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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
7741
Principles for managing OUD related to chronic pain in the Nordic countries based on a structured assessment of current practice
Type: Journal Article
Year: 2018
Publication Place: England
Abstract: BACKGROUND: Long-term use of opioid analgesics (OA) for chronic pain may result in opioid use disorder (OUD). This is associated with adverse outcomes for individuals, families and society. Treatment needs of people with OUD related to chronic pain are different compared to dependence related to use, and also injection, of illicit opioids. In Nordic countries, day-to-day practical advice to assist clinical decision-making is insufficient. AIM: To develop principles based on expert clinical insights for treatment of OUD related to the long-term use of OA in the context of chronic pain. METHODS: Current status including an assessment of barriers to effective treatment in Finland, Denmark, Iceland, Norway, Sweden was defined using a patient pathway model. Evidence to describe best practice was identified from published literature, clinical guidelines and expert recommendations from practice experience. RESULTS: Availability of national treatment guidelines for OUD related to chronic pain is limited across the Nordics. Important barriers to effective care identified: patients unlikely to present for help, healthcare system set up limits success, diagnosis tools not used, referral pathways unclear and treatment choices not elucidated. Principles include the development of a specific treatment pathway, awareness/ education programs for teams in primary care, guidance on use of diagnostic tools and a flexible treatment plan to encourage best practice in referral, treatment assessment, choice and ongoing management via an integrated care pathway. Healthcare systems and registries in Nordic countries offer an opportunity to further research and identify population risks and solutions. CONCLUSIONS: There is an opportunity to improve outcomes for patients with OUD related to chronic pain by developing and introducing care pathways tailored to specific needs of the population.
Topic(s):
Opioids & Substance Use
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7746
Principles of the patient-centered medical home and preventive services delivery
Type: Journal Article
Year: 2010
Publication Place: United States
Abstract: PURPOSE: Limited research exists examining the principles of the patient-centered medical home (PCMH) and improved outcomes. We examined whether PCMH principles (personal physician, physician-directed team, whole-person orientation, coordination of care, quality and safety, and enhanced access) are associated with receipt of preventive services. METHODS: We undertook cross-sectional analyses using baseline patient and practice member surveys and chart audits from a quality improvement trial in 24 primary care offices. Association of PCMH principles with preventive services (receipt of cancer screening, lipid screening, influenza vaccination, and behavioral counseling) was examined using hierarchical linear modeling. RESULTS: Higher global PCMH scores were associated with receipt of preventive services (beta = 2.3; P <.001). Positive associations were found with principles of personal physician (beta = 3.7; P <.001), in particular, continuity with the same physician (beta = 4.4; P = .002) and number of visits within 2 years (15% higher for patients with 13 or more visits; P <.001); and whole-person orientation (beta = 5.6; P <.001), particularly, having a well-visit within 5 years (beta = 12.3; P <.001) and being treated for chronic diseases (6% higher if more than 3 chronic diseases; P = .002). Having referral systems to link patients to community programs for preventive counseling (beta = 8.0; P <.001) and use of clinical decision-support tools (beta = 5.0; P = .04) were also associated with receipt of preventive services. CONCLUSIONS: Relationship-centered aspects of PCMH are more highly correlated with preventive services delivery in community primary care practices than are information technology capabilities. Demonstration projects and tools that measure PCMH principles should have greater emphasis on these key primary care attributes.
Topic(s):
Medical Home
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Reference Links: View the PubMed citation for Principles of the patient-centered medical home and preventive services delivery
7750
Prioritization of evidence-based preventive health services during periodic health examinations
Type: Journal Article
Year: 2012
Publication Place: Netherlands
Topic(s):
Education & Workforce
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Reference Links:
View the DOI record for Prioritization of evidence-based preventive health services during periodic health examinations
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View the PubMed citation for Prioritization of evidence-based preventive health services during periodic health examinations7751
Priority mental health disorders of children and adolescents in primary-care pediatric setting in India 1: developing a child and adolescent mental health policy, program, and service model
Type: Journal Article
Year: 2012
Publication Place: India
Abstract: India has a huge child and adolescent population. Psychiatric disorders are widely prevalent and the mental health needs of these children are well recognized. Nonetheless, there are no country-centric and child specific mental health policies, plans or programs. There is also a significant lack of human resources for child and adolescent mental health in India. This combination of factors makes the primary care a critical setting for the early identification, treatment, consultation and referral of children and adolescents with mental health and developmental needs. Even though the importance of primary care as a system for addressing the mental health care has been recognized for decades, its potential requires further development in India as the Child and Adolescent Mental Health Services (CAMHS) emerge and evolve. A country and child specific mental health policy, plan and program needs to be formulated as well an integrated, multi-tier CAMHS with a focus on the primary-care physicians as care providers for this population has to be developed.
Topic(s):
Healthcare Disparities
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7752
Priority mental health disorders of children and adolescents in primary-care pediatric settings in India 3: psychotherapy and other non-pharmacological interventions
Type: Journal Article
Year: 2012
Publication Place: India
Abstract: The pediatrician is a primary column of support for children and adolescents with a myriad of mental health problems in low-mental health care resource countries like India. While majority of mental health consultations happen in primary-care, and only 10% are referred successfully for specialised help, there is a clear role for pediatrician psychotherapists in primary care. The primary-care pediatricians should be aware of the indications for psychotherapy, the various approaches that could be used in primary-care settings, the structure and the process of the psychotherapeutic technique involved, the suggested specific techniques for the Priority Mental Health Disorders and the evidence available to support their use as well as the developmental modifications that are required based on the cognitive development of the child or adolescent.
Topic(s):
Education & Workforce
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7753
Priority mental health disorders of children and adolescents in primary-care pediatric settings in India 4: training and capacity building
Type: Journal Article
Year: 2012
Publication Place: India
Abstract: Training in the primary-care child and adolescent mental health should take into consideration the local milieu, national health care education and development. It should aim to improve the mental health knowledge, competency as well as develop professional relationships between various primary, secondary and tertiary-care mental health providers to enhance outcomes. The collaborative training between the various stakeholders in the Child and Adolescent Mental Health (CAMH) should be enhanced. Currently, the favoured methods, to augment the training for practicing Primary-care Physicians, like CME and short training programs with their specific goals, settings and methodology are well documented. However, to improve the skills in CAMH for medical trainees at undergraduate and postgraduate levels, restructuring of the curriculum is essential.
Topic(s):
Education & Workforce
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7754
PRISM-E: comparison of integrated care and enhanced specialty referral in managing at-risk alcohol use
Type: Journal Article
Year: 2006
Topic(s):
Opioids & Substance Use
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Reference Links:
View the DOI record for PRISM-E: comparison of integrated care and enhanced specialty referral in managing at-risk alcohol use
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View the PubMed citation for PRISM-E: comparison of integrated care and enhanced specialty referral in managing at-risk alcohol use7755
PRISM-E: comparison of integrated care and enhanced specialty referral models in depression outcomes
Type: Journal Article
Year: 2006
Topic(s):
Key & Foundational
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, Opioids & Substance Use
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Reference Links:
View the DOI record for PRISM-E: comparison of integrated care and enhanced specialty referral models in depression outcomes
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View the PubMed citation for PRISM-E: comparison of integrated care and enhanced specialty referral models in depression outcomes7758
Problem recognition and treatment beliefs relate to mental health utilization among veteran primary care patients
Type: Journal Article
Year: 2019
Publication Place: United States
Topic(s):
Measures
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Reference Links:
View the DOI record for Problem recognition and treatment beliefs relate to mental health utilization among veteran primary care patients
View DOI Record
View the PubMed citation for Problem recognition and treatment beliefs relate to mental health utilization among veteran primary care patients7759
Problem-solving therapy for depression and common mental disorders in Zimbabwe: piloting a task-shifting primary mental health care intervention in a population with a high prevalence of people living with HIV
Type: Journal Article
Year: 2011
Publication Place: England
Abstract: BACKGROUND: There is limited evidence that interventions for depression and other common mental disorders (CMD) can be integrated sustainably into primary health care in Africa. We aimed to pilot a low-cost multi-component 'Friendship Bench Intervention' for CMD, locally adapted from problem-solving therapy and delivered by trained and supervised female lay workers to learn if was feasible and possibly effective as well as how best to implement it on a larger scale. METHOD: We trained lay workers for 8 days in screening and monitoring CMD and in delivering the intervention. Ten lay workers screened consecutive adult attenders who either were referred or self-referred to the Friendship Bench between July and December 2007. Those scoring above the validated cut-point of the Shona Symptom Questionnaire (SSQ) for CMD were potentially eligible. Exclusions were suicide risk or very severe depression. All others were offered 6 sessions of problem-solving therapy (PST) enhanced with a component of activity scheduling. Weekly nurse-led group supervision and monthly supervision from a mental health specialist were provided. Data on SSQ scores at 6 weeks after entering the study were collected by an independent research nurse. Lay workers completed a brief evaluation on their experiences of delivering the intervention. RESULTS: Of 395 potentially eligible, 33 (8%) were excluded due to high risk. Of the 362 left, 2% (7) declined and 10% (35) were lost to follow-up leaving an 88% response rate (n = 320). Over half (n = 166, 52%) had presented with an HIV-related problem. Mean SSQ score fell from 11.3 (sd 1.4) before treatment to 6.5 (sd 2.4) after 3-6 sessions. The drop in SSQ scores was proportional to the number of sessions attended. Nine of the ten lay workers rated themselves as very able to deliver the PST intervention. CONCLUSION: We have found preliminary evidence of a clinically meaningful improvement in CMD associated with locally adapted problem-solving therapy delivered by lay health workers through routine primary health care in an African setting. There is a need to test the effectiveness of this task-shifting mental health intervention in an appropriately powered randomised controlled trial. TRIAL REGISTRATION: ISRCTN: ISRCTN25476759.
Topic(s):
Healthcare Disparities
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