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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).

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11272 Results
7481
Physical health screening for patients with severe mental illness
Type: Journal Article
Authors: Tonsha Emerson, Kimberly Williams, Maxie Gordon
Year: 2016
Topic(s):
General Literature See topic collection
7483
Physical Symptoms and Psychosocial Correlates of Somatization in Pediatric Primary Care
Type: Journal Article
Authors: Jennifer M. Andresen, Robert L. Woolfolk, Lesley A. Allen, Michael A. Fragoso, Neil L. Youngerman, Timothy J. Patrick-Miller, Michael A. Gara
Year: 2011
Publication Place: URL
Topic(s):
Medically Unexplained Symptoms See topic collection
7484
Physical symptoms that predict psychiatric disorders in rural primary care adults
Type: Journal Article
Authors: N. H. Rasmussen, M. E. Bernard, W. S. Harmsen
Year: 2008
Publication Place: England
Abstract: RATIONALE, AIMS AND OBJECTIVES: There is a robust association between physical symptoms and mental distress, but recognition rates of psychiatric disorders by primary care doctors are low. We investigated patient-reported physical symptoms as predictors of concurrent psychiatric disorders in rural primary care adult outpatients. METHOD: A convenience sample of 1092 patients were assessed with a two-stage diagnostic system consisting of a brief screening questionnaire and a clinician-administered semi-structured interview that linked common physical symptoms with the concurrent presence of psychiatric disorders. RESULTS: Somatoform physical symptoms were highly predictive of the concurrent presence of a psychiatric disorder, with odds ratios ranging from 10.4 (fainting spells) to 54.6 (shortness of breath). Aggregate analysis of somatoform and non-somatoform symptoms relative to no physical symptom produced odds ratios of 3.0 or higher for headaches, chest pain, dizziness, sleep problem, shortness of breath, tired or low energy, and fainting spells. As the number of symptoms (especially somatoform) increased, the odds of a psychiatric disorder increased. CONCLUSION: Although individual physical symptoms are valid triggers for suspecting a psychiatric disorder, the most powerful correlates are total number of physical complaints and somatoform symptom status.
Topic(s):
Medically Unexplained Symptoms See topic collection
7485
Physical-mental health comorbidity: A population-based cross-sectional study
Type: Journal Article
Authors: M. Jürisson, H. Pisarev, A. Uusküla, K. Lang, M. Oona, L. Elm, R. Kalda
Year: 2021
Abstract:

BACKGROUND: Multimorbidity is associated with physical-mental health comorbidity (PMHC). However, the scope of overlap between physical and mental conditions, associated factors, as well as types of mental illness involved are not well described in Eastern Europe. This study aims to assess the PMHC burden in the Estonian population. METHODS: In this population-based cross-sectional study we obtained health claims data for 55 chronic conditions from the Estonian Health Insurance Fund (EHIF) database, which captures data for all publicly insured individuals (n = 1 240 927 or 94.1% of the total population as of 31 December 2017). We assessed the period-prevalence (3 years) of chronic physical and mental health disorders, as well as associations between them, by age and sex. RESULTS: Half of the individuals (49.1% (95% CI 49.0-49.3)) had one or more chronic conditions. Mental health disorders (MHD) were present in 8.1% (8.1-8.2) of individuals, being higher among older age groups, women, and individuals with a higher number of physical conditions. PMHC was present in 6.2% (6.1-6.2) of the study population, and 13.1% (13.0-13.2) of the subjects with any chronic physical disorder also presented with at least one MHD. Dominating MHDs among PMHC patients were anxiety and depression. The prevalence of MHD was positively correlated with the number of physical disorders. We observed variation in the type of MHD as the number of physical comorbidities increased. The prevalence of anxiety, depression, and mental and behavioral disorders due to the misuse of alcohol and other psychoactive substances increased as physical comorbidities increased, but the prevalence of schizophrenia and dementia decreased with each additional physical disease. After adjusting for age and sex, this negative association changed the sign to a positive association in the case of dementia and mental and behavioral disorders due to psychoactive substance misuse. CONCLUSIONS: The burden of physical-mental comorbidity in the Estonian population is relatively high. Further research is required to identify clusters of overlapping physical and mental disorders as well as the interactions between these conditions. Public health interventions may include structural changes to health care delivery, such as an increased emphasis on integrated care models that reduce barriers to mental health care.

Topic(s):
Healthcare Disparities See topic collection
7486
Physical, Mental Health and Developmental Conditions, and Sociodemographic Characteristics Associated With Adverse Childhood Experiences Among Young Children in Pediatric Primary Care
Type: Journal Article
Authors: Stacy Sterling, Felicia Chi, Judy Lin, Padmaja Padalkar, Uma Vinayagasundaram, Esti Iturralde, Kelly Young-Wolff, Verena E. Metz, Arnd Herz, Rahel Negusse, Melanie Jackson-Morris, Paul Espinas
Year: 2021
Topic(s):
Financing & Sustainability See topic collection
,
Healthcare Disparities See topic collection
7487
Physician "Costs" in Providing Behavioral Health in Primary Care
Type: Journal Article
Authors: Tawnya Meadows, Rachel Valleley, Mary Kelly Haack, Ryan Thorson, Joseph Evans
Year: 2011
Abstract: OBJECTIVE: To examine pediatricians time spent, and resulting reimbursement payments for, addressing behavioral health concerns in a rural primary care pediatric practice. METHODS: Research assistants observed 228 patient visits in a rural pediatric primary care office. The length of the visit (in minutes), content of visit, number and type of codes billed, and related insurance reimbursement amounts were recorded. Interrater reliability, scored for 22% of patient visits, was =90%. RESULTS: Medical only visits lasted, on average, 8 minutes as compared with behavioral only visits that required nearly 20 minutes of physician time. Pediatricians billed up to 10 different billing codes for medical only visits but only billed 1 code for behavioral only visits. Consequently, pediatricians were reimbursed significantly less, per minute, for behavioral only visits as compared with those sessions addressing medical only or a combination of medical and behavior concerns. CONCLUSION: Findings converge with previous research, demonstrating that behavioral health concerns dramatically affect the length of visit for primary care physicians. Moreover, this study is the first to document the specific impact of such concerns on pediatrician reimbursement for providing behavioral services. These results provide further support for integrating behavioral health services into pediatric primary care settings, thus allowing physicians to refer more difficult patients with behavioral issues to in-house collaborating behavioral health providers who can spend additional time necessary to address the behavioral health issue and who are licensed to receive mental health reimbursement.
Topic(s):
Financing & Sustainability See topic collection
,
Healthcare Disparities See topic collection
7488
Physician Advice to Adolescents About Drinking and Other Health Behaviors
Type: Journal Article
Authors: R. W. Hingson, W. Zha, R. J. Iannotti, B. Simons-Morton
Year: 2013
Topic(s):
Healthcare Disparities See topic collection
,
Opioids & Substance Use See topic collection
7489
Physician and enrollee knowledge of Medicaid coverage for tobacco dependence treatments
Type: Journal Article
Authors: S. B. McMenamin, H. A. Halpin, J. K. Ibrahim, C. T. Orleans
Year: 2004
Publication Place: Netherlands
Abstract: BACKGROUND: The 2000 Public Health Service Clinical Practice Guideline, Treating Tobacco Use and Dependence, recommends health insurance coverage for tobacco-dependence treatments proven effective in helping smokers to quit. Two states with comprehensive coverage for tobacco-dependence treatments in their Medicaid programs were selected to document awareness of coverage for tobacco-dependence treatments among primary care physicians who treat Medicaid enrollees and Medicaid-enrolled smokers. METHODS: In 2000, surveys were conducted among Medicaid smokers (n =400) and physicians (n =160) to document knowledge of covered tobacco-dependence treatments under state Medicaid programs in two states with comprehensive coverage. RESULTS: Only 36% of Medicaid-enrolled smokers and 60% of Medicaid physicians knew that their state Medicaid program offered any coverage for tobacco-dependence treatments. Physicians were more than twice as likely to know that pharmacotherapies were covered compared to counseling. CONCLUSIONS: Greater effort is needed to make Medicaid smokers and physicians aware that effective pharmacotherapies and counseling services are available to assist in treating tobacco dependence. Additionally, future research should explore the methods that are most effective in informing patients and providers regarding covered benefits.
Topic(s):
Financing & Sustainability See topic collection
7490
Physician and nurse practitioner perceptions of social worker and community health worker roles in primary care practices caring for frail elders: Insights for social work
Type: Journal Article
Authors: Julie Berrett-Abebe, Karen ScD. EdM. Donelan, Barbara D.S.W. Berkman PhD., David M.S. Auerbach PhD., Peter M.P.H. L.C.S.W. Maramaldi PhD
Year: 2020
Publication Place: New York
Topic(s):
Education & Workforce See topic collection
,
Healthcare Disparities See topic collection
7491
Physician assistants in English primary care teams: A survey
Type: Journal Article
Authors: Vari M. Drennan
Year: 2012
Topic(s):
Education & Workforce See topic collection
7492
Physician Assistants in Primary Care: Trends and Characteristics
Type: Journal Article
Authors: B. Coplan, J. Cawley, J. Stoehr
Year: 2013
Topic(s):
Education & Workforce See topic collection
7493
Physician blame and vulnerability: novel predictors of physician willingness to work with patients who misuse opioids
Type: Journal Article
Authors: B. Franz, L . Y. Dhanani, D. L. Brook
Year: 2021
Abstract:

BACKGROUND: Successfully combating the opioid crisis requires patients who misuse opioids to have access to affirming and effective health care. However, there is a shortage of physicians who are willing to work with these patients. We investigated novel predictors of what might be contributing to physicians' unwillingness to engage with this patient population to better identify and direct interventions to improve physician attitudes. METHODS: 333 physicians who were board certified in the state of Ohio completed a survey about their willingness to work with patients who misuse opioids. The hypothesized relationships between the proposed predictors and willingness to work with this patient population were tested using multivariate regression, supplemented with qualitative analysis of open-text responses to questions about the causes of addiction. RESULTS: Perceptions of personal invulnerability to opioid misuse and addiction, opioid misuse and addiction controllability, and health care provider blame for the opioid crisis were negatively associated with physician willingness to work with patients who misuse opioids after controlling for known predictors of physician bias toward patients with substance use disorders. Physicians working in family and internal medicine, addiction medicine, and emergency medicine were also more willing to work with this patient population. CONCLUSIONS: Distancing oneself and health care professionals from opioid misuse and placing blame on those who misuse are negatively associated with treatment willingness. Interventions to improve physician willingness to work with patients who misuse opioids can target these beliefs as a way to improve physician attitudes and provide patients with needed health care resources.

Topic(s):
Education & Workforce See topic collection
,
Opioids & Substance Use See topic collection
7494
Physician coding for mental illness reimbursement and the need for mental health parity
Type: Web Resource
Authors: V. Nicholson
Year: 2007
Publication Place: United States -- Texas
Abstract: Many patients with anxiety and depression initially seek treatment from their primary care physicians. Changes in insurance coverage and current mental parity laws, make reimbursement for services a problem. This has led to a coding dilemma for physicians seeking payment for their services. This study seeks to determine first the frequency at which primary care physicians use alternative coding, and secondly, if physicians would change their coding practices, provided reimbursement was assured through changes in mental parity laws. A mail survey was sent to 260 randomly selected primary care physicians, who are family practice, internal medicine, and general practice physicians, and members of the Harris County Medical Society. The survey evaluated the physicians' demographics, the number of patients with psychiatric disorders seen by primary care physicians, the frequency with which physicians used alternative coding, and if mental parity laws changed, the rate at which physicians would use a psychiatric illness diagnosis as the primary diagnostic code. The overall response rate was 23%. Only 47 of the 59 physicians, who responded, qualified for the study and of those 45% used a psychiatric disorder to diagnose patients with a primary psychiatric disorder, 47% used a somatic/symptom disorder, and 8% used a medical diagnosis. From the physicians who would not use a psychiatric diagnosis as a primary ICD-9 code, 88% were afraid of not being reimbursed and 12% were worried about stigma or jeopardizing insurability. If payment were assured using a psychiatric diagnostic code, 81% physicians would use a psychiatric diagnosis as the primary diagnostic code. However, 19% would use an alternative diagnostic code in fear of stigmatizing and/or jeopardizing patients' insurability. Although the sample size of the study design was adequate, our survey did not have an ideal response rate, and no significant correlation was observed. However, it is evident that reimbursement for mental illness continues to be a problem for primary care physicians. The reformation of mental parity laws is necessary to ensure that patients receive mental health services and that primary care physicians are reimbursed. Despite the possibility of improved mental parity legislation, some physicians are still hesitant to assign patients with a mental illness diagnosis, due to the associated stigma, which still plays a role in today's society.
Topic(s):
Financing & Sustainability See topic collection
,
Financing & Sustainability See topic collection
,
Healthcare Policy See topic collection
,
Medically Unexplained Symptoms See topic collection
,
Grey Literature See topic collection
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.

7495
Physician conceptions of responsibility to individual patients and distributive justice in health care
Type: Journal Article
Authors: Mary Catherine Beach, Lisa S. Meredith, Jodi Halpern, Kenneth B. Wells, Daniel E. Ford
Year: 2005
Topic(s):
General Literature See topic collection
7496
Physician continuing education to reduce opioid misuse, abuse, and overdose: Many opportunities, few requirements
Type: Journal Article
Authors: Corey S. Davis, Derek Carr
Year: 2016
Topic(s):
Education & Workforce See topic collection
,
Opioids & Substance Use See topic collection
7497
Physician education in addiction medicine
Type: Journal Article
Authors: Evan Wood, Jeffrey H. Samet, Nora D. Volkow
Year: 2013
Topic(s):
Opioids & Substance Use See topic collection
,
Education & Workforce See topic collection
7498
Physician Guide to Appropriate Opioid Prescribing for Noncancer Pain
Type: Journal Article
Authors: T. Munzing
Year: 2017
Publication Place: United States
Abstract: Prescription opioid use for relief of noncancer pain has risen dramatically in the last 15 years, contributing to a quadrupling of opioid overdoses and prescription opioid-related deaths. This crisis is resulting in heightened attention by health care professionals and organizations, law enforcement, and the government. In this article, I highlight key topics in the management of patients using opioids (or potentially needing opioids) in outpatient clinical practice; federal and state law enforcement actions regarding physicians' illegal prescribing of opioids; multimodal approaches to pain control; nonmedication management of pain; response strategies when suspecting a patient of diverting or misusing opioids; and warning signs for abuse or diversion. For those patients for whom opioids are appropriate, I describe key elements for prescribing, including documentation of a detailed history and examination, appropriate evaluation to arrive at a specific diagnosis, individualizing management, and ongoing monitoring (including the use of urine drug screening and a prescription drug monitoring program). In addition to individual action, when possible, the initiation of systemwide and clinicwide safe prescribing practices supports the physician and patient such that the patient's well-being is at the heart of all pain management decisions. Physicians are encouraged to further educate themselves to treat pain safely and effectively; to screen patients for opioid use disorder and, when diagnosed, to connect them with evidence-based treatment; and to follow Centers for Disease Control and Prevention guidelines whenever possible.
Topic(s):
Opioids & Substance Use See topic collection
7499
Physician identification and management of psychosocial problems in primary care
Type: Journal Article
Authors: M. M. Steele, A. S. Lochrie, M. C. Roberts
Year: 2010
Publication Place: United States
Abstract: Often the burden of identifying children with behavioral or developmental problems is left up to the primary care physician (PCP). However, previous literature shows that PCPs consistently underidentify children with developmental/behavioral problems in pediatric primary care. For the current study, questionnaires containing three vignettes followed by questions addressing common psychosocial problems, general questions about their practice and training, and the Physician Belief Scale were distributed to physicians. Results indicated that physicians were better at identifying severe problems, had more difficulty identifying psychosocial problems with mild symptomatology, and tended to refer to a medical specialist or mental health professional more often for severe problems, depression or a developmental problem. Physicians tended to view treating psychosocial problems favorably.
Topic(s):
Education & Workforce See topic collection
7500
Physician perception regarding side-effect profile at the onset of antidepressant treatment: a survey of Israeli psychiatrists and primary care physicians
Type: Journal Article
Authors: U. Nitzan, T. Bekerman, G. Becker, P. Lichtenberg, S. Lev-Ran, G. Walter, H. Maoz, Y. Bloch
Year: 2016
Publication Place: England
Abstract: BACKGROUND: One of the major factors affecting treatment compliance and outcome in patients is the wide range of side effects (SEs) associated with antidepressants. In the present study, we aimed to assess the extent to which Israeli primary care (PC) physicians and psychiatrists discuss the SEs of selective serotonin reuptake inhibitors (SSRIs) with patients prior to the onset of treatment. METHODS: A cross-sectional questionnaire survey was conducted among PC physicians (N = 123) and psychiatrists (N = 105). Questionnaires were distributed using a mixed-modality design, combining a web survey and in-person delivery of questionnaires. RESULTS: A significant percentage of our respondents reported that they rarely discuss psychological (60 %) or severe (29 %) SEs of SSRIs. Nearly half (41 %) admitted to avoiding discussion of impact on suicidal ideation. Specialists were noted to discuss and evaluate SEs significantly more than residents, and Psychiatrists more than PC physicians. Specifically, psychiatrists more often discussed the possibility of sexual dysfunction (t (225) = 2.23; p < 0.05) and suicidal ideation (t (225) = 2.11; p < 0.05). CONCLUSIONS: It seems that PC physicians and psychiatrists surveyed in this study do not share sufficient information regarding the SEs of SSRIs with their patients at the onset of treatment. In improving this practice, the integration of proper SE management into educational interventions has potential in enhancing compliance and improving expertise and level of care.
Topic(s):
Education & Workforce See topic collection