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Opioids & SU
The Literature Collection contains over 10,000 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).
10858 Results
7382
Predictors of neonatal abstinence syndrome in buprenorphine exposed newborn: can cord blood buprenorphine metabolite levels help?
Type: Journal Article
Year: 2016
Publication Place: Switzerland
Abstract: BACKGROUND: Buprenorphine is a semi-synthetic opioid used for the treatment of opioid dependence. Opioid use, including buprenorphine, has been increasing in recent years, in the general population and in pregnant women. Consequently, there has been a rise in frequency of neonatal abstinence syndrome (NAS), associated with buprenorphine use during pregnancy. The purpose of this study was to investigate correlations between buprenorphine and buprenorphine-metabolite concentrations in cord blood and onset of NAS in buprenorphine exposed newborns. METHODS: Nineteen (19) newborns who met inclusion criteria were followed after birth until discharge in a double-blind non-intervention study, after maternal consent. Cord blood and tissue samples were collected and analyzed by liquid chromatography-mass spectrometry (LC-MS) for buprenorphine and metabolites. Simple and multiple logistic regressions were used to examine relationships between buprenorphine and buprenorphine metabolite concentrations in cord blood and onset of NAS, need for morphine therapy, and length of stay. RESULTS: Each increase in 5 ng/ml level of norbuprenorphine in cord blood increases odds of requiring treatment by morphine 2.5 times. Each increase in 5 ng/ml of buprenorphine-glucuronide decreases odds of receiving morphine by 57.7 %. Along with concentration of buprenorphine metabolites, birth weight and gestational age also play important roles, but not maternal buprenorphine dose. CONCLUSIONS: LC-MS analysis of cord blood concentrations of buprenorphine and metabolites is an effective way to examine drug and metabolite levels in the infant at birth. Cord blood concentrations of the active norbuprenorphine metabolite and the inactive buprenorphine-glucuronide metabolite show promise in predicting necessity of treatment of NAS. These finding have implications in improving patient care and reducing healthcare costs if confirmed in a larger sample.
Topic(s):
Opioids & Substance Use
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, Healthcare Disparities
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7389
Predictors of Poor Response to Depression Treatment in Primary Care
Type: Journal Article
Year: 2016
Publication Place: United States
Abstract: OBJECTIVE: Depression is pervasive and costly, and the majority of depression is treated in primary care. The objective of this study was to identify patient characteristics predictive of poor depression outcomes in primary care clinics. METHODS: This observational study followed 792 patients receiving usual care for depression in 83 clinics across Minnesota for at least six months between 2008 and 2010. The primary outcome was an ordinal outcome of remission or response without remission ("response") six months after the start of treatment. The outcome was assessed via telephone administration of the Patient Health Questionnaire-9. Associations of patient characteristics with the primary outcome were assessed by using ordinal logistic regression. RESULTS: The majority of patients were female, Caucasian, and employed, and most had some college education and good, very good, or excellent self-rated health. At baseline, 32% had mild depression, 40% moderate depression, 20% moderately severe depression, and 8% severe depression. One-third of patients had psychotherapy or psychiatric care in addition to antidepressant medications. At six months, only 47% of patients obtained depression remission or response. Patients were significantly less likely to experience remission or response if they rated their health as poor or fair or if they were unemployed and were more likely to achieve remission or response if they were younger or had mild depression. CONCLUSIONS: Patients with poor or fair health or who were unemployed were less likely to respond to usual depression care and may be good candidates for limited, but potentially more effective, intensive treatment resources for depression.
Topic(s):
General Literature
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View the DOI record for Predictors of Poor Response to Depression Treatment in Primary Care
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View the PubMed citation for Predictors of Poor Response to Depression Treatment in Primary Care7391
Predictors of primary care management of depression in the Veterans Affairs healthcare system
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: BACKGROUND: Primary care providers (PCPs) vary in skills to effectively treat depression. Key features of evidence-based collaborative care models (CCMs) include the availability of depression care managers (DCMs) and mental health specialists (MHSs) in primary care. Little is known, however, about the relationships between PCP characteristics, CCM features, and PCP depression care. OBJECTIVE: To assess relationships between various CCM features, PCP characteristics, and PCP depression management. DESIGN: Cross-sectional analysis of a provider survey. PARTICIPANTS: 180 PCPs in eight VA sites nationwide. MAIN MEASURES: Independent variables included scales measuring comfort and difficulty with depression care; collaboration with a MHS; self-reported depression caseload; availability of a collocated MHS, and co-management with a DCM or MHS. Covariates included provider type and gender. For outcomes, we assessed PCP self-reported performance of key depression management behaviors in primary care in the past 6 months. KEY RESULTS: Response rate was 52 % overall, with 47 % attending physicians, 34 % residents, and 19 % nurse practitioners and physician assistants. Half (52 %) reported greater than eight veterans with depression in their panels and a MHS collocated in primary care (50 %). Seven of the eight clinics had a DCM. In multivariable analysis, significant predictors for PCP depression management included comfort, difficulty, co-management with MHSs and numbers of veterans with depression in their panels. CONCLUSIONS: PCPs who felt greater ease and comfort in managing depression, co-managed with MHSs, and reported higher depression caseloads, were more likely to report performing depression management behaviors. Neither a collocated MHS, collaborating with a MHS, nor co-managing with a DCM independently predicted PCP depression management. Because the success of collaborative care for depression depends on the ability and willingness of PCPs to engage in managing depression themselves, along with other providers, more research is necessary to understand how to engage PCPs in depression management.
Topic(s):
Education & Workforce
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Reference Links:
View the DOI record for Predictors of primary care management of depression in the Veterans Affairs healthcare system
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View the PubMed citation for Predictors of primary care management of depression in the Veterans Affairs healthcare system7392
Predictors of Receipt of Physical Health Services in Mental Health Clinics
Type: Journal Article
Year: 2019
Publication Place: United States
Abstract: To inform efforts to improve physical health care for adults with serious mental illness, this study examines predictors of provision and receipt of physical health services in freestanding mental health clinics in New York state. The number of services provided over the initial 12-months of implementation varied across clinics from 0 to 1407. Receipt of services was associated with a diagnosis of schizophrenia, frequent mental and physical health visits in the prior year, and prescription of antipsychotic medications. Additional support may also be needed to enable clinics to target patients without established patterns of frequent mental health or medical visits.
Topic(s):
Healthcare Disparities
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Reference Links:
View the DOI record for Predictors of Receipt of Physical Health Services in Mental Health Clinics
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View the PubMed citation for Predictors of Receipt of Physical Health Services in Mental Health Clinics7396
Predictors of treatment retention in postpartum women prescribed buprenorphine during pregnancy
Type: Journal Article
Year: 2018
Publication Place: United States
Topic(s):
Healthcare Disparities
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, Opioids & Substance Use
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Reference Links:
View the DOI record for Predictors of treatment retention in postpartum women prescribed buprenorphine during pregnancy
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View the PubMed citation for Predictors of treatment retention in postpartum women prescribed buprenorphine during pregnancy7397
Predictors of treatment satisfaction among older adults with anxiety in a primary care psychology program
Type: Journal Article
Year: 2013
Publication Place: England
Abstract: Increasing numbers of patients are treated in integrated primary care mental health programs. The current study examined predictors of satisfaction with treatment in patients from a randomized clinical trial of late-life generalized anxiety disorder (GAD) in primary care. Higher treatment satisfaction was associated with receiving CBT rather than enhanced usual care. Treatment credibility, treatment expectancies, social support, and improvements in depression and anxiety symptoms predicted higher treatment satisfaction in the total sample. In the CBT group, only credibility and adherence with treatment predicted satisfaction. This suggests that older patients receiving CBT who believe more strongly in the treatment rationale and follow the therapist's recommendations more closely are likely to report satisfaction at the end of treatment. In addition, this study found that adherence mediated the relationship between treatment credibility and treatment satisfaction. In other words, patients' perceptions that the treatment made sense for them led to greater treatment adherence which then increased their satisfaction with treatment.
Topic(s):
General Literature
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Reference Links:
View the DOI record for Predictors of treatment satisfaction among older adults with anxiety in a primary care psychology program
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View the PubMed citation for Predictors of treatment satisfaction among older adults with anxiety in a primary care psychology program7400
Preface. Psychiatric diagnosis and management in primary care
Type: Journal Article
Year: 2014
Publication Place: United States
Topic(s):
Healthcare Disparities
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Reference Links:
View the DOI record for Preface. Psychiatric diagnosis and management in primary care
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View the PubMed citation for Preface. Psychiatric diagnosis and management in primary care