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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
7663
Primary care providers' beliefs about teen and parent barriers to depression care
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: OBJECTIVE: Only one-third of US adolescents with depression obtain treatment for depression. Teen and parent barriers differ, but both contribute to low treatment rates. Primary care providers (PCPs) may be able to elicit and address such barriers, but little is known about their perceptions of teen and parent barriers, and whether they recognize these differences. METHODS: We administered a survey to 58 PCPs assessing their perceptions of the importance of specific barriers to depression care for teens and parents using McNemar's test to examine differences. RESULTS: Most PCPs believed barriers for parents included difficulty making appointments, worry about what others would think, and cost. PCPs believed barriers for teens included not wanting treatment and worry about what others would think. PCPs believed parents and teens differed in the extent to which they would perceive cost, difficulty in making appointments, and not wanting care as a barrier (p < .001). CONCLUSIONS: Primary care providers recognize that teens and parents have different barriers to care, but may have discordant perceptions of the importance of certain barriers for teens and their parents. PCPs may need to probe parents and teens individually about barriers, which impede depression care to enhance shared decision making and treatment uptake.
Topic(s):
Healthcare Disparities
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Reference Links: 
View the DOI record for Primary care providers' beliefs about teen and parent barriers to depression care
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View the PubMed citation for Primary care providers' beliefs about teen and parent barriers to depression care7664
Primary care providers' experiences caring for complex patients in primary care: a qualitative study
Type: Journal Article
Year: 2016
Publication Place: England
Abstract: BACKGROUND: Complex patients are increasingly common in primary care and often have poor clinical outcomes. Healthcare system barriers to effective care for complex patients have been previously described, but less is known about the potential impact and meaning of caring for complex patients on a daily basis for primary care providers (PCPs). Our objective was to describe PCPs' experiences providing care for complex patients, including their experiences of health system barriers and facilitators and their strategies to enhance provision of effective care. METHODS: Using a general inductive approach, our qualitative research study was guided by an interpretive epistemology, or way of knowing. Our method for understanding included semi-structured in-depth interviews with internal medicine PCPs from two university-based and three community health clinics. We developed an interview guide, which included questions on PCPs' experiences, perceived system barriers and facilitators, and strategies to improve their ability to effectively treat complex patients. To focus interviews on real cases, providers were asked to bring de-identified clinical notes from patients they considered complex to the interview. Interview transcripts were coded and analyzed to develop categories from the raw data, which were then conceptualized into broad themes after team-based discussion. RESULTS: PCPs (N = 15) described complex patients with multidimensional needs, such as socio-economic, medical, and mental health. A vision of optimal care emerged from the data, which included coordinating care, preventing hospitalizations, and developing patient trust. PCPs relied on professional values and individual care strategies to overcome local and system barriers. Team based approaches were endorsed to improve the management of complex patients. CONCLUSIONS: Given the barriers to effective care described by PCPs, individual PCP efforts alone are unlikely to meet the needs of complex patients. To fulfill PCP's expressed concepts of optimal care, implementation of effective systemic approaches should be considered.
Topic(s):
Education & Workforce
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, Healthcare Disparities
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Reference Links:
View the DOI record for Primary care providers' experiences caring for complex patients in primary care: a qualitative study
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View the PubMed citation for Primary care providers' experiences caring for complex patients in primary care: a qualitative study7668
Primary care providers' experiences with urine toxicology tests to manage prescription opioid misuse and substance use among chronic noncancer pain patients in safety net health care settings
Type: Journal Article
Year: 2016
Publication Place: United States
Abstract: BACKGROUND: Guideline recommendations to reduce prescription opioid misuse among patients with chronic noncancer pain include the routine use of urine toxicology tests for high-risk patients. Yet little is known about how the implementation of urine toxicology tests among patients with co-occurring chronic noncancer pain and substance use impacts primary care providers' management of misuse. Clinicians' perspectives on the benefits and challenges of implementing urine toxicology tests in the monitoring of opioid misuse and substance use in safety net health care settings are presented in this paper. METHODS: Twenty-three primary care providers from 6 safety net health care settings whose patients had a diagnosis of co-occurring chronic noncancer pain and substance use were interviewed. Interviews were transcribed, coded, and analyzed using grounded theory methodology. RESULTS: The benefits of implementing urine toxicology tests for primary care providers included less reliance on intuition to assess for misuse and the ability to identify unknown opioid misuse and/or substance use. The challenges of implementing urine toxicology tests included insufficient education and training about how to interpret and implement tests, and a lack of clarity on how and when to act on tests that indicated misuse and/or substance use. CONCLUSIONS: These data suggest that primary care clinicians' lack of education and training to interpret and implement urine toxicology tests may impact their management of patient opioid misuse and/or substance use. Clinicians may benefit from additional education and training about the clinical implementation and use of urine toxicology tests. Additional research is needed on how primary care providers implementation and use of urine toxicology tests impacts chronic noncancer pain management in primary care and safety net health care settings among patients with co-occurring chronic non cancer pain and substance use.
Topic(s):
Education & Workforce
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, Opioids & Substance Use
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7669
Primary care providers' initial treatment decisions and antidepressant prescribing for adolescent depression
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: OBJECTIVE: Adolescent depression is a serious and undertreated public health problem. Nonetheless, pediatric primary care providers (PCPs) may have low rates of antidepressant prescribing due to structural and training barriers. This study examined the impact of symptom severity and provider characteristics on initial depression treatment decisions in a setting with fewer structural barriers, an integrated behavioral health network. METHODS: A cross-sectional survey was administered to 58 PCPs within a large pediatric practice network. PCP reports of initial treatment decisions were compared in response to 2 vignettes describing depressed adolescents with either moderate or severe symptoms. PCP depression knowledge, attitudes toward addressing psychosocial concerns, demographics, and practice characteristics were measured. RESULTS: Few PCPs (25% for moderate, 32% for severe) recommended an antidepressant. Compared with treatment recommendations for moderate depression, severe depression was associated with a greater likelihood of child psychiatry referral (odds ratio [OR], 5.50; 95% confidence interval [CI], 2.47-12.2] p < .001). Depression severity did not affect the likelihood of antidepressant recommendation (OR, 1.58 [95% CI, 0.80-3.11] p = .19). Antidepressants were more likely to be recommended by PCPs with greater depression knowledge (OR, 1.72 [95% CI, 1.14-2.59] p = .009) and access to an on-site mental health provider (OR, 5.13 [95% CI, 1.24-21.2] p = .02) and less likely to be recommended by PCPs who reported higher provider burden when addressing psychosocial concerns (OR, 0.85 [95% CI, 0.75-0.98] p = .02). CONCLUSION: PCPs infrequently recommended antidepressants for adolescents, regardless of depression severity. Continued PCP support through experiential training, accounting for provider burden when addressing psychosocial concerns, and co-management with mental health providers may increase PCPs' antidepressant prescribing.
Topic(s):
Healthcare Disparities
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Reference Links:
View the DOI record for Primary care providers' initial treatment decisions and antidepressant prescribing for adolescent depression
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View the PubMed citation for Primary care providers' initial treatment decisions and antidepressant prescribing for adolescent depression7670
Primary care providers' perceptions of and experiences with an integrated healthcare model
Type: Journal Article
Year: 2008
Publication Place: United States
Abstract: OBJECTIVE AND PARTICIPANTS: The authors examined the experiences of primary care providers participating in an integrated healthcare service between mental health and primary care in a university health center. In this program, behavioral health providers work collaboratively with primary care providers in the treatment of students. Participants consisted of the 10 primary care providers participating in the program during the summer of 2004. METHODS: The authors evaluated the program using a descriptive survey, analyzed by a combination of measures of central tendency and multidimensional scaling with cluster analysis. RESULTS: They found a 2-dimensional, 3-cluster solution for the last 3 items. Findings indicate that although primary care providers valued behavioral health as a resource, a gap exists between what they believe behavioral health can assist with and their actual referral practice. CONCLUSIONS: These findings indicate a need for further communication about the roles that mental health can play in the collaborative treatment of physical symptoms.
Topic(s):
Education & Workforce
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Reference Links:
View the DOI record for Primary care providers' perceptions of and experiences with an integrated healthcare model
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View the PubMed citation for Primary care providers' perceptions of and experiences with an integrated healthcare model7673
Primary care psychiatry in Italy
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: In Italy, the importance of integrating primary care and mental health has only recently been grasped. Several reasons may explain this delay: a) until 2005, primary care physicians worked individually instead of in group practices, without any functional network or structured contacts with colleagues; b) community mental health centers with multiprofessional teams were well structured and widespread in several regions but focused on people with severe and persistent mental disorders; and c) specific national government health policies were lacking. Only two regions have implemented explicit policies on this issue. The "G. Leggieri" program started by the Emilia-Romagna region health government in 1999 aims to coordinate unsolicited bottom-up cooperation initiatives developing since the 1980s. In Liguria, a regional work group was established in 2010 to boost the strategic role of collaborative programs between primary care and mental health services. This article describes the most innovative experiences relating to primary care psychiatry in Italy.
Topic(s):
General Literature
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Reference Links:
View the DOI record for Primary care psychiatry in Italy
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View the PubMed citation for Primary care psychiatry in ItalyExport Citation: Download the RIS reference file for Primary care psychiatry in Italy
7674
Primary care psychiatry: pertinent Arabian perspectives
Type: Journal Article
Year: 2005
Publication Place: Egypt
Abstract: There is substantive evidence of significant psychiatric morbidity among primary care patients, mainly in the form of anxiety and depressive disorders. A careful critical approach is essential for ensuring the cultural relevance, validity and reliability of the psychiatric screening instruments used to identify such morbidity. Most psychiatric morbidity among primary care patients passes undetected by the primary care practitioners. This will inevitably lead to unnecessary investigation and medication and the continuation of suffering for patients. Comorbidity and physical presentation in most instances contribute significantly to failure to detect psychiatric disorders. To deal with this problem of hidden psychiatric morbidity, carefully designed educational and training programmes need to be tailored to address the particular weaknesses and needs of primary care doctors.
Topic(s):
Education & Workforce
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, Medically Unexplained Symptoms
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Reference Links: View the PubMed citation for Primary care psychiatry: pertinent Arabian perspectives
7675
Primary care psychiatry: Pertinent Arabian perspectives
Type: Journal Article
Year: 2005
Publication Place: Egypt
Abstract: There is substantive evidence of significant psychiatric morbidity among primary care patients, mainly in the form of anxiety and depressive disorders. A careful critical approach is essential for ensuring the cultural relevance, validity and reliability of the psychiatric screening instruments used to identify such morbidity. Most psychiatric morbidity among primary care patients passes undetected by the primary care practitioners. This will inevitably lead to unnecessary investigation and medication and the continuation of suffering for patients. Comorbidity and physical presentation in most instances contribute significantly to failure to detect psychiatric disorders. To deal with this problem of hidden psychiatric morbidity, carefully designed educational and training programmes need to be tailored to address the particular weaknesses and needs of primary care doctors.
Topic(s):
Education & Workforce
See topic collection
, Medically Unexplained Symptoms
See topic collection
Reference Links: View the PubMed citation for Primary care psychiatry: Pertinent Arabian perspectives
7678
Primary care reform and service use by people with serious mental illness in Ontario
Type: Journal Article
Year: 2014
Publication Place: Canada
Topic(s):
Healthcare Policy
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, Financing & Sustainability
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Reference Links: View the PubMed citation for Primary care reform and service use by people with serious mental illness in Ontario
7679
Primary care registration of the mental health needs of patients treated at outpatient specialized services: Results from a medium-sized city in Brazil
Type: Journal Article
Year: 2021
Topic(s):
General Literature
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