Literature Collection

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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).

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11231 Results
501
A Qualitative Study on the Barriers to Learning in a Primary Care-Behavioral Health Integration Program in an Academic Hospital: the Family Medicine Perspective
Type: Journal Article
Authors: M. Aggarwal, E. Knifed, N. A. Howell, P. Papneja, N. Charach, A. Cheung, N. Grujich
Year: 2020
Publication Place: United States
Abstract: OBJECTIVE: Integrating behavioral health services into the primary care setting is a recognized approach to improving timely access and building capacity for primary care providers. The aim of this study was to examine barriers to family medicine resident learning in a co-located primary care-behavioral health integration program with psychiatrists in an academic hospital. METHODS: The authors used a descriptive qualitative study design to collect data on participants' learning experiences from focus groups and semi-structured interviews with 5 family medicine residents, 3 psychiatry residents, 5 family physicians, 3 psychiatrists, 2 office coordinators, and 2 educational coordinators. Thematic analysis of transcripts was performed. RESULTS: Three themes were identified with respect to barriers to learning in the program from the family medicine perspective. Organizational barriers encompassed lack of clear vision, goals, roles, and responsibilities. Administrative barriers involved complex appointment bookings and scheduling. Communication and engagement barriers included insufficient communication between team members and lack of patient engagement in the program. CONCLUSIONS: The study findings highlight the importance of several factors for the successful implementation of a co-located academic primary care-behavioral health integrated model. This includes the formalization of program structure that encompasses shared vision, goals, roles, and responsibilities; coordinated processes for appointment bookings; team communication and patient engagement; and diverse educational and longitudinal care opportunities. With the growing number of integrated care programs, these results provide guidance for health care leaders involved in the design and management of primary care-behavioral health integration programs.
Topic(s):
General Literature See topic collection
502
A qualitative study to determine perspectives of clinicians providing telehealth opioid use disorder treatment
Type: Journal Article
Authors: B. Burke, E. Miller, B. Clear, S. G. Weiner
Year: 2024
Topic(s):
Opioids & Substance Use See topic collection
,
HIT & Telehealth See topic collection
,
Education & Workforce See topic collection
503
A qualitative study: Barriers and facilitators to health care access for individuals with psychiatric disabilities
Type: Journal Article
Authors: M. Mesidor, V. Gidugu, E. S. Rogers, V. M. Kash-Macdonald, J. B. Boardman
Year: 2011
Publication Place: United States
Abstract: OBJECTIVE: This qualitative study was conducted as part of a larger randomized trial to examine barriers and facilitators to accessing and providing comprehensive primary health care for individuals with serious mental illnesses. We examined the perspectives of administrators and providers in a behavioral health organization surrounding the use of a nurse practitioner model of delivering primary healthcare. METHODS: Ten key informant interviews were conducted and analyzed using qualitative data analysis software. Concepts and themes regarding access to and delivery of primary healthcare were inductively derived from the data. RESULTS: Results confirmed significant issues related to chronic physical health problems among individuals with psychiatric disabilities and detailed a host of barriers to receiving health care as well as the perceived benefits of the nurse practitioner intervention. Financial challenges played a significant role in the organization's ability to make primary and mental health care integration a sustainable endeavor. In addition, staff faced increased burdens on their time due to adding a focus on physical health to their existing job duties. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: A nurse practitioner stationed in a behavioral healthcare setting is viewed by administrators and providers as extremely beneficial in addressing issues of access to comprehensive and integrated primary healthcare for individuals with severe psychiatric disabilities but sustaining such a model of care is not without organizational challenges.
Topic(s):
Financing & Sustainability See topic collection
504
A Quality Improvement Project to Improve Education Provided by Nurses to ED Patients Prescribed Opioid Analgesics at Discharge
Type: Journal Article
Authors: Daria L. Waszak, Ann M. Mitchell, Dianxu Ren, Laura A. Fennimore
Year: 2018
Publication Place: Philadelphia
Topic(s):
Education & Workforce See topic collection
,
Opioids & Substance Use See topic collection
505
A Quality Improvement Project to Reduce Postcesarean Opioid Consumption
Type: Journal Article
Authors: K. M. Kahn, K. Demarco, J. Pavsic, J. Sangillo
Year: 2021
Publication Place: United States
Topic(s):
Education & Workforce See topic collection
,
Healthcare Disparities See topic collection
,
Measures See topic collection
,
Opioids & Substance Use See topic collection
506
A randomised controlled trial of enhanced key-worker liaison psychiatry in general practice
Type: Journal Article
Authors: J. S. Emmanuel, A. McGee, O. C. Ukoumunne, P. Tyrer
Year: 2002
Publication Place: Germany
Abstract: BACKGROUND: Despite much interest in the development of liaison psychiatry in general practice there is no clear evidence that any form of intervention is effective. We carried out a pilot randomised controlled trial, the first we believe into this type of care, of one such model; enhanced liaison with individual patients by key workers, in general practices in Paddington and North Kensington in London. METHODS: All patients referred from primary to secondary psychiatric care from four general practices over a 10-month period, and still in contact with services, were eligible to be included in the study. The practices were allocated in a constrained randomised procedure to either normal care or enhanced key-worker liaison. The latter involved encouraging individual key workers to adopt improved communication between primary and secondary care. Baseline assessments of symptomatology and social functioning were made before randomisation and after 6 months by an independent researcher. RESULTS: Of the 84 eligible patients, 43 were seen at baseline and 34 re-assessed after 6 months. There was no difference between the clinical outcomes in the two groups but self-rated social function was significantly improved in the enhanced liaison service compared with standard care (adjusted P = 0.05). Costs were similar but somewhat more expensive for enhanced liaison. Less than half (42 %) of all key workers in the enhanced liaison arm felt they had involved the primary health care team more in the care of their patient, with 21 % of these altering their practice markedly during the study. CONCLUSIONS: It is concluded that without additional resources enhanced key-worker liaison for psychiatry in primary and secondary care has limited benefits although this does not necessarily apply to other forms of liaison practice.
Topic(s):
Education & Workforce See topic collection
507
A randomised controlled trial of the effectiveness of a program for early detection and treatment of depression in primary care
Type: Journal Article
Authors: A. Picardi, I. Lega, L. Tarsitani, M. Caredda, G. Matteucci, M. P. Zerella, R. Miglio, A. Gigantesco, M. Cerbo, A. Gaddini, F. Spandonaro, M. Biondi, SET-DEP Group
Year: 2016
Publication Place: Netherlands
Topic(s):
General Literature See topic collection
508
A randomised trial of the cost effectiveness of buprenorphine as an alternative to methadone maintenance treatment for heroin dependence in a primary care setting
Type: Journal Article
Authors: A. H. Harris, E. Gospodarevskaya, A. J. Ritter
Year: 2005
Publication Place: New Zealand
Abstract: BACKGROUND AND AIM: Buprenorphine offers an alternative to methadone in the treatment of heroin dependence, and has the advantage of allowing alternate-day dosing. This study is the first to examine the cost effectiveness of buprenorphine as maintenance treatment for heroin dependence in a primary care setting using economic and clinical data collected within a randomised trial. STUDY DESIGN AND METHODS: The study was a randomised, open-label, 12-month trial of 139 heroin-dependent patients in a community setting receiving individualised treatment regimens of buprenorphine or methadone. Those who were currently on a methadone program (n = 57; continuing therapy subgroup) were analysed separately from new treatment recipients (n = 82; initial therapy subgroup). The study took a broad societal perspective and included health, crime and personal costs. Data on resource use and outcomes were a combination of clinical records and self report at interview. The main outcomes were incremental cost per additional day free of heroin use and per QALY. An analysis of uncertainty calculated the likelihood of net benefits for a range of acceptable money values of outcomes. All costs were in 1999 Australian dollars (DollarA). RESULTS: The estimated mean number of heroin-free days did not differ significantly between those randomised to methadone (225 [95% CI 91, 266]), or buprenorphine (222 [95% CI 194, 250]) over the year of the trial. Buprenorphine was associated with an average 0.03 greater QALYs over 52 weeks (not significant). The total cost was DollarA 17,736 (95% CI -DollarA 2981, DollarA 38,364) with methadone and DollarA 11,916 (95% CI DollarA 7697, DollarA 16,135) with buprenorphine; costs excluding crime were DollarA 4513 (95% CI DollarA 3495, DollarA 5531) and DollarA 5651 (95% CI DollarA 4202, DollarA 7100). With additional heroin-free days as the outcome, and crime costs included buprenorphine has a lower cost but less heroin-free days. If crime costs are excluded buprenorphine has a higher cost and worse outcome than methadone. With additional QALYs as the outcome, the cost effectiveness of buprenorphine is DollarA 39,404 if crime is excluded, but buprenorphine is dominant if crime is included. CONCLUSIONS: The trial found no significant differences in costs or outcomes between methadone and buprenorphine maintenance in this particular setting. Although some of the results suggest that methadone may have a cost advantage, it is difficult to infer from the trial data that offering buprenorphine as an alternative would have a significant effect on total costs or outcomes. The point estimates of costs and outcomes suggest that buprenorphine may have an advantage in those initiating therapy. The confidence intervals were wide, however, and the likelihood of net benefits from substituting one treatment for another was close to 50%.
Topic(s):
Financing & Sustainability See topic collection
509
A Randomized Clinical Trial Investigating the Effect of a Healthcare Access Model for Individuals with Severe Psychiatric Disabilities
Type: Journal Article
Authors: Sally E. Rogers, Mihoko Maru, Megan Kash-Macdonald, Mariah Archer-Williams, Lobat Hashemi, Judith Boardman
Year: 2016
Publication Place: New York
Topic(s):
General Literature See topic collection
510
A Randomized Clinical Trial of a Care Recommendation Letter Intervention for Somatization in Primary Care
Type: Journal Article
Authors: Perry Dickinson, Miriam Dickinson, Frank V. deGruy, Deborah S. Main, Lucy M. Candib, Kathryn Rost
Year: 2003
Publication Place: Inc.
Topic(s):
Medically Unexplained Symptoms See topic collection
511
A randomized clinical trial of a theory-based fentanyl overdose education and fentanyl test strip distribution intervention to reduce rates of opioid overdose: study protocol for a randomized controlled trial
Type: Journal Article
Authors: B. P. Jacka, J. E. Goldman, J. L. Yedinak, E. Bernstein, S. E. Hadland, J. A. Buxton, S. G. Sherman, K. B. Biello, B. D. L. Marshall
Year: 2020
Abstract:

BACKGROUND: Opioid overdose deaths involving synthetic opioids, particularly illicitly manufactured fentanyl, remain a substantial public health concern in North America. Responses to overdose events (e.g., administration of naloxone and rescue breathing) are effective at reducing mortality; however, more interventions are needed to prevent overdoses involving illicitly manufactured fentanyl. This study protocol aims to evaluate the effectiveness of a behavior change intervention that incorporates individual counseling, practical training in fentanyl test strip use, and distribution of fentanyl test strips for take-home use among people who use drugs. METHODS: Residents of Rhode Island aged 18-65 years who report recent substance use (including prescription pills obtained from the street; heroin, powder cocaine, crack cocaine, methamphetamine; or any drug by injection) (n = 500) will be recruited through advertisements and targeted street-based outreach into a two-arm randomized clinical trial with 12 months of post-randomization follow-up. Eligible participants will be randomized (1:1) to receive either the RAPIDS intervention (i.e., fentanyl-specific overdose education, behavior change motivational interviewing (MI) sessions focused on using fentanyl test strips to reduce overdose risk, fentanyl test strip training, and distribution of fentanyl test strips for personal use) or standard overdose education as control. Participants will attend MI booster sessions (intervention) or attention-matched control sessions at 1, 2, and 3 months post-randomization. All participants will be offered naloxone at enrolment. The primary outcome is a composite measure of self-reported overdose in the previous month at 6- and/or 12-month follow-up visit. Secondary outcome measures include administratively linked data regarding fatal (post-mortem investigation) and non-fatal (hospitalization or emergency medical service utilization) overdoses. DISCUSSION: If the RAPIDS intervention is found to be effective, its brief MI and fentanyl test strip training components could be easily incorporated into existing community-based overdose prevention programming to help reduce the rates of fentanyl-related opioid overdose. TRIAL REGISTRATION: ClinicalTrials.gov NCT04372238 . Registered on 01 May 2020.

Topic(s):
Healthcare Disparities See topic collection
,
Measures See topic collection
,
Opioids & Substance Use See topic collection
512
A randomized clinical trial of buprenorphine for prisoners: Findings at 12-months post-release
Type: Journal Article
Authors: M. S. Gordon, T. W. Kinlock, R. P. Schwartz, K. E. O'Grady, T. T. Fitzgerald, F. J. Vocci
Year: 2017
Publication Place: Ireland
Topic(s):
Healthcare Disparities See topic collection
,
Opioids & Substance Use See topic collection
513
A Randomized Clinical Trial of Clinician-Supported PTSD Coach in VA Primary Care Patients
Type: Journal Article
Authors: K. Possemato, E. Johnson, K. Barrie, S. Ghaus, D. Noronha, M. Wade, M. A. Greenbaum, C. Rosen, M. Cloitre, J. Owen, S. Jain, G. Beehler, A. Prins, K. Seal, E. Kuhn
Year: 2023
514
A randomized clinical trial of outpatient geriatric evaluation and management
Type: Journal Article
Authors: C. Boult, L. B. Boult, L. Morishita, B. Dowd, R. L. Kane, C. F. Urdangarin
Year: 2001
Topic(s):
Healthcare Disparities See topic collection
515
A randomized clinical trial to assess feasibility, acceptability and preliminary effects of telehealth-delivered cognitive-behavioral therapy for perceived social isolation among individuals with opioid use disorders
Type: Journal Article
Authors: L. Ashrafioun, N. P. Allan, T. A. Stecker
Year: 2024
Abstract:

BACKGROUND: The purpose of this study was to report on feasibility, acceptability, and initial efficacy data cognitive-behavioral therapy for perceived isolation (CBT-PSI) compared to health education among individuals with opioid use disorders (OUD) reporting elevated loneliness. METHODS: Participants (n = 125) with OUD reporting elevated loneliness were recruited using online advertising to participate in a telehealth-delivered randomized clinical trial. Participants received either a 6-session CBT-PSI (n = 63) or health education (n = 62). Measures assessing loneliness, quantity of social interactions, perceived social support, substance use, substance use consequences, and treatment engagement among others, were completed at baseline, post-intervention, and 1- and 2-months post-intervention. Participants also reported on treatment acceptability for both conditions. RESULTS: Target enrollment was met with loneliness, social disconnectedness measures, and substance use reflecting a clinically severe sample. Retention was high (> 80%) for both conditions. Participants rated both Health Education and CBT-PSI as acceptable, helpful, and useful interventions to address loneliness and opioid use. Loneliness was reduced and quantity of social interactions and perceived social support were increased to the same extent for both conditions and across the follow-up assessments. Opioid use and overall substance use were reduced in both conditions; however, the reductions among participants received CBT-PSI were significantly greater compared to Health Education. CONCLUSIONS: This study supports the feasibility and acceptability of CBT-PSI. CBT-PSI findings related to loneliness, substance use, and other social connectedness outcomes are encouraging. Additional testing of CBT-PSI in a fully-powered trial is warranted.

Topic(s):
Opioids & Substance Use See topic collection
516
A randomized controlled trial for a peer-facilitated telemedicine hepatitis c treatment intervention for people who use drugs in rural communities: study protocol for the "peer tele-HCV" study
Type: Journal Article
Authors: M. C. Herink, A. Seaman, G. Leichtling, J. E. Larsen, T. Gailey, R. Cook, A. Thomas, P. T. Korthuis
Year: 2023
Topic(s):
Opioids & Substance Use See topic collection
,
Healthcare Disparities See topic collection
,
HIT & Telehealth See topic collection
517
A randomized controlled trial for aggression and substance use involvement among Veterans: Impact of combining Motivational Interviewing, Cognitive Behavioral Treatment and telephone-based Continuing Care
Type: Journal Article
Authors: S. T. Chermack, E. E. Bonar, J. E. Goldstick, J. Winters, F. C. Blow, S. Friday, M. A. Ilgen, S. A. M. Rauch, B. E. Perron, Q. M. Ngo, M. A. Walton
Year: 2019
Publication Place: United States
Topic(s):
Opioids & Substance Use See topic collection
,
Healthcare Disparities See topic collection
,
HIT & Telehealth See topic collection
519
A randomized controlled trial of a brief intervention for illicit drugs linked to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in clients recruited from primary health-care settings in four countries
Type: Journal Article
Authors: R. Humeniuk, R. Ali, T. Babor, M. L. Souza-Formigoni, R. B. de Lacerda, W. Ling, B. McRee, D. Newcombe, H. Pal, V. Poznyak, S. Simon, J. Vendetti
Year: 2012
Publication Place: England
Topic(s):
Opioids & Substance Use See topic collection
,
Measures See topic collection
520
A randomized controlled trial of an intervention to reduce stigma toward people with opioid use disorder among primary care clinicians
Type: Journal Article
Authors: S. A. Hooker, A. L. Crain, A. B. LaFrance, S. Kane, J. K. Fokuo, G. Bart, R. C. Rossom
Year: 2023