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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).
11196 Results
5008
Incidence of future arrests in adults involved in the criminal justice system with opioid use disorder receiving extended release naltrexone compared to treatment as usual
Type: Journal Article
Year: 2019
Publication Place: Ireland
Topic(s):
Healthcare Disparities
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, Opioids & Substance Use
See topic collection
5009
Incidence of Naloxone Redosing in the Age of the New Opioid Epidemic
Type: Journal Article
Year: 2017
Publication Place: England
Abstract:
STUDY OBJECTIVE: Naloxone, an opioid-antagonist deliverable by an intra-nasal route, has become widely available and utilized by law enforcement officers as well as basic life support (BLS) providers in the prehospital setting. This study aimed to determine the frequency of repeat naloxone dosing in suspected narcotic overdose (OD) patients and identify patient characteristics. METHODS: A retrospective chart review of patients over 17 years of age with suspected opioid overdose, treated with an initial intranasal (IN) dose of naloxone and subsequently managed by paramedics, was performed from April 2014 to June 2016. Demographic data was analyzed using descriptive statistics to identify those aspects of the history, physical exam findings. Results: A sample size of 2166 patients with suspected opioid OD received naloxone from first responders. No patients who achieved GCS 15 after treatment required redosing; 195 (9%) received two doses and 53 patients received three doses of naloxone by advanced life support. Patients were primarily male (75.4%), Caucasian (88.2%), with a mean age of 36.4 years. A total of 76.7% of patients were found in the home, 23.1% had a suspected mixed ingestion, and 27.2% had a previous OD. Two percent of all patients required a third dose of naloxone. CONCLUSION: In this prehospital study, we confirmed that intranasal naloxone is effective in reversing suspected opioid toxicity. Nine percent of patients required two or more doses of naloxone to achieve clinical reversal of suspected opioid toxicity. Two percent of patients received a third dose of naloxone.
Topic(s):
Opioids & Substance Use
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Reference Links: 
View the DOI record for Incidence of Naloxone Redosing in the Age of the New Opioid Epidemic
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View the PubMed citation for Incidence of Naloxone Redosing in the Age of the New Opioid Epidemic5010
Including safety-net providers in integrated delivery systems: issues and options for policymakers
Type: Journal Article
Year: 2012
Publication Place: United States
Abstract: Health care reform legislation has spurred efforts to develop integrated health care delivery systems that seek to coordinate the continuum of health services. These systems may be of particular benefit to patients who face barriers to accessing care or have multiple health conditions. But it remains to be seen how safety-net providers, including community health centers and public hospitals--which have long experience in caring for these vulnerable populations--will be included in integrated delivery systems. This issue brief explores key considerations for incorporating safety-net providers into integrated delivery systems and discusses the roles of state and federal agencies in sup-porting and testing models of integrated care delivery. The authors conclude that the most important principles in creating integrated delivery systems for vulnerable populations are: (1) an emphasis on primary care; (2) coordination of all care, including behavioral, social, and public health services; and (3) accountability for population health outcomes.
Topic(s):
Financing & Sustainability
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, Healthcare Policy
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Reference Links: View the PubMed citation for Including safety-net providers in integrated delivery systems: issues and options for policymakers
5011
Including the family in research evaluating integrated care: A call for expanding investigators' scope beyond single-person measures
Type: Journal Article
Year: 2014
Topic(s):
General Literature
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5012
Inclusion of persons with mental illness in patient-centred medical homes: cross-sectional findings from Ontario, Canada
Type: Journal Article
Year: 2013
Publication Place: Canada
Abstract: BACKGROUND: In Ontario, Canada, the patient-centred medical home is a model of primary care delivery that includes 3 model types of interest for this study: enhanced fee-for-service, blended capitation, and team-based blended capitation. All 3 models involve rostering of patients and have similar practice requirements but differ in method of physician reimbursement, with the blended capitation models incorporating adjustments for age and sex, but not case mix, of rostered patients. We evaluated the extent to which persons with mental illness were included in physicians' total practices (as rostered and non-rostered patients) and were included on physicians' rosters across types of medical homes in Ontario. METHODS: Using population-based administrative data, we considered 3 groups of patients: those with psychotic or bipolar diagnoses, those with other mental health diagnoses, and those with no mental health diagnoses. We modelled the prevalence of mental health diagnoses and the proportion of patients with such diagnoses who were rostered across the 3 medical home model types, controlling for demographic characteristics and case mix. RESULTS: Compared with enhanced fee-for-service practices, and relative to patients without mental illness, the proportions of patients with psychosis or bipolar disorders were not different in blended capitation and team-based blended capitation practices (rate ratio [RR] 0.91, 95% confidence interval [CI] 0.82-1.01; RR 1.06, 95% CI 0.96-1.17, respectively). However, there were fewer patients with other mental illnesses (RR 0.94, 95% CI 0.90-0.99; RR 0.89, 95% CI 0.85-0.94, respectively). Compared with expected proportions, practices based on both capitation models were significantly less likely than enhanced fee-for-service practices to roster patients with psychosis or bipolar disorders (for blended capitation, RR 0.92, 95% CI 0.90-0.93; for team-based capitation, RR 0.92, 95% CI 0.88-0.93) and also patients with other mental illnesses (for blended capitation, RR 0.94, 95% CI 0.92-0.95; for team-based capitation, RR 0.93, 95% CI 0.92-0.94). INTERPRETATION: Persons with mental illness were under-represented in the rosters of Ontario's capitation-based medical homes. These findings suggest a need to direct attention to the incentive structure for including patients with mental illness.
Topic(s):
Education & Workforce
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, Financing & Sustainability
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, Medical Home
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5014
Incorporating Alcohol Pharmacotherapies Into Medical Practice. Treatment Improvement Protocol (TIP) 49. HHS Publication No. (SMA): 09-4380
Type: Government Report
Year: 2009
Publication Place: Rockville, MD
Abstract: This literature review is part of the Substance Abuse and Mental Health Services Administration's (SAMHSA's) Treatment Improvement Protocol (TIP) 49, Incorporating Alcohol Pharmacotherapies Into Medical Practice. Developed by a panel of experts for SAMHSA's Center for Substance Abuse Treatment (CSAT), the TIP can assist physicians and other medical professionals in providing pharmacologic treatment, combined with psychosocial therapy, for patients who are alcohol dependent, both in primary care settings and in specialized substance abuse treatment settings. TIP 49 focuses on the best currently recognized clinical practices for the medical maintenance of patients with alcohol use disorders (AUDs), using the four medications (disulfiram, oral naltrexone, injectable naltrexone, and acamprosate) approved by the U.S. Food and Drug Administration (FDA) for this purpose. The TIP presents best practices according to the scientific literature and the clinical experts who developed the TIP. This literature review emphasizes recent research published from 2000 to 2007 but also includes classic research studies published before 2000.
Topic(s):
Grey Literature
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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.
View the PubMed citation for Incorporating Alcohol Pharmacotherapies Into Medical Practice. Treatment Improvement Protocol (TIP) 49. HHS Publication No. (SMA): 09-4380Download the PDF (945.27 KB)for Incorporating Alcohol Pharmacotherapies Into Medical Practice. Treatment Improvement Protocol (TIP) 49. HHS Publication No. (SMA): 09-4380
Download the PDF (945.27 KB)for Incorporating Alcohol Pharmacotherapies Into Medical Practice. Treatment Improvement Protocol (TIP) 49. HHS Publication No. (SMA): 09-4380 Reference Links: View the PubMed citation for Incorporating Alcohol Pharmacotherapies Into Medical Practice. Treatment Improvement Protocol (TIP) 49. HHS Publication No. (SMA): 09-4380Download the PDF (945.27 KB)for Incorporating Alcohol Pharmacotherapies Into Medical Practice. Treatment Improvement Protocol (TIP) 49. HHS Publication No. (SMA): 09-4380
Download the PDF (945.27 KB)for Incorporating Alcohol Pharmacotherapies Into Medical Practice. Treatment Improvement Protocol (TIP) 49. HHS Publication No. (SMA): 09-4380 5015
Incorporating mental health checkups into adolescent primary care visits
Type: Journal Article
Year: 2011
Publication Place: United States
Topic(s):
General Literature
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Reference Links: View the PubMed citation for Incorporating mental health checkups into adolescent primary care visits
5016
Incorporating Patients' Social Determinants of Health into Hypertension and Depression Care: A Pilot Randomized Controlled Trial
Type: Journal Article
Year: 2017
Publication Place: United States
Abstract: The objective of this study was to carry out a randomized controlled pilot trial to test the effectiveness of an integrated intervention for hypertension and depression incorporating patients' social determinants of health (enhanced intervention) versus an integrated intervention alone (basic intervention). In all, 54 patients were randomized. An electronic monitor was used to measure blood pressure, and the nine-item Patient Health Questionnaire (PHQ-9) assessed depressive symptoms. Patients in the enhanced intervention had a significantly improved PHQ-9 mean change from baseline in comparison with patients in the basic intervention group at 12 weeks (p = 0.024). Patients in the enhanced intervention had a significantly improved systolic and diastolic blood pressure mean change from baseline in comparison with patients in the basic intervention group at 12 weeks (p = 0.003 and p = 0.019, respectively). Our pilot trial results indicate integrated care management that addresses the social determinants of health for patients with hypertension and depression may be effective.
Topic(s):
General Literature
See topic collection
5017
Incorporating recognition and management of perinatal and postpartum depression into pediatric practice
Type: Journal Article
Year: 2010
Publication Place: United States
Abstract: Every year, more than 400,000 infants are born to mothers who are depressed, which makes perinatal depression the most underdiagnosed obstetric complication in America. Postpartum depression leads to increased costs of medical care, inappropriate medical care, child abuse and neglect, discontinuation of breastfeeding, and family dysfunction and adversely affects early brain development. Pediatric practices, as medical homes, can establish a system to implement postpartum depression screening and to identify and use community resources for the treatment and referral of the depressed mother and support for the mother-child (dyad) relationship. This system would have a positive effect on the health and well-being of the infant and family. State chapters of the American Academy of Pediatrics, working with state Early Periodic Screening, Diagnosis, and Treatment (EPSDT) and maternal and child health programs, can increase awareness of the need for perinatal depression screening in the obstetric and pediatric periodicity of care schedules and ensure payment. Pediatricians must advocate for workforce development for professionals who care for very young children and for promotion of evidence-based interventions focused on healthy attachment and parent-child relationships.
Topic(s):
General Literature
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Reference Links:
View the DOI record for Incorporating recognition and management of perinatal and postpartum depression into pediatric practice
View DOI Record
View the PubMed citation for Incorporating recognition and management of perinatal and postpartum depression into pediatric practice5018
Incorporating Recognition and Management of Perinatal Depression Into Pediatric Practice
Type: Journal Article
Year: 2019
Publication Place: United States
Topic(s):
Financing & Sustainability
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, Healthcare Disparities
See topic collection
, Medical Home
See topic collection
Reference Links: View the PubMed citation for Incorporating Recognition and Management of Perinatal Depression Into Pediatric Practice
5019
Increase in untreated cases of psychiatric disorders during the transition to adulthood
Type: Journal Article
Year: 2015
Publication Place: United States
Abstract: OBJECTIVE: During the transition to adulthood, youths face challenges that may limit their likelihood of obtaining services for psychiatric problems. The goal of this analysis was to estimate changes in rates of service use and untreated psychiatric disorders during the transition from adolescence to adulthood. METHODS: In a prospective, population-based study, participants were assessed up to four times in adolescence (ages 13-16; 3,983 observations of 1,297 participants, 1993-2000) and three times in young adulthood (ages 19, 21, and 24-26; 3,215 observations of 1,273 participants, 1999-2010). Structured diagnostic interviews were used to assess service need (participants meeting DSM-IV diagnostic criteria for a psychiatric disorder) and use of behavioral services in 21 service settings in the past three months. RESULTS: During young adulthood, 28.9% of cases of psychiatric disorders were associated with some treatment, compared with a rate of 50.9% for the same participants during adolescence. This decrease included a near-complete drop in use of educational and vocational services as well as declines in use of specialty behavioral services. Young adults most frequently accessed services in specialty behavioral or general medical settings. Males, African Americans, participants with substance dependence, and participants living independently were least likely to get treatment. For cases of psychiatric disorders among young adults, insurance and poverty status were unrelated to likelihood of service use. CONCLUSIONS: Young adults were much less likely to receive treatment for psychiatric problems than they were as adolescents. Public policy must address gaps in service use during the transition to adulthood.
Topic(s):
Healthcare Disparities
See topic collection
Reference Links:
View the DOI record for Increase in untreated cases of psychiatric disorders during the transition to adulthood
View DOI Record
View the PubMed citation for Increase in untreated cases of psychiatric disorders during the transition to adulthood5020
Increased access to evidence-based primary mental health care: Will the implementation match the rhetoric?
Type: Journal Article
Year: 2007
Publication Place: Australia
Abstract: There is clear evidence that coordinated systems of medical and psychological care ("collaborative care") are superior to single-provider-based treatment regimens. Although other general practice-based mental health schemes promoted collaborative care, the new Medicare Benefits Schedule payments revert largely to individual-provider service systems and fee-for-service rebates. Such systems have previously resulted in high out-of-pocket expenses, poor geographical and socioeconomic distribution of specialist services, and proliferation of individual-provider-based treatments rather than collaborative care. The new arrangements for broad access to psychological therapies should provide the financial basis for major structural reform. Unless this reform is closely monitored for equity of access, degree of out-of-pocket expenses, extent of development of evidence-based collaborative care structures, and impact on young people in the early phases of mental illness, we may waste this opportunity. The responsibility for achieving the best outcome does not lie only with governments. To date, the professions have not placed enough emphasis on systematically adopting evidence-based forms of collaborative care.
Topic(s):
Financing & Sustainability
See topic collection
, Healthcare Policy
See topic collection
Reference Links: View the PubMed citation for Increased access to evidence-based primary mental health care: Will the implementation match the rhetoric?