Literature Collection

6521

On-site mental health workers in primary care: effects on professional practice

Type: Journal Article

Authors: P. Bower, B. Sibbald

Year: 2000

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6522

Once-monthly subcutaneous buprenorphine (Sublocade) for opioid use disorder

Type: Journal Article

Year: 2018

Publication Place: United States

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6523

One size does not fit all: parents' evaluations of a support program in a newborn intensive care nursery

Type: Journal Article

Authors: I. Hurst

Year: 2006

Publication Place: United States

Abstract: As intensive care nursery personnel increasingly seek to provide comprehensive care to families, there is a renewed emphasis on offering family support programs. PURPOSE: The purpose of this study was to identify parents' utilization and evaluation of a support program based in a newborn intensive care unit (NICU) that offered a combination of formats for support services: group support, one-to-one support, and telephone support. METHODS: Program records and a survey developed by the author documented parental use and evaluation of services. Data analysis consisted of descriptive statistics and qualitative content analysis of demographic data, survey results, and parental comments. RESULTS: Of the total 477 participants, 78% utilized 1 support service format exclusively. Eighteen percent utilized 2 support formats concurrently. A subsample of 48 parents completed an evaluation survey. Continuity of care was a critical component of the program overall. Group support offered more opportunities for families to problem-solve communication issues with nursery personnel and provide information that assisted parents' involvement in their babies' care. CONCLUSIONS: Parent support programs that utilize only one type of format may not be optimal for providing the range of support needed by many NICU families. Parent support programs offer an important mechanism to assess provider approaches to facilitate family-centered care.

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6524

One size fits some: The impact of patient treatment attitudes on the cost-effectiveness of a depression primary-care intervention

Type: Journal Article

Authors: J. M. Pyne, K. M. Rost, F. Farahati, S. P. Tripathi, J. Smith, D. K. Williams, J. Fortney, J. C. Coyne

Year: 2005

Publication Place: England

Abstract: BACKGROUND: Despite their impact on outcomes, the effect of patient treatment attitudes on the cost-effectiveness of health-care interventions is not widely studied. This study estimated the impact of patient receptivity to antidepressant medication on the cost-effectiveness of an evidence-based primary-care depression intervention. METHOD: Twelve community primary-care practices were stratified and then randomized to enhanced (intervention) or usual care. Subjects included 211 patients beginning a new treatment episode for major depression. At baseline, 111 (52.6%) and 145 (68.7%) reported receptivity to antidepressant medication and counseling respectively. The intervention trained the primary-care teams to assess, educate, and monitor depressed patients. Twelve-month incremental (enhanced minus usual care) total costs and quality-adjusted life years (QALYs) were calculated. RESULTS: Among patients receptive to antidepressants, the mean incremental cost-effectiveness ratio was dollar 5,864 per QALY (sensitivity analyses up to dollar 14,689 per QALY). For patients not receptive to antidepressants, the mean incremental QALY score was negative (for both main and sensitivity analyses), or the intervention was at least no more effective than usual care. CONCLUSIONS: These findings suggest a re-thinking of the 'one size fits all' depression intervention, given that half of depressed primary-care patients may be non-receptive to antidepressant medication treatment. A brief assessment of treatment receptivity should occur early in the treatment process to identify patients most likely to benefit from primary-care quality improvement efforts for depression treatment. Patient treatment preferences are also important for the development, design, and analysis of depression interventions.

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6525

One-Visit Behavioral Intervention for Older Primary Care Patients with Mild to Moderate Depressive Symptoms

Type: Journal Article

Authors: A. M. Gum, L. Schonfeld, S. Tyler, S. Fishleder, L. Guerra

Year: 2016

Publication Place: United States

Abstract: OBJECTIVES: We pilot tested a one-visit behavioral intervention with telephone follow-up for older primary care patients with mild to moderate depressive symptoms. METHODS: A total of 16 English-speaking primary care patients aged 60 years and older who scored 5 to 14 on the Patient Health Questionnaire-9 (PHQ-9) engaged in the intervention visit. Outcomes were assessed at baseline and 4 weeks: activity goals, readiness to change (University of Rhode Island Change Assessment), PHQ-9, Generalized Anxiety Disorder-7, World Health Organization Disability Assessment Schedule 2.0, and satisfaction. RESULTS: The 14 participants who completed the study met or exceeded 73% of activity goals on average. They also improved on all outcomes (P < 0.05) with medium (University of Rhode Island Change Assessment, GAD-7) to large effect sizes (PHQ-9, World Health Organization Disability Assessment Schedule 2.0), and they were satisfied. CONCLUSIONS: This pilot study provided preliminary evidence that a one-visit behavioral activation intervention is acceptable and feasible and improves outcomes. If findings are confirmed, then this intervention could be integrated into existing collaborative care programs.

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6526

One-year follow-up of collaborative depression care for low-income, predominantly Hispanic patients with cancer

Type: Journal Article

Authors: K. Ell, B. Xie, S. Kapetanovic, D. I. Quinn, P. J. Lee, A. Wells, C. P. Chou

Year: 2011

Publication Place: United States

Abstract: OBJECTIVE: This study assessed longer-term outcomes of low-income patients with cancer (predominantly female and Hispanic) after treatment in a collaborative model of depression care or in enhanced usual care. METHODS: The randomized controlled trial, conducted in safety-net oncology clinics, recruited 472 patients with major depression symptoms. Patients randomly assigned to a 12-month intervention (a depression care manager and psychiatrist provided problem-solving therapy, antidepressants, and symptom monitoring and relapse prevention) or enhanced usual care (control group) were interviewed at 18 and 24 months after enrollment. RESULTS: At 24 months, 46% of patients in the intervention group and 32% in the control group had a >/=50% decrease in depression score over baseline (odds ratio=2.09, 95% confidence interval=1.13-3.86; p=.02); intervention patients had significantly better social (p=.03) and functional (p=.01) well-being. Treatment receipt among intervention patients declined (72%, 21%, and 18% at 12, 18, and 24 months, respectively); few control group patients reported treatment receipt (10%, 6%, and 13%, respectively). Significant differences in receipt of counseling or antidepressants disappeared at 24 months. Depression recurrence was similar between groups (intervention, 36%; control, 39%). Among patients with depression recurrence, intervention patients were more likely to receive treatment after 12 months (34% versus 10%; p=.03). At 24 months, attrition (262 patients, 56%) did not vary by group; 22% were deceased, 20% declined further participation, and 14% could not be located. CONCLUSIONS: Collaborative care reduced depression symptoms and enhanced quality of life; however, results call for ongoing depression symptom monitoring and treatment for low-income cancer survivors.

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6527

One-Year Follow-Up of Heroin-Dependent Adolescents Treated with Buprenorfine/Naloxone for the First Time in a Substance Treatment Unit

Type: Journal Article

Authors: C. Mutlu, A. C. Demirci, O. Yalcin, A. G. Kilicoglu, M. Topal, G. Karacetin

Year: 2016

Publication Place: United States

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6528

One-year follow-up results of unsupported online computerized cognitive behavioural therapy for depression in primary care: A randomized trial

Type: Journal Article

Authors: L. E. de Graaf, S. A. Gerhards, A. Arntz, H. Riper, J. F. Metsemakers, S. M. Evers, J. L. Severens, G. Widdershoven, M. J. Huibers

Year: 2011

Publication Place: Netherlands

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6529

One-year postcollaborative depression care trial outcomes among predominantly Hispanic diabetes safety net patients

Type: Journal Article

Authors: K. Ell, W. Katon, P. J. Lee, S. Kapetanovic, J. Guterman, C. P. Chou

Year: 2011

Abstract: Abstract. OBJECTIVE: The aim of this study was to determine sustained effectiveness in reducing depression symptoms and improving depression care 1 year following intervention completion. METHOD: Of 387 low-income, predominantly Hispanic diabetes patients with major depression symptoms randomized to 12-month socioculturally adapted collaborative care (psychotherapy and/or antidepressants, telephone symptom monitoring/relapse prevention) or enhanced usual care, 264 patients completed 2-year follow-up. Depression symptoms (Symptom Checklist-20 [SCL-20], Patient Health Questionnaire-9 [PHQ-9]), treatment receipt, diabetes symptoms and quality of life were assessed 24 months postenrollment using intent-to-treat analyses. RESULTS: At 24 months, more intervention patients received ongoing antidepressant treatment (38% vs. 25%, ?(2)=5.11, df=1, P=.02); sustained depression symptom improvement [SCL-20 <0.5 (adjusted odds ratio=2.06, 95% confidence interval=1.09-3.90, P=.03), SCL-20 score (adjusted mean difference -0.22, P=.001) and PHQ-9 ?50% reduction (adjusted odds ratio=1.87, 95% confidence interval =1.05-3.32, P=.03)]. Over 2 years, improved effects were found in significant study group by time interaction for Short Form-12 mental health, Sheehan Disability Scale (SDS) functional impairment, diabetes symptoms, anxiety and socioeconomic stressors (P=.02 for SDS; P<.0001 for all others); however, group differences narrowed over time and were no longer significant at 24 months. CONCLUSIONS: Socioculturally tailored collaborative care that included maintenance antidepressant medication, ongoing symptom monitoring and behavioral activation relapse prevention was associated with depression improvement over 24 months for predominantly Hispanic patients in primary safety net care.

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6530

One-year trajectories of depression and anxiety symptoms in older patients presenting in general practice with musculoskeletal pain: A latent class growth analysis

Type: Journal Article

Authors: Magdalena Rzewuska, Christian D. Mallen, Victoria Y. Strauss, John Belcher, George Peat

Year: 2015

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6531

Online CBT training for mental health providers in primary care

Type: Journal Article

Authors: Sorocco Kristen, Joseph Mignogna, Michael R. Kauth, Natalie Hundt, Melinda A. Stanley, Thakur Elyse, Chelsea G. Ratcliff, Jeffrey A. Cully

Year: 2018

Publication Place: Brighton

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6532

Online cognitive behavioral therapy for depressed primary care patients: a pilot feasibility project

Type: Journal Article

Authors: U. Whiteside, J. Richards, B. Steinfeld, G. Simon, S. Caka, C. Tachibana, S. Stuckey, E. Ludman

Year: 2014

Publication Place: United States

Abstract: CONTEXT: Cognitive behavioral therapy (CBT) is a goal-oriented treatment that guides patients to healthy thoughts and behaviors. Internet-delivered CBT with supportive coaching can be as effective as in-person psychotherapy treatment of depression. OBJECTIVE: To test the feasibility of engaging depressed primary care patients not currently receiving psychotherapy and to measure the outcomes of Internet-delivered CBT with supportive coaching. DESIGN: Pilot feasibility project. MAIN OUTCOME MEASURES: 1) Uptake rate. 2) Reduction in depressive symptoms (average score on 20-item Hopkins Symptom Checklist) from baseline to 4-month follow-up. METHODS: Medical records data were queried to identify patients experiencing a new episode of depression. Eligible patients were invited via secure messaging (patient and clinician communication using a secure Web site linked to the medical record) to participate in the Internet-delivered CBT program (also known as Thrive), which was algorithm-driven and delivered through didactic segments, interactive tools, and assessments. Patients completed a self-administered online follow-up survey four months after enrollment. RESULTS: Of 196 eligible patients who were sent an invitation, 39 (20%) enrolled in the Internet-delivered CBT program. At follow-up, enrolled patients experienced a clinically significant decrease (average = 46%) in depressive symptoms. Suicidal thoughts also decreased both overall and by severity. CONCLUSIONS: Seamless, scalable integration of Internet-delivered CBT into health care systems is feasible. The 20% uptake rate suggests that future work should focus on strategies to increase the initial response rate. One promising direction is the addition of "human touch" to the secure message invitation. Depression outcomes suggest promise for systemwide implementation of Internet-delivered CBT programs.

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6533

Online communities of practice to support collaborative mental health practice in rural areas

Type: Journal Article

Authors: L. Cassidy

Year: 2011

Publication Place: England

Abstract: The provision of quality mental health services in rural areas continues to be an ongoing challenge for nurses and the patients they serve. The use of computer mediated communication to construct collaborative learning environments similar to those suggested in Wenger's community of practice framework has the potential to mitigate a number of the difficulties faced by rural health care providers. The author presents a brief discussion of social learning theories, the communities of practice framework, and related concepts. Examples of current online communities of practice used as a means for knowledge construction in various professional disciplines are presented in building the case for the fit between online communities of practice and the needs of nurses in rural mental health. Nurses providing mental health care in rural areas have documented needs for interdisciplinary teamwork, access to a collaborative learning environment, and ongoing contact with expert resources. The construction of online communities of practice could potentially address a multitude of concerns identified by nurses practicing mental health care in rural areas.

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6534

Online prescribing

Type: Web Resource

Authors: Center for Connected Health Policy

Year: 2021

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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.

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6535

Online training of behavioral health providers for primary care practice

Type: Journal Article

Authors: D. J. Mullin, J. A. Savageau, K. Sullivan

Year: 2021

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6536

Only One In Twenty Justice-Referred Adults In Specialty Treatment For Opioid Use Receive Methadone Or Buprenorphine

Type: Journal Article

Authors: N. Krawczyk, C. E. Picher, K. A. Feder, B. Saloner

Year: 2017

Publication Place: United States

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6537

Onsite treatment of HCV infection with direct acting antivirals within an opioid treatment program

Type: Journal Article

Authors: J. L. Butner, N. Gupta, C. Fabian, S. Henry, J. M. Shi, J. M. Tetrault

Year: 2017

Publication Place: United States

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6538

Ontario's Primary Care Reforms Have Transformed The Local Care Landscape, But A Plan Is Needed For Ongoing Improvement

Type: Journal Article

Authors: B. Hutchison, R. Glazier

Year: 2013

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6539

Open Access as a Revolution: Knowledge Alters Power

Type: Journal Article

Year: 2019

Publication Place: Canada

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6540

Open access in the patient-centered medical home: lessons from the Veterans Health Administration

Type: Journal Article

Authors: G. True, A. E. Butler, B. G. Lamparska, M. L. Lempa, J. A. Shea, D. A. Asch, R. M. Werner

Year: 2013

Publication Place: United States

Abstract: BACKGROUND: The Veterans Health Administration (VHA) has undertaken a 5-year initiative to transform to a patient-centered medical home model. An early focus of implementation was on creating open access, defined as continuity and capacity in primary care. OBJECTIVE: We describe the impact of readiness for implementation on efforts of pilot teams to make changes to improve access and identify successful strategies used by early adopters to overcome barriers to change. DESIGN: A qualitative, formative evaluation of the first 18 months of implementation in one Veterans Integrated Service Network (VISN) spread across six states. PARTICIPANTS: Members of local implementation teams including administrators, primary care providers, and staff from primary care clinics located at 10 medical centers and 45 outpatient clinics. APPROACH: We conducted site visits during the first 6 months of implementation, observations at Learning Collaboratives, semi-structured interviews, and review of internal organizational documents. All data collection took place between April 2010 and December 2011. KEY RESULTS: Early adopters employed various strategies to enhance access, with a focus on decreasing demand for face-to-face care, increasing supply of different types of primary care encounters, and improving clinic efficiencies. Our interviews with key contacts revealed three important areas where readiness for implementation (or lack thereof) had an impact on interventions to improve access: leadership engagement, staffing resources, and access to information and knowledge. CONCLUSIONS: Key factors related to readiness for implementation had an impact on which interventions pilot teams could put into place, as well as the viability and sustainability of access gains. Wide variations in interventions to improve access occurring across sites situated within one organization have important implications for efforts to measure the impact of enhanced access on patient outcomes, costs, and other systems-level indicators of the Medical Home.

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