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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
6082
Medical home services for children with behavioral health conditions
Type: Journal Article
Year: 2010
Publication Place: United States
Abstract: OBJECTIVES: Whether medical services received by children and youth with behavioral health conditions are consistent with a Medical Home has not been systematically studied. The objectives of this study were to examine the variation among four behavioral health conditions in regard to services related to the Medical Home. METHODS: Cross-sectional analyses of the 2003 National Survey of Children's Health were conducted. Multiple logistic regression analyses tested the impact of behavioral health conditions on medical needs, on Medical Home components, and on likelihood of having a Medical Home overall. RESULTS: Autism, Depression/Anxiety, and Behavior/Conduct problems were associated with reduced likelihood of having a Medical Home, whereas Attention-Deficit Hyperactivity Disorder was associated with increased likelihood. All health conditions predicted increased access to a primary care physician (PCP) and a preventive visit in the past year. However, all were also associated with higher needs for specialty care and all behavioral health conditions except Attention-Deficit Hyperactivity Disorder were associated with difficulties accessing this care. CONCLUSIONS: A detailed examination of the receipt of services among children and youth with behavioral health conditions reveals two primary reasons why such care is less likely to be consistent with a Medical Home model: (1) parents are more likely to report needing specialty care; and (2) these needs are less likely to be met. These data suggest that the reason why services received by children and youth with behavioral health conditions are not consistent with the Medical Home has more to do with difficulty accessing specialty care than with problems accessing quality primary care.
Topic(s):
Medical Home
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Reference Links: 
View the DOI record for Medical home services for children with behavioral health conditions
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View the PubMed citation for Medical home services for children with behavioral health conditions6083
Medical homes for at-risk children: Parental reports of clinician-parent relationships, anticipatory guidance, and behavior changes
Type: Journal Article
Year: 2005
Abstract: BACKGROUND: Family-centeredness, compassion, and trust are 3 attributes of the clinician-parent relationship in the medical home. Among adults, these attributes are associated with patients' adherence to clinicians' advice. OBJECTIVES: The objectives were (1) to measure medical home attributes related to the clinician-parent relationship, (2) to measure provision of anticipatory guidance regarding injury and illness prevention, (3) to relate anticipatory guidance to parental behavior changes, and (4) to relate medical home attributes to anticipatory guidance and parental behavior changes. METHODS: A cross-sectional study of data collected among at-risk families when children were 1 year of age, in a randomized, controlled trial of a home-visiting program to prevent child abuse and neglect, was performed. Modified subscales of the Primary Care Assessment Survey were used to measure parental ratings of clinicians' family-centeredness, compassion, and trust. Parental reports of provision of anticipatory guidance regarding injury and illness prevention topics (smoke alarms, infant walkers, car seats, hot water temperature, stair guards, sunscreen, firearm safety, and bottle propping) and behavior changes were recorded. RESULTS: Of the 564 mothers interviewed when their children were 1 year of age, 402 (71%) had a primary care provider and had complete data for anticipatory guidance items. By definition, poverty, partner violence, poor maternal mental health, and maternal substance abuse were common in the study sample. Maternal ratings of clinicians' family-centeredness, compassion, and trust were fairly high but ranged widely and varied among population subgroups. Families reported anticipatory guidance for a mean of 4.6 +/- 2.2 topics relevant for discussion. Each medical home attribute was positively associated with parental reports of completeness of anticipatory guidance, ie, family-centeredness (beta = .026, SE = .004), compassion (beta = .019, SE = .005), and trust (beta = .016, SE = .005). Parents' perceptions of behavior changes were positively associated with trust (beta = .018, SE = .006). Analyses were adjusted for potential confounding by randomized, controlled trial group assignment, receipt of >or=5 well-child visits, and baseline attributes. CONCLUSIONS: Among at-risk families, we found an association between parental ratings of the medical home and parental reports of the completeness of anticipatory guidance regarding selected injury and illness prevention topics. Parents' trust of the clinician was associated with parent-reported behavior changes for discussed topics.
Topic(s):
Medical Home
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6086
Medical illness and response to treatment in primary care panic disorder
Type: Journal Article
Year: 2005
Topic(s):
General Literature
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Reference Links:
View the DOI record for Medical illness and response to treatment in primary care panic disorder
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View the PubMed citation for Medical illness and response to treatment in primary care panic disorder6087
Medical interventions for addictions in the primary care setting
Type: Journal Article
Year: 2010
Publication Place: United States
Abstract: Primary care physicians treating HIV-infected patients should not be afraid or reluctant to engage in medication-assisted treatment for substance dependence. Effective medications are available for many types of substance addictions, including buprenorphine for opioid dependence, disulfiram for cocaine dependence, bupropion for methamphetamine dependence, and naltrexone for alcohol dependence. Physician use of medications coupled with encouragement to adhere to all aspects of treatment including counseling and other psychosocial interventions can produce substantial rewards in terms of keeping patients involved in their HIV care and improving overall patient health and functioning. This article summarizes a presentation made by R. Douglas Bruce, MD, MA, MSc, at the 12th Annual Clinical Conference for the Ryan White HIV/AIDS Program held in October 2009 in Dallas, Texas. The original presentation is available as a Webcast at www.iasusa.org.
Topic(s):
Opioids & Substance Use
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Reference Links: View the PubMed citation for Medical interventions for addictions in the primary care setting
6089
Medical provider attitudes about behavioral health consultants in integrated primary care: A preliminary study
Type: Journal Article
Year: 2014
Publication Place: United States
Topic(s):
Education & Workforce
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Reference Links:
View the DOI record for Medical provider attitudes about behavioral health consultants in integrated primary care: A preliminary study
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View the PubMed citation for Medical provider attitudes about behavioral health consultants in integrated primary care: A preliminary study6090
Medical providers' knowledge and concerns about opioid overdose education and take-home naloxone rescue kits within Veterans Affairs health care medical treatment settings
Type: Journal Article
Year: 2017
Publication Place: United States
Abstract:
BACKGROUND: Overdose from opioids is a serious public health and clinical concern. Veterans are at increased risk for opioid overdose compared with the civilian population, suggesting the need for enhanced efforts to address overdose prevention in Department of Veterans Affairs (VA) health care settings, such as primary care clinics. METHODS: Prescribing providers (N = 45) completed surveys on baseline knowledge and concerns about the VA Overdose Education and Naloxone Distribution (OEND) initiative prior to attending an OEND educational training. RESULTS: Survey items were grouped into 4 OEND-related categories, reflecting (1) lack of knowledge/familiarity/comfort; (2) concerns about iatrogenic effects; (3) concerns about impressions of unsafe opioid prescribing; and (4) concerns about risks of naloxone prescribing. Although certain OEND-related categories were associated with each other, concerns related to iatrogenic effects of OEND (e.g., patients will use more opioids and/or be less likely to see treatment) and lack of knowledge/familiarity/comfort with OEND were endorsed more than concerns related to giving impressions of unsafe opioid prescribing. The majority of providers endorsed the belief that those prescribing opioids to patients should be responsible for providing overdose education to those patients. System-wide naloxone prescription rates and sources increased over 320% following initiation of OEND expansion efforts, although these increases cannot be viewed as a direct result of the in-service trainings. CONCLUSIONS: Findings demonstrate that some providers believe they lack knowledge of opioid overdose prevention techniques and hold concerns about OEND implementation. More training of medical providers outside substance use treatment settings is needed, with particular attention to concerns about harmful consequences resulting from the receipt of naloxone.
Topic(s):
Education & Workforce
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, Opioids & Substance Use
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6092
Medical Student Exposure to Integrated Behavioral Health
Type: Journal Article
Year: 2019
Publication Place: United States
Abstract: OBJECTIVE: Integrated behavioral health (IBH) allows for effective care delivery for patients with mental health and behavioral health disorders in primary care settings. This study assesses the state of exposure current medical students have to the IBH model in family medicine clerkships, in order to augment the readiness of students to participate in IBH as developing professionals. METHODS: Clerkship directors at US and Canadian medical schools with a required family medicine run course (n = 141) were asked to estimate the percentage of students exposed to IBH in their clerkships, as part of the Council of Academic Family Medicine Educational Research Alliance (CERA) 2016 survey. RESULTS: The response rate was 86% (n = 118). Forty-four percent of clerkship directors reported that 0-20% of students are exposed to the IBH model in their clerkships. A comparison of schools with low and high exposure showed no significant differences among clerkship characteristics. CONCLUSIONS: A majority of medical students in the USA and Canada are not exposed to IBH models during their primary care clerkship. Larger systematic studies are needed to elucidate the steps necessary to prepare graduating medical students to collaborate in IBH models.
Topic(s):
Education & Workforce
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Reference Links: View the PubMed citation for Medical Student Exposure to Integrated Behavioral Health
6093
Medical treatments for opioid use disorder in Iran: a randomized, double-blind placebo-controlled comparison of buprenorphine/naloxone and naltrexone maintenance treatment
Type: Journal Article
Year: 2016
Publication Place: England
Topic(s):
Opioids & Substance Use
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6094
Medically Assisted Withdrawal (Detoxification): Considering the Mother-Infant Dyad
Type: Journal Article
Year: 2017
Publication Place: United States
Abstract:
Recommendations for opioid agonist pharmacotherapy and against medically assisted withdrawal were based upon early reports that associated withdrawal with maternal relapse and fetal demise. Data from recent case series have called these recommendations into question. Although these data do not support an association between medically assisted withdrawal and fetal demise, relapse remains a significant clinical concern with reported rates ranging from 17% to 96% (average 48%). Given the high loss to follow-up in these studies, the actual relapse rate is likely even greater. Furthermore, while medically assisted withdrawal is being proposed as a public health strategy to reduce neonatal abstinence syndrome (NAS), current data do not support a reduction in NAS with medically assisted withdrawal relative to opioid agonist pharmacotherapy. Overall, the data do not support either benefit of medically assisted withdrawal or equivalence to opioid agonist pharmacotherapy for the maternal-newborn dyad. Medically assisted withdrawal increases the risk of maternal relapse and poor treatment engagement and does not improve newborn health. Treatment of chronic maternal disease, including opioid agonist disorder, should be directed toward optimal long-term outcome.
Topic(s):
Healthcare Disparities
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, Opioids & Substance Use
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Reference Links:
View the DOI record for Medically Assisted Withdrawal (Detoxification): Considering the Mother-Infant Dyad
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View the PubMed citation for Medically Assisted Withdrawal (Detoxification): Considering the Mother-Infant Dyad6095
Medically unexplained physical symptoms in primary care: a controlled study on the effectiveness of cognitive-behavioral treatment by the family physician
Type: Journal Article
Year: 2009
Publication Place: United States
Abstract: BACKGROUND: Disabling medically unexplained physical symptoms occur in 16% of all patients in primary care. OBJECTIVE: The aim of this study was to assess the effectiveness of a cognitive-behavioral intervention by the family physician. METHOD: In a controlled design with detailed information on patient selection, 6,409 patients were screened on somatoform disorder, and 65 participants were allocated to care-as-usual or the experimental condition. RESULTS: After 6 and 12 months, the cognitive-behavioral intervention by trained family physicians was not more effective than care-as-usual. CONCLUSION: Possibly, the intensity of treatment was insufficient for the severe and persistent symptoms that were encountered in primary care.
Topic(s):
Medically Unexplained Symptoms
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6096
Medically unexplained physical symptoms: the feasibility of group cognitive-behavioural therapy in primary care
Type: Journal Article
Year: 2004
Publication Place: England
Abstract: OBJECTIVE: The aim of this study was to estimate the number of patients with medically unexplained physical symptoms (MUPS) that could be eligible for group cognitive-behavioural treatment (CBT) and to assess the acceptability of this treatment. METHODS: For 3 months, all consultations of one general practitioner (GP) were screened for MUPS. Patients with MUPS who were considered eligible for group CBT were interviewed and offered treatment. RESULTS: From January to March 1999, 1084 consultations of 796 patients were screened. The GP classified the symptoms of 104 patients aged 25-79 as unexplained. Of these, 71 patients were not considered to be eligible for treatment, mainly due to a psychological attribution of the symptoms. The research interview was offered to 33 patients, 16 of them declined and 12 were interviewed. Seven out of the 12 eligible patients accepted treatment. CONCLUSION: In primary care, 18% of patients aged 25-79 years was estimated to have MUPS. For only a minority of these patients, group CBT was considered suitable and acceptable.
Topic(s):
Medically Unexplained Symptoms
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Reference Links:
View the DOI record for Medically unexplained physical symptoms: the feasibility of group cognitive-behavioural therapy in primary care
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View the PubMed citation for Medically unexplained physical symptoms: the feasibility of group cognitive-behavioural therapy in primary care6099
Medically unexplained symptoms in family medicine: defining a research agenda. Proceedings from WONCA 2007
Type: Journal Article
Year: 2008
Publication Place: England
Abstract: BACKGROUND: Medically unexplained symptoms (MUSs) are frequently presented in primary care. Unfortunately, knowledge of these patients and/or symptoms in primary care is still limited. Available research comes mainly from Europe and North America, while the perspectives of cultures such as Africa, Asia and South America are relatively unknown. To bring cultural perspectives together, a symposium and workshop on MUS in primary care was held at the WONCA World Conference 2007 in Singapore. OBJECTIVE: Main goals of this symposium and workshop-apart from presenting ongoing research and bringing together experts in MUS-were to detect knowledge gaps in MUS and to establish priorities in MUS research. This publication focuses on the proposed research agenda. METHODS: Using a nominal group technique, we generated research topics and set priorities. Research topics were grouped into research themes. RESULTS: Participants' (66 researchers and GPs from 29 nationalities) most important research topics were 'formulating a broadly accepted definition of MUS', 'finding a strategy to recognize MUS better and at an earlier stage', 'studying the value of self-management and empowerment in patients with MUS' and 'finding predictors to decide which strategy will best help the individual patient with MUS'. Priorities in research themes of MUS are as follows: (i) therapeutic options for patients with MUS and (ii) problems in consultations with these patients. CONCLUSIONS: More research on MUS in primary care is needed to improve the consultations with and management of these patients. Internationally primary care conferences are excellent for exchanging ideas and formulating central issues of research.
Topic(s):
Medically Unexplained Symptoms
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Reference Links:
View the DOI record for Medically unexplained symptoms in family medicine: defining a research agenda. Proceedings from WONCA 2007
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View the PubMed citation for Medically unexplained symptoms in family medicine: defining a research agenda. Proceedings from WONCA 20076100
Medically unexplained symptoms: perceptions of physicians in primary health care
Type: Journal Article
Year: 2004
Publication Place: England
Abstract: BACKGROUND: Patients presenting with multiple symptoms represent a substantial part of a GP's total work load. At the same time, these patients account for the majority of the people on long-term sick-leave in Sweden today. OBJECTIVE: The aim of this study was to explore GPs' perceptions and ways of managing patients with medically unexplained symptoms (MUS). METHODS: Five focus group discussions were conducted with a total of 27 GPs. In the collection and analysis of data, a phenomenographic approach was used. RESULTS: The GPs described how they used four different approaches to manage patients with MUS: a biomedical, a psychological, an educational and a psychosocial approach. Different approaches were used, depending on the patient and the situation, and the GPs even switched approach when working with the same patient. CONCLUSIONS: In their work with patients with MUS, GPs need support and further training to improve the way the biomedical frame of reference is integrated with the humanistic perspective.
Topic(s):
Medically Unexplained Symptoms
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Reference Links: View the PubMed citation for Medically unexplained symptoms: perceptions of physicians in primary health care