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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
4422
Iatrogenic Opioid Withdrawal in Critically Ill Patients: A Review of Assessment Tools and Management
Type: Journal Article
Year: 2017
Publication Place: United States
Abstract: OBJECTIVE: To (1) provide an overview of the epidemiology, clinical presentation, and risk factors of iatrogenic opioid withdrawal in critically ill patients and (2) conduct a literature review of assessment and management of iatrogenic opioid withdrawal in critically ill patients. DATA SOURCES: We searched MEDLINE (1946-June 2017), EMBASE (1974-June 2017), and CINAHL (1982-June 2017) with the terms opioid withdrawal, opioid, opiate, critical care, critically ill, assessment tool, scale, taper, weaning, and management. Reference list of identified literature was searched for additional references as well as www.clinicaltrials.gov . STUDY SELECTION AND DATA EXTRACTION: We restricted articles to those in English and dealing with humans. DATA SYNTHESIS: We identified 2 validated pediatric critically ill opioid withdrawal assessment tools: (1) Withdrawal Assessment Tool-Version 1 (WAT-1) and (2) Sophia Observation Withdrawal Symptoms Scale (SOS). Neither tool differentiated between opioid and benzodiazepine withdrawal. WAT-1 was evaluated in critically ill adults but not found to be valid. No other adult tool was identified. For management, we identified 5 randomized controlled trials, 2 prospective studies, and 2 systematic reviews. Most studies were small and only 2 studies utilized a validated assessment tool. Enteral methadone, alpha-2 agonists, and protocolized weaning were studied. CONCLUSION: We identified 2 validated assessment tools for pediatric intensive care unit patients; no valid tool for adults. Management strategies tested in small trials included methadone, alpha-2 agonists, and protocolized sedation/weaning. We challenge researchers to create validated tools assessing specifically for opioid withdrawal in critically ill children and adults to direct management.
Topic(s):
Measures
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, Opioids & Substance Use
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Reference Links: 
View the DOI record for Iatrogenic Opioid Withdrawal in Critically Ill Patients: A Review of Assessment Tools and Management
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View the PubMed citation for Iatrogenic Opioid Withdrawal in Critically Ill Patients: A Review of Assessment Tools and Management4423
Ibogaine treatment outcomes for opioid dependence from a twelve-month follow-up observational study
Type: Journal Article
Year: 2018
Publication Place: England
Topic(s):
Opioids & Substance Use
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Reference Links:
View the DOI record for Ibogaine treatment outcomes for opioid dependence from a twelve-month follow-up observational study
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View the PubMed citation for Ibogaine treatment outcomes for opioid dependence from a twelve-month follow-up observational study4424
Ibudilast attenuates peripheral inflammatory effects of methamphetamine in patients with methamphetamine use disorder
Type: Journal Article
Year: 2020
Topic(s):
Opioids & Substance Use
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View the DOI record for Ibudilast attenuates peripheral inflammatory effects of methamphetamine in patients with methamphetamine use disorder
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View the PubMed citation for Ibudilast attenuates peripheral inflammatory effects of methamphetamine in patients with methamphetamine use disorder4427
Identification and Management of Adolescent Depression in a Large Pediatric Care Network
Type: Journal Article
Year: 2020
Publication Place: United States
Abstract: OBJECTIVE: Primary care has been promoted as a setting to identify and manage adolescent depression. This study examined primary care-based adolescent depression identification and follow-up care when elevated symptoms were identified. METHODS: Data came from a large pediatric care network with an organizational recommendation to screen for depression at age 16 well-visits using an electronic health record (EHR)-integrated standardized measure. Analyses examined rates of screening and elevated symptoms, pediatricians' initial responses to elevated scores, and types of follow-up care received over 1 year using retrospective EHR data extraction and manual chart reviews. RESULTS: Across program sites, 76.3% (n = 6981) of patients attending their age 16 well-visits were screened. About one-quarter had an elevated score (6.7% mild and 19.2% moderate-to-severe), many of whom received active follow-up on their well-visit date. Over 1 year, three-fourths of patients with scores in the moderate-to-severe range and 40.0% of patients with scores in the mild range received follow-up care (e.g., antidepressant prescriptions) as per EHR extraction. Follow-up rates were higher as per manual chart reviews. CONCLUSION: Routine adolescent depression screening is feasible across diverse primary care sites. Most patients with elevated scores were not already receiving behavioral health services, suggesting screening identified previously undetected concerns. In turn, many adolescents with elevated scores initiated treatment after screening, which indicates providing screen results at the point of care may facilitate pediatrician actions. Still, gaps in follow-up care demonstrate the need for greater investment in primary care-based behavioral health services to support high-quality treatment and ultimately decrease the burden of adolescent depression.
Topic(s):
General Literature
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Reference Links:
View the DOI record for Identification and Management of Adolescent Depression in a Large Pediatric Care Network
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View the PubMed citation for Identification and Management of Adolescent Depression in a Large Pediatric Care Network4428
Identification and Management of Adolescent Depression in a Large Pediatric Care Network
Type: Journal Article
Year: 2020
Publication Place: United States
Abstract: OBJECTIVE: Primary care has been promoted as a setting to identify and manage adolescent depression. This study examined primary care-based adolescent depression identification and follow-up care when elevated symptoms were identified. METHODS: Data came from a large pediatric care network with an organizational recommendation to screen for depression at age 16 well-visits using an electronic health record (EHR)-integrated standardized measure. Analyses examined rates of screening and elevated symptoms, pediatricians' initial responses to elevated scores, and types of follow-up care received over 1 year using retrospective EHR data extraction and manual chart reviews. RESULTS: Across program sites, 76.3% (n = 6981) of patients attending their age 16 well-visits were screened. About one-quarter had an elevated score (6.7% mild and 19.2% moderate-to-severe), many of whom received active follow-up on their well-visit date. Over 1 year, three-fourths of patients with scores in the moderate-to-severe range and 40.0% of patients with scores in the mild range received follow-up care (e.g., antidepressant prescriptions) as per EHR extraction. Follow-up rates were higher as per manual chart reviews. CONCLUSION: Routine adolescent depression screening is feasible across diverse primary care sites. Most patients with elevated scores were not already receiving behavioral health services, suggesting screening identified previously undetected concerns. In turn, many adolescents with elevated scores initiated treatment after screening, which indicates providing screen results at the point of care may facilitate pediatrician actions. Still, gaps in follow-up care demonstrate the need for greater investment in primary care-based behavioral health services to support high-quality treatment and ultimately decrease the burden of adolescent depression.
Topic(s):
General Literature
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Reference Links:
View the DOI record for Identification and Management of Adolescent Depression in a Large Pediatric Care Network
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View the PubMed citation for Identification and Management of Adolescent Depression in a Large Pediatric Care Network4429
Identification and Management of Behavioral/Mental Health Problems in Primary Care Pediatrics: Perceived Strengths, Challenges, and New Delivery Models
Type: Journal Article
Year: 2012
Abstract: This study describes the experiences of and barriers for pediatricians in Kentucky in providing behavioral/mental health (B-MH) services in primary care settings. These data will serve as a foundation for improving service delivery. An online survey was completed by 70 pediatricians. Descriptive data are presented. More than 90% of the respondents said that they saw at least one patient a month with 1 of 10 specific B-MH diagnoses. Physicians' comfort with diagnosing and treating disorders varied widely by diagnosis, age-group, and drug classification. Major barriers to providing optimal care were inaccessibility of mental health professionals for consultation and referral, lack of communication, and lack of knowledge. Respondents were more likely to favor consultation and co-location models over an integration model of care delivery. Overall, the authors found that pediatricians are dealing with patients with B-MH problems for which they may not have been adequately trained. Communication and collaboration needs were identified.
Topic(s):
Education & Workforce
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, Healthcare Policy
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4430
Identification and management of depression in Australian primary care and access to specialist mental health care
Type: Journal Article
Year: 2012
Publication Place: United States
Abstract: OBJECTIVE: The authors evaluated management of illness, including access to specialist mental health care, among people identified by general practitioners as clinically depressed. METHODS: Australian primary care practitioners recruited in 2009 completed case reports and collected self-report assessments from five to seven consecutively presenting patients whom they identified as having clinical depression. RESULTS: Among 735 patients with clinical depression, 55% met criteria for major depressive syndrome, 86% reported clinically significant sleep disturbance, and 47% had been depressed for more than 12 months. Most (77%) were prescribed antidepressants, and 30% were prescribed anxiolytics or hypnotics. Patients under shared care with specialist mental health care providers (42%) had more severe, chronic, and recurrent conditions but no demographic advantages. CONCLUSIONS: Depressed patients of general practitioners often had chronic, recurrent, and moderately to severely disabling conditions, but fewer than half received specialist care. Access to specialist care, however, appeared to be based on clinical need, with little inequity in sociodemographic characteristics observed.
Topic(s):
General Literature
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Reference Links:
View the DOI record for Identification and management of depression in Australian primary care and access to specialist mental health care
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View the PubMed citation for Identification and management of depression in Australian primary care and access to specialist mental health care4431
Identification and Management of Domestic and Sexual Violence in Primary Care in the #MeToo Era: an Update
Type: Journal Article
Year: 2019
Publication Place: United States
Topic(s):
Healthcare Disparities
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Reference Links:
View the DOI record for Identification and Management of Domestic and Sexual Violence in Primary Care in the #MeToo Era: an Update
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View the PubMed citation for Identification and Management of Domestic and Sexual Violence in Primary Care in the #MeToo Era: an Update4432
Identification and Management of Opioid Use Disorder in Primary Care: an Update
Type: Journal Article
Year: 2020
Publication Place: United States
Abstract:
PURPOSE OF REVIEW: The rising prevalence of opioid use disorder (OUD) and related complications in North America coupled with limited numbers of specialists in addiction medicine has led to large gaps in treatment. Primary care providers (PCPs) are ideally suited to diagnose and care for people with OUD and are increasingly being called upon to improve access to care. This review will highlight the recent literature pertaining to the care of patients with OUD by PCPs. RECENT FINDINGS: The prevalence of patients with OUD in primary care practice is increasing, and models of office-based opioid treatment (OBOT) are evolving to meet local needs of both ambulatory practices and patients. OBOT has been shown to increase access to care and demonstrates comparable outcomes when compared to more specialty-driven care. OBOT is an effective means of increasing access to care for patients with OUD. The ideal structure of OBOT depends on local factors. Future research must explore ways to increase the identification and diagnosis of patients with OUD, improve treatment retention rates, reduce stigma, and promote interdisciplinary approaches to care.
Topic(s):
Education & Workforce
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, Opioids & Substance Use
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Reference Links:
View the DOI record for Identification and Management of Opioid Use Disorder in Primary Care: an Update
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View the PubMed citation for Identification and Management of Opioid Use Disorder in Primary Care: an Update4434
Identification and treatment of depression in minority populations
Type: Journal Article
Year: 2011
Publication Place: United States
Abstract: Depression is a common condition, representing close to 6% of visits to primary care providers. Although minorities are more likely to have chronic depression, they are more likely to be incorrectly diagnosed and less likely to receive treatment when compared to the mainstream population. Screening and appropriate treatment within primary care is recommended in clinical practices that have systems in place to assure accurate diagnosis, effective treatment, and follow-up. This recommendation is especially relevant for treatment of minority populations, as they are more likely to seek care for mental health problems from primary care providers rather than specialists. A number of self-report screening tools that simplify screening are available. Treatment modalities that are supported by evidence are psychotherapy, prescription medications, and electroconvulsive therapy for severe depression. Selective serotonin reuptake inhibitors (SSRIs) have become the cornerstone of therapy for depression since the Food and Drug Administration (FDA) approval of fluoxetine in 1987. No substantial differences in efficacy of SSRIs have been found, although data suggest differences with respect to onset of action and adverse effects that may be relevant in the choice of one medicine over another. Common side effects of serotonin reuptake inhibitors include nausea, diarrhea, insomnia, somnolence and dizziness, akathisia, and sexual dysfunction. While most of these symptoms tend to subside within several weeks of use, sexual dysfunction appears to be a long-term side effect that typically reverses within a few days after discontinuation of the causative medication. Selective norepinephrine reuptake inhibitors (SNRIs), bupropion, mirtazapine, and tricyclic antidepressants (TCAs) are other commonly used medications. Complementary and alternative treatments, such as St. John's wort (Hypericum perforatum), exercise, acupuncture, music therapy, and relaxation, have limited data supporting their efficacy.
Topic(s):
Healthcare Disparities
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Reference Links: View the PubMed citation for Identification and treatment of depression in minority populations
4436
Identification of developmental-behavioral problems in primary care: a systematic review
Type: Journal Article
Year: 2011
Publication Place: United States
Abstract: CONTEXT: Recent mandates and recommendations for formal screening programs are based on the claim that pediatric care providers underidentify children with developmental-behavioral disorders, yet the research to support this claim has not been systematically reviewed. OBJECTIVE: To review research literature for studies regarding pediatric primary care providers' identification of developmental-behavioral problems in children. METHODS: On the basis of a Medline search conducted on September 22, 2010, using relevant key words, we identified 539 articles for review. We included studies that (1) were conducted in the United States, (2) were published in peer-reviewed journals, (3) included data that addressed pediatric care providers' identification of developmental-behavioral problems in individual patients, (4) included an independent assessment of patients' developmental-behavioral problems, such as diagnostic interviews or validated screening instruments, and (5) reported data sufficient to calculate sensitivity and specificity. Studies were not limited by sample size. Eleven articles met these criteria. We used Quality Assessment of Diagnostic Accuracy Studies (QUADAS) criteria to evaluate study quality. Although the studies were similar in many ways, heterogeneous methodology precluded a meta-analysis. RESULTS: Sensitivities for pediatric care providers ranged from 14% to 54%, and specificities ranged from 69% to 100%. The authors of 1 outlier study reported a sensitivity of 85% and a specificity of 61%. CONCLUSIONS: Pediatricians are often the first point of entry into developmental and mental health systems. Knowing their accuracy in identifying children with developmental-behavioral disabilities is essential for implementing optimal evaluation programs and achieving timely identification. Moreover, these statistics are important to consider when planning large-scale screening programs.
Topic(s):
General Literature
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Reference Links:
View the DOI record for Identification of developmental-behavioral problems in primary care: a systematic review
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View the PubMed citation for Identification of developmental-behavioral problems in primary care: a systematic review4437
Identification of somatic and anxiety symptoms which contribute to the detection of depression in primary health care
Type: Journal Article
Year: 2004
Publication Place: France
Abstract: Somatic symptoms and anxiety symptoms are often disregarded in the detection of depression in primary care. The present investigation examined to what extent somatic and anxiety symptoms recorded with the Composite International Diagnostic Interview-Primary Health Care Version (CIDI-PHC) can improve the detection of depression as compared to the General Health Questionnaire-12-item version alone. Data from the World Health Organization study on Psychological Problems in General Health Care were used. The study sample consisted of primary care attenders from 15 centres from all over the world who underwent a psychiatric examination with the CIDI-PHC. Medically unexplained somatic symptoms (back pain, feelings of heaviness/lightness in parts of the body, periods of bodily weakness, seizures/convulsions, permanent tiredness, exhaustion after a minimum of effort) and-to a smaller extent-diverse anxiety symptoms (e.g. feelings of anxiousness/nervousness, feelings of tension, difficulties relaxing) significantly contributed to the detection of depression in a logistic regression analysis. The results confirm the observation that in primary care somatic symptoms play an important role in the manifestation of depressive disorders. The items investigated herein could prove beneficial for future depression screening instruments to improve the detection of depressive disorders in primary care.
Topic(s):
Medically Unexplained Symptoms
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Reference Links:
View the DOI record for Identification of somatic and anxiety symptoms which contribute to the detection of depression in primary health care
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View the PubMed citation for Identification of somatic and anxiety symptoms which contribute to the detection of depression in primary health care4438
Identifiers, or "red flags," of complexity and need for integrated care
Type: Journal Article
Year: 2006
Publication Place: United States
Abstract: Because complex medical patients are a subgroup of the medical population and because complexity assessment involves extra effort, preselection of these patients through identifiers is necessary. There is no best identifier for complexity, and the one most suitable for the population served should be selected. This article provides a table with potential identifiers and discusses the difference between disease-oriented screening and treatment and a more generic approach such as complexity screening and complexity management.
Topic(s):
Medically Unexplained Symptoms
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View the PubMed citation for Identifiers, or "red flags," of complexity and need for integrated care
Reference Links:
View the DOI record for Identifiers, or "red flags," of complexity and need for integrated care
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View the PubMed citation for Identifiers, or "red flags," of complexity and need for integrated care