Literature Collection

Medications for opioid use disorder (MOUD) remain highly inaccessible despite demonstrated effectiveness. We examine the extent of screening for opioid use and availability of MOUD in a national cross-section of multi-physician primary care and multispecialty practices. Drawing on an existing framework to characterize the internal and environmental context, we assess socio-technical, organizational-managerial, market-based, and state-regulation factors associated with the use of opioid screening and offering of MOUD in a practice. A total of 26.2% of practices offered MOUD, while 69.4% of practices screened for opioid use. Having advanced health information technology functionality was positively associated with both screening for opioid use and offering MOUD in a practice, while access to on-site behavioral clinicians was positively associated with offering MOUD in adjusted models. These results suggest that improving access to information and expertise may enable physician practices to respond more effectively to the nation's ongoing opioid epidemic.

BACKGROUND: Perinatal mental illnesses (PMI) affect up to 20% of women and 10% of men during pregnancy and in the first year after the birth of the child. Perinatal mental illness contributes significantly to maternal mortality and adverse neonatal, infant, and child outcomes. Because of the high prevalence and the impact of PMI on both the parents and the infant, there is an urgent need for rapid and effective care. The aim of this scoping review was to identify comprehensive evidence-based guidelines and care models for the prevention and treatment of PMI and summarize their common characteristics. METHODS: We searched manually in several databases and on websites of relevant institutions and contacted experts. We included guidelines and guidance documents based on pre-defined inclusion criteria. RESULTS: We identified six relevant guidelines and care models from four countries (United Kingdom, Ireland, Canada, Australia). The identified documents highlight the need for integrated care models (including prevention, early identification, counseling, treatment), clear referral pathways, stepped-care approaches and multi-professional, coordinated networks. CONCLUSIONS: The 'ideal' care model should consider not only the mental health of the mother, but also that of the father/co-parent and the children, as well as the parent-infant relationship. The results from this scoping review can be used for further discussion and as decision support for designing, developing, and implementing perinatal and infant mental health (PIMH) care.

BACKGROUND: While the associations between coronary heart disease (CHD) and depression are well-documented, their synergistic interplay requires quantification in large, representative populations. Operating within a cross-sectional framework, this study’s objective was to investigate the associations of CHD and depression with current health status and to explore their interaction using a nationally representative U.S. sample. METHODS: This study utilized data from 172,741 participants in the 2022 Behavioral Risk Factor Surveillance System (BRFSS). CHD and depression were based on self-reported history. Outcomes were frequent physical and mental distress (≥ 14 unhealthy days in the past 30 days). We used multivariable logistic regression with inverse probability of treatment weighting (IPTW) to adjust for confounding and estimate adjusted odds ratios (aORs) with 95% confidence intervals (CIs). An exploratory analysis assessed the extent to which the association between CHD and health status was statistically explained by depression, and additive interaction was also examined. RESULTS: After IPTW adjustment, CHD was significantly associated with a higher likelihood of both frequent physical distress (aOR = 1.47, 95% CI: 1.35–1.60) and frequent mental distress (aOR = 2.59, 95% CI: 2.44–2.75). Depression statistically explained 2.19% of the association between CHD and poor physical health and 21.69% of the association with poor mental health. A significant positive additive interaction was found between CHD and depression. The synergy index indicated that their combined association with poor physical health was 1.26 times greater, and with poor mental health was 1.40 times greater, than the sum of their individual associations. CONCLUSION: In a large U.S. adult sample, CHD and depression are independently and synergistically associated with poorer physical and mental health. These findings underscore the importance of integrated care models that address both conditions to improve patient well-being. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-026-26334-3.