Literature Collection

7861

Primary Care Behavioral Health Integration and Care Utilization: Implications for Patient Outcome and Healthcare Resource Use

Type: Journal Article

Authors: Daniel D. Maeng, Ellen Poleshuck, Tziporah Rosenberg, Amie Kulak, Thomas Mahoney, George Nasra, Hochang B. Lee, Yue Li

Year: 2022

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7862

Primary Care Behavioral Health Integration for Anxiety Management in a Safety-Net Health Care System

Type: Journal Article

Authors: Ranjani K. Paradise, Karen E. Finnegan, Blessing Dube, Leah Zallman, Emily Benedetto, Ellie Grossman, Hsiang Huang, Colleen O'Brien, Robert C. Joseph

Year: 2020

Publication Place: Baltimore

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7863

Primary Care Behavioral Health Integration: Promoting the Quadruple Aim

Type: Journal Article

Authors: E. Christian, V. Krall, S. Hulkower, S. Stigleman

Year: 2018

Publication Place: United States

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7864

Primary care behavioral health patients' stage of change: Correlates and relation to follow-up session attendance

Type: Journal Article

Authors: A. J. Bridges, A. R. Mapes, M. Scafe, L. E. Guzman

Year: 2022

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7865

Primary Care Behavioral Health Provider Training: Systematic Development and Implementation in a Large Medical System

Type: Journal Article

Authors: A. C. Dobmeyer, C. L. Hunter, M. L. Corso, M. K. Nielsen, K. A. Corso, N. C. Polizzi, J. E. Earles

Year: 2016

Publication Place: United States

Abstract: The expansion of integrated, collaborative, behavioral health services in primary care requires a trained behavioral health workforce with specific competencies to deliver effective, evidence-informed, team-based care. Most behavioral health providers do not have training or experience working as primary care behavioral health consultants (BHCs), and require structured training to function effectively in this role. This article discusses one such training program developed to meet the needs of a large healthcare system initiating widespread implementation of the primary care behavioral health model of service delivery. It details the Department of Defense's experience in developing its extensive BHC training program, including challenges of addressing personnel selection and hiring issues, selecting a model for training, developing and implementing a phased training curriculum, and improving the training over time to address identified gaps. Future directions for training improvements and lessons learned in a large healthcare system are discussed.

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7866

Primary care behavioral health toolkit

Type: Report

Authors: Mountainview Consulting Group, Patient-Centered Primary Care Institute

Year: 2013

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, ,

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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.

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7867

Primary Care Behavioral Health Training in Family Medicine Residencies: A Qualitative Study From a Large Health Care System

Type: Journal Article

Authors: R. R. Landoll, R. M. Cervero, J. D. Quinlan, L. A. Maggio

Year: 2020

Publication Place: United States

Abstract: BACKGROUND AND OBJECTIVES: Primary care behavioral health (PCBH) is a service delivery model of integrated care linked to a wide variety of positive patient and system outcomes. However, considerable challenges with provider training and attrition exist. While training for nonphysician behavioral scientists is well established, little is known about how to train physicians to work efficiently within integrated teams. METHODS: We conducted a case study analysis of family medicine residencies in the military health system using a series of 30 to 45-minute semistructured interviews. We conducted qualitative template analysis of these cases to chart programs' current educational processes related to PCBH. Thirteen individuals consisting of program directors, behavioral and nonbehavioral faculty, and residents across five programs participated in the study. RESULTS: Current educational processes included a variety of content on PCBH (eg, treatment for depression, clinical referral pathways, patient-centered communication), primarily using a mix of didactic and practice-based placements. Resource allocation was seen as a critical contributor to quality. There was variability in the degree to which integrated behavioral health providers were incorporated as residency faculty, such that programs where these specialists were more incorporated reported more intentional curriculum development and health care systems-level content. CONCLUSIONS: While behavioral health content was well represented in family medicine residency curriculum, the depth and integration of content was inconsistent. More intentional and integrated curriculum accompanied faculty development and integration of behavioral health faculty. Future research should evaluate if faculty development programs and faculty status of behavioral scientists results in different educational or health care outcomes.

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7868

Primary Care Behavioral Health Training in Family Medicine Residencies: A Qualitative Study From a Large Health Care System

Type: Journal Article

Authors: R. R. Landoll, R. M. Cervero, J. D. Quinlan, L. A. Maggio

Year: 2020

Publication Place: United States

Abstract: BACKGROUND AND OBJECTIVES: Primary care behavioral health (PCBH) is a service delivery model of integrated care linked to a wide variety of positive patient and system outcomes. However, considerable challenges with provider training and attrition exist. While training for nonphysician behavioral scientists is well established, little is known about how to train physicians to work efficiently within integrated teams. METHODS: We conducted a case study analysis of family medicine residencies in the military health system using a series of 30 to 45-minute semistructured interviews. We conducted qualitative template analysis of these cases to chart programs' current educational processes related to PCBH. Thirteen individuals consisting of program directors, behavioral and nonbehavioral faculty, and residents across five programs participated in the study. RESULTS: Current educational processes included a variety of content on PCBH (eg, treatment for depression, clinical referral pathways, patient-centered communication), primarily using a mix of didactic and practice-based placements. Resource allocation was seen as a critical contributor to quality. There was variability in the degree to which integrated behavioral health providers were incorporated as residency faculty, such that programs where these specialists were more incorporated reported more intentional curriculum development and health care systems-level content. CONCLUSIONS: While behavioral health content was well represented in family medicine residency curriculum, the depth and integration of content was inconsistent. More intentional and integrated curriculum accompanied faculty development and integration of behavioral health faculty. Future research should evaluate if faculty development programs and faculty status of behavioral scientists results in different educational or health care outcomes.

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7869

Primary care behavioral health: Ethical issues in military settings.

Type: Journal Article

Authors: Anne C. Dobmeyer

Year: 2013

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7870

Primary care behavioral interventions to prevent or reduce illicit drug and nonmedical pharmaceutical use in children and adolescents: A systematic evidence review for the U.S. Preventive Services Task Force

Type: Government Report

Authors: Carrie D. Patnode, United States

Year: 2014

Publication Place: Rockville, MD

Abstract: Drug use in youth is associated with multiple negative health and social consequences. Even infrequent use increases one's risk of serious adverse events due to an increase in risk-taking behaviors while intoxicated or impaired. Primary care could play a role in helping to prevent and reduce drug use in children and adolescents. PURPOSE: To systematically review the evidence on the benefits and harms of primary care-relevant interventions designed to reduce illicit drug use or the nonmedical use of prescription drugs in children and adolescents. METHODS: We searched PubMed, PsycINFO, and the Cochrane Collaboration Registry of Controlled Trials to identify relevant literature published between January 1992 and June 4, 2013 and MEDLINE through August 31, 2013. We also examined the references from other relevant reviews and included studies. Two investigators independently reviewed all titles/abstracts and full-text articles against a set of predetermined inclusion and quality criteria. One reviewer abstracted data into a standard evidence table and a second reviewer checked the data for completeness and accuracy. We qualitatively synthesized the results for the three Key Questions and grouped the included studies by intervention type (primary care-based vs. primary care-relevant computer-based interventions conducted outside of primary care). RESULTS: We included six studies reported in seven publications. Four of the six trials examined the effect of the intervention on a health outcome. One study found no effects of either a therapist-led or computer-based brief intervention on marijuana use consequences or driving under the influence of marijuana. Only one of the three computer-based interventions that reported depression outcomes found greater improvement in the intervention group compared with the control group at 6 months only. All six trials reported a drug use outcome. Four of the five studies assessing self-reported marijuana use found statistically significant differences in favor of the intervention group compared with the control group. All three computer-based trials also reported differences in nonmedical prescription drug use occasions. Individual studies reported additional substance use outcomes with mixed results. CONCLUSIONS: There is inadequate evidence on the benefits of primary care-relevant behavioral interventions in reducing self-reported illicit and pharmaceutical drug use in adolescents.

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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.

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7871

Primary care behavioral interventions to prevent or reduce illicit drug use and nonmedical pharmaceutical use in children and adolescents: a systematic evidence review for the U.S. Preventive services task force

Type: Journal Article

Authors: C. D. Patnode, E. O'Connor, M. Rowland, B. U. Burda, L. A. Perdue, E. P. Whitlock

Year: 2014

Publication Place: United States

Abstract: BACKGROUND: Drug use among youths is associated with negative health and social consequences. Even infrequent use increases the risk for serious adverse events by increasing risk-taking behaviors in intoxicated or impaired persons. PURPOSE: To systematically review the benefits and harms of primary care-relevant interventions designed to prevent or reduce illicit drug use or the nonmedical use of prescription drugs among youths. DATA SOURCES: PubMed, PsycINFO, and the Cochrane Central Register of Controlled Trials through 4 June 2013; MEDLINE through 31 August 2013; and manual searches of reference lists and gray literature. STUDY SELECTION: Two investigators independently reviewed 2253 abstracts and 144 full-text articles. English-language trials of primary care-relevant behavioral interventions that reported drug use, health outcomes, or harms were included. DATA EXTRACTION: One investigator abstracted data from good- and fair-quality trials into prespecified evidence tables, and a second investigator checked these data. DATA SYNTHESIS: Six trials were included, 4 of which examined the effect of the intervention on a health or social outcome. One trial found no effect of the intervention on marijuana-related consequences or driving under the influence of marijuana; 3 trials generally found no reduction in depressed mood at 12 or 24 months. Four of the 5 trials assessing self-reported marijuana use found statistically significant differences favoring the intervention group participants (such as a between-group difference of 0.10 to 0.17 use occasions in the past month). Three trials also reported positive outcomes in nonmedical prescription drug use occasions. LIMITATIONS: The body of evidence was small, and there were heterogeneous measures of outcomes of limited clinical applicability. Trials primarily included adolescents with little or no substance use. CONCLUSION: Evidence is inadequate on the benefits of primary care-relevant behavioral interventions in reducing self-reported illicit and pharmaceutical drug use among adolescents. PRIMARY FUNDING SOURCE: Agency for Healthcare Research and Quality.

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7872

Primary care behavioral interventions to reduce illicit drug and nonmedical pharmaceutical use in children and adolescents: U.S. Preventive services task force recommendation statement

Type: Journal Article

Authors: V. A. Moyer, U.S. Preventive Services Task Force

Year: 2014

Publication Place: United States

Abstract: DESCRIPTION: Update of the 2008 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for illicit drug use. METHODS: The USPSTF reviewed the evidence on interventions to help adolescents who have never used drugs to remain abstinent and interventions to help adolescents who are using drugs but do not meet criteria for a substance use disorder to reduce or stop their use. POPULATION: This recommendation applies to children and adolescents younger than age 18 years who have not been diagnosed with a substance use disorder. RECOMMENDATION: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of primary care-based behavioral interventions to prevent or reduce illicit drug or nonmedical pharmaceutical use in children and adolescents. (I statement).

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7873

Primary Care Clinic Re-Design for Prescription Opioid Management

Type: Journal Article

Authors: M. L. Parchman, M. Von Korff, L. M. Baldwin, M. Stephens, B. Ike, D. Cromp, C. Hsu, E. H. Wagner

Year: 2017

Publication Place: United States

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7874

Primary care clinician responses to positive suicidal ideation risk assessments in veterans of Iraq and Afghanistan

Type: Journal Article

Authors: Steven K. Dobscha, Lauren M. Denneson, Anne E. Kovas, Kathryn Corson, Drew A. Helmer, Matthew J. Bair

Year: 2014

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7875

Primary care clinicians evaluate integrated and referral models of behavioral health care for older adults: Results from a multisite effectiveness trial (PRISM-e)

Type: Journal Article

Authors: J. J. Gallo, C. Zubritsky, J. Maxwell, M. Nazar, H. R. Bogner, L. M. Quijano, H. J. Syropoulos, K. L. Cheal, H. Chen, H. Sanchez, J. Dodson, S. E. Levkoff, PRISM-E Investigators

Year: 2004

Publication Place: United States

Abstract: BACKGROUND: Recent studies have shown that integrated behavioral health services for older adults in primary care improves health outcomes. No study, however, has asked the opinions of clinicians whose patients actually experienced integrated rather than enhanced referral care for depression and other conditions. METHOD: The Primary Care Research in Substance Abuse and Mental Health for the Elderly (PRISM-E) study was a randomized trial comparing integrated behavioral health care with enhanced referral care in primary care settings across the United States. Primary care clinicians at each participating site were asked whether integrated or enhanced referral care was preferred across a variety of components of care. Managers also completed questionnaires related to the process of care at each site. RESULTS: Almost all primary care clinicians (n = 127) stated that integrated care led to better communication between primary care clinicians and mental health specialists (93%), less stigma for patients (93%), and better coordination of mental and physical care (92%). Fewer thought that integrated care led to better management of depression (64%), anxiety (76%), or alcohol problems (66%). At sites in which the clinicians were rated as participating in mental health care, integrated care was highly rated as improving communication between specialists in mental health and primary care. CONCLUSIONS: Among primary care clinicians who cared for patients that received integrated care or enhanced referral care, integrated care was preferred for many aspects of mental health care.

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7876

Primary care clinicians' recognition and management of depression: A model of depression care in real-world primary care practice.

Type: Journal Article

Authors: Seong-Yi Baik, Benjamin F. Crabtree, Junius J. Gonzales

Year: 2013

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7877

Primary care consultations about medically unexplained symptoms: Patient presentations and doctor responses that influence the probability of somatic intervention

Type: Journal Article

Authors: Peter Salmon, Gerry M. Humphris, Adele Ring, John C. Davies, Christopher F. Dowrick

Year: 2007

Publication Place: US: Lippincott Williams & Wilkins

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7878

Primary care decision making in response to psychological complaints: The influence of patient race

Type: Journal Article

Authors: Antonietta Di Caccavo, Nasreen Fazal-Short, Timothy P. Moss

Year: 2000

Publication Place: United Kingdom

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7879

PRimary carE digital Support ToOl in mental health (PRESTO): Design, development and study protocols

Type: Journal Article

Authors: G. Anmella, M. Primé-Tous, X. Segú, A. Solanes, V. Ruíz, I. Martín-Villalba, I. Morilla, A. Also-Fontanet, E. Sant, S. Murgui, M. Sans-Corrales, A. Murru, R. Zahn, A. H. Young, V. Vicens, C. Viñas-Bardolet, J. F. Martínez-Cerdá, J. Blanch, J. Radua, M. À. Fullana, M. Cavero, E. Vieta, D. Hidalgo-Mazzei

Year: 2021

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7880

Primary care doctors should not screen their patients for depression

Type: Journal Article

Authors: B. D. Thombs, R. C. Ziegelstein

Year: 2017

Publication Place: England

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