management of depression
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View the PubMed citation for Family doctors' problems and motivating factors in management of depression3887
Family health teams: Can health professionals learn to work together?
Type: Journal Article
Year: 2007
Publication Place: Canada
Abstract: OBJECTIVE: To learn what educators across the health professions involved in primary health care think about the use and development of academic family health teams to provide, teach, and model interprofessional collaboration and about the introduction of interprofessional education (IPE) within structured academic primary care. DESIGN: Qualitative study using focus groups. SETTING: Higher education institutions across Ontario. PARTICIPANTS: Purposeful sample of 36 participants from nursing, pharmacy, speech language pathology, occupational and physical therapy, social work, and family medicine. METHOD: Participants were invited to join focus groups of 6 to 8 health professionals. Themes were derived from qualitative analysis of data gathered using a grounded-theory approach. MAIN FINDINGS: Three major themes were identified: the lack of consensus on opportunities for future academic family health teams to teach IPE, the lack of formalized teaching of interprofessional collaboration and the fact that what little has been developed is primarily for family physicians and hardly at all for other health professionals, and the confusion around the definition of IPE across health professions. CONCLUSION: The future role of family health teams in academic primary care settings as a place for learners to see teamwork in action and to learn collaboration needs to be examined. Unless academic settings are developed to provide the necessary training for primary health care professionals to work in teams, a new generation of health care professionals will continue to work in status quo environments, and reform initiatives are unlikely to become sustainable over time.
Topic(s):
Education & Workforce
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Reference Links: View the PubMed citation for Family health teams: Can health professionals learn to work together?
3890
Family Medicine Physicians' Perspectives Regarding Rural Behavioral Health Care: Informing Ideas for Increasing Access to High-Quality Services
Type: Journal Article
Year: 2021
Topic(s):
Education & Workforce
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, Healthcare Disparities
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3893
Family Physicians Play Key Role in Bridging the Gap in Access to Opioid Use Disorder Treatment
Type: Journal Article
Year: 2020
Publication Place: United States
Topic(s):
Education & Workforce
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, Financing & Sustainability
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, Healthcare Disparities
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, Opioids & Substance Use
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Reference Links: View the PubMed citation for Family Physicians Play Key Role in Bridging the Gap in Access to Opioid Use Disorder Treatment
3895
Family physicians' involvement and self-reported comfort and skill in care of children with behavioral and emotional problems: A population-based survey
Type: Journal Article
Year: 2005
Publication Place: England
Abstract: BACKGROUND: Little is known about general and family practitioners' (GP/FPs') involvement and confidence in dealing with children with common psychosocial problems and mental health conditions. The aims of this study were to ascertain GP/FPs' preferred level of involvement with, and perceived comfort and skill in dealing with children with behavioral problems, social-emotional difficulties, attention-deficit/hyperactivity disorder (ADHD), and mood disorders; and to identify factors associated with GP/FPs' involvement, comfort and skill. METHODS: Postal survey of a representative sample of 801 GP/FPs in British Columbia, Canada, which enquired about level of involvement (from primarily refer out to deal with case oneself); ratings of comfort/skill with assessment/diagnosis and management; beliefs regarding psychosocial problems in children; basic demographics; and practice information. RESULTS: Surveys were completed by 405 of 629 eligible GP/FPs (64.4%). Over 80% of respondents reported collaborative arrangements with specialists across problem and condition types, although for children with behavior problems or ADHD, more physicians primarily refer (chi2 (1) = 9.0; P < 0.005; and chi2 (1) = 103.9; P < 0.001, respectively). Comfort/skill levels (mean +/- s.d) were higher for mood disorders (4.4 +/- 1.3) than behavior problems (3.6 +/- 1.1; F [3, 1155] = 84.0, P < .0001; effect size = 0.67), but not different from social-emotional difficulties (3.8 +/- 1.1) or ADHD (3.9 +/- 1.3). Taking primary responsibility for a case was consistently related to self-reported comfort/skill with each condition type (34% to 61% of variance across condition types), while comfort/skill ratings for each condition were related to exposure to relevant continuing medical education (all P < or = 0.001), and beliefs that these problems are significant and that GP/FPs have a role to play in dealing with them (P values ranged from 0.01 to < 0.001). CONCLUSION: Supporting GP/FPs in their care for children with common psychosocial and mental health problems should include efforts to bolster their confidence and modify attitudes in relation towards these problems, especially behavior problems and ADHD, possibly within innovative continuing education programs.
Topic(s):
Education & Workforce
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3896
Family physicians' proficiency in urine drug test interpretation
Type: Journal Article
Year: 2007
Publication Place: United States
Abstract: OBJECTIVE: To determine the proficiency in urine drug test interpretation among family medicine physicians who order these tests to monitor adherence in their patients on chronic opioid therapy. METHODS: A seven-question instrument, consisting of six, five-option, single-best-answer multiple choice questions and one yes/no question was administered to 80 family medicine physicians attending a University of Kentucky Family Medicine Review Course. We calculated frequencies and performed chi2 analyses to examine bivariate associations between urine drug test utilization and interpretive knowledge. RESULTS: The instrument was completed by 60/80 (75 percent) of eligible physicians (44 order urine drug testing; 16 do not). None of the physicians who order urine drug testing answered more than five of the seven questions correctly, and only 20 percent answered more than half correctly. Physicians who order urine drug testing performed better than physicians who do not order urine drug testing on only four of the seven questions, although there were no statistically significant differences between the groups on any question. CONCLUSIONS: Family medicine physicians who order urine drug testing to monitor their patients on chronic opioid therapy are not proficient in their interpretation. This study highlights the need for improved physician education in this area. It is imperative for physicians to work closely with certified laboratory professionals when ordering and interpreting urine drug tests.
Topic(s):
Opioids & Substance Use
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, Education & Workforce
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Reference Links: View the PubMed citation for Family physicians' proficiency in urine drug test interpretation
3897
Family practice enhancements for patients with severe mental illness
Type: Journal Article
Year: 2013
Publication Place: United States
Abstract: Individuals with severe mental health disorders experience difficulty maneuvering the complexity encountered in primary care (PC). This study describes the impact of three components of primary care practice enhancements on: changes in missed appointments, changes in health outcomes, number of ER visits and hospitalization days, and perceptions of integrated care. Missed PC appointments: baseline to post practice enhancement changed from 42 to 11, statistically significant (p < .01). Changes in health outcomes: SF-12 scores had no significant change nor did ER utilization and hospitalization; however, outcomes are low-base rate and assessment period was short. Integration of care: liaison was most helpful in accessing and navigating PC, educating and reconciling medication lists. Behavioral health staff voiced relief regarding access and felt better informed. Strategies focusing on increasing communication, staff education, and reducing barriers to access and receipt of PC may improve integration and continuity of care.
Topic(s):
Education & Workforce
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Reference Links:
View the DOI record for Family practice enhancements for patients with severe mental illness
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View the PubMed citation for Family practice enhancements for patients with severe mental illness3899
Family Related Factors and Concurrent Heroin Use in Methadone Maintenance Treatment in China
Type: Journal Article
Year: 2018
Publication Place: England
Abstract: BACKGROUND: The use of heroin during Methadone Maintenance Treatment (MMT) is a challenging problem that contributes to poor treatment outcomes. Families may play an important role in addressing concurrent heroin use during MMT, especially in collectivist societies such as China. OBJECTIVES: In this study, we explored the relationship between family-related factors and concurrent heroin use during MMT in China. METHODS: This study was conducted at 68 MMT clinics in five provinces of China. There were 2,446 MMT clients in the analysis. Demographic information, MMT dosage, family members' heroin use status, family support of MMT, family problem, and self-reported heroin use were collected in a cross-sectional survey. The most recent urinalysis of opiate use was obtained from clinical records. RESULTS: Of the 2,446 participants, 533 (21.79%) self-reported heroin use in the previous seven days or had a positive urine morphine test result in the clinic record. Participants whose family member[s] used heroin were 1.59 times (95% CI: 1.17, 2.15) more likely to use concurrently during treatment. Those with family members who totally support them on the MMT were less likely to use (AOR: 0.75, 95% CI: 0.60, 0.94). Having more family problems was positively associated with concurrent heroin use (AOR: 2.01, 95% CI: 1.03, 3.93). CONCLUSIONS: The results highlight the importance of the family's role in concurrent heroin use during MMT programs. The study's findings may have implications for family-based interventions that address concurrent heroin use.
Topic(s):
Opioids & Substance Use
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Reference Links:
View the DOI record for Family Related Factors and Concurrent Heroin Use in Methadone Maintenance Treatment in China
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View the PubMed citation for Family Related Factors and Concurrent Heroin Use in Methadone Maintenance Treatment in China3900
Family science and family-based research in integrated and health care contexts: Future considerations for Families, Systems, & Health
Type: Journal Article
Year: 2020
Publication Place: United States
Topic(s):
Education & Workforce
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