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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).
11269 Results
7881
Primary Care Behavioral Health Training in Family Medicine Residencies: A Qualitative Study From a Large Health Care System
Type: Journal Article
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.
Topic(s):
Education & Workforce
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7884
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
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.
Topic(s):
Healthcare Disparities
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, Opioids & Substance Use
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7885
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
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).
Topic(s):
Healthcare Disparities
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, Opioids & Substance Use
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7886
Primary Care Clinic Re-Design for Prescription Opioid Management
Type: Journal Article
Year: 2017
Publication Place: United States
Topic(s):
Opioids & Substance Use
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Reference Links: 
View the DOI record for Primary Care Clinic Re-Design for Prescription Opioid Management
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View the PubMed citation for Primary Care Clinic Re-Design for Prescription Opioid Management7888
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
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.
Topic(s):
Education & Workforce
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, Key & Foundational
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7892
PRimary carE digital Support ToOl in mental health (PRESTO): Design, development and study protocols
Type: Journal Article
Year: 2021
Topic(s):
HIT & Telehealth
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Reference Links:
View the DOI record for PRimary carE digital Support ToOl in mental health (PRESTO): Design, development and study protocols
View DOI Record
View the PubMed citation for PRimary carE digital Support ToOl in mental health (PRESTO): Design, development and study protocols7893
Primary care doctors should not screen their patients for depression
Type: Journal Article
Year: 2017
Publication Place: England
Topic(s):
Education & Workforce
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Reference Links:
View the DOI record for Primary care doctors should not screen their patients for depression
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View the PubMed citation for Primary care doctors should not screen their patients for depression7894
Primary Care Engagement Among Individuals with Experiences of Homelessness and Serious Mental Illness: an Evidence Map
Type: Journal Article
Year: 2022
Topic(s):
Healthcare Disparities
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Reference Links:
View the DOI record for Primary Care Engagement Among Individuals with Experiences of Homelessness and Serious Mental Illness: an Evidence Map
View DOI Record
View the PubMed citation for Primary Care Engagement Among Individuals with Experiences of Homelessness and Serious Mental Illness: an Evidence Map7895
Primary care expenditures before the onset of Alzheimer's disease
Type: Journal Article
Year: 2002
Publication Place: United States
Abstract: OBJECTIVE: To investigate primary care expenditures in the period before diagnosis of AD. METHODS: In a population-based sample of Medicare enrollees in New York City, person-level 1996 Medicare claims, summed over primary care encounters, were examined for people who developed AD in 1997 to 1998 and those who did not. RESULTS: People who developed AD were more likely to use Medicare outpatient and ambulatory care 1 to 2 years before diagnosis. Compared with respondents who did not develop AD, the excess cost for men was $1,167 (85% higher) and for women $239 (26% higher). Among elderly people > or = 75 years in the United States, the prodromal period of AD was associated with an excess Medicare-based primary care cost of $128.5 to $194.7 million. CONCLUSION: In addition to huge costs associated with AD after diagnosis, prediagnosis costs are an unrecognized source of expenditures related to the disease.
Topic(s):
Financing & Sustainability
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Reference Links: View the PubMed citation for Primary care expenditures before the onset of Alzheimer's disease
7896
Primary care experience of people with long-standing psychological problems: evidence from a national survey in England
Type: Journal Article
Year: 2011
Publication Place: England
Abstract: People with psychological problems face important challenges in obtaining high quality healthcare. We review evidence on the experience of primary care by people with mental health problems, including reasons why their care may be reported as worse than other groups. In the 2009 English GP Patient Survey, 5.7% of 2,163,456 respondents reported that they had a long-standing psychological or emotional condition. In an unadjusted regression model, respondents with long-standing emotional or psychological conditions rated their experiences worse than people without such problems, with scores which were up to 3 percentage points lower on individual survey items. However, after controlling for age, gender, ethnicity, deprivation and self-reported general health, people with long-standing psychological or emotional problems had slightly higher scores on 16 out of the 18 survey items, though with the equivalent of less than 2 percentage points difference for most items. Part of the reason for the difference between the adjusted and unadjusted models was the high prevalence of self-reported 'fair' or 'poor' general health among people who reported psychological problems. Overall, the results suggest that people with long-standing psychological and emotional conditions have similar experiences of English primary care compared to the rest of the population.
Topic(s):
General Literature
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Reference Links:
View the DOI record for Primary care experience of people with long-standing psychological problems: evidence from a national survey in England
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View the PubMed citation for Primary care experience of people with long-standing psychological problems: evidence from a national survey in England7897
Primary care experiences of veterans with opioid use disorder in the Veterans Health Administration
Type: Journal Article
Year: 2020
Topic(s):
Education & Workforce
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, Healthcare Disparities
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, Opioids & Substance Use
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Reference Links:
View the DOI record for Primary care experiences of veterans with opioid use disorder in the Veterans Health Administration
View DOI Record
View the PubMed citation for Primary care experiences of veterans with opioid use disorder in the Veterans Health Administration7898
Primary care for deaf people with mental health problems
Type: Journal Article
Year: 2014
Publication Place: England
Abstract: There are approximately 10 million people in the UK who have some form of hearing loss, and the prevalence of mental health problems among deaf people appears to be significantly higher compared with the wider population. Deaf people find it harder to establish good relationships with health professionals and, sadly, many of the issues arise from discrimination and practical obstacles faced within the healthcare system. Some of these issues include a lack of awareness, funding, and prioritisation within the wider political and healthcare agenda. This article provides an overview of the background of hearing loss and mental ill health, policy and current access to mental health services for deaf people, what has changed and recommendations for the future.
Topic(s):
Healthcare Disparities
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Reference Links: View the PubMed citation for Primary care for deaf people with mental health problems
7899
Primary care for patient complexity, not only disease
Type: Journal Article
Year: 2009
Abstract: Primary care is increasingly geared toward standardized care and decision-making for common chronic conditions, combinations of medical and mental health conditions, and the behavioral aspects of care for those conditions. Yet even with well-integrated team-based care for health conditions in place, some patients do not engage or respond as well as clinicians would wish or predict. This troubles patients and clinicians alike and is often chalked up informally to "patient complexity." Indeed, every clinician has encountered complex patients and reacted with "Oh my gosh"-but not necessarily with a patterned vocabulary for exactly how the patient is complex and what to do about it. Based on work in the Netherlands, patient complexity is defined here as interference with standard care and decision-making by symptom severity or impairments, diagnostic uncertainty, difficulty engaging care, lack of social safety or participation, disorganization of care, and difficult patient-clinician relationships. A blueprint for patient-centered medical home must address patient complexity by promoting the interplay of usual care for conditions and individualized attention to patient-specific sources of complexity-across whatever diseases and conditions the patient may have.
Topic(s):
Medical Home
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7900
Primary Care for Persons Who Inject Drugs
Type: Journal Article
Year: 2019
Publication Place: United States
Abstract: More than 750,000 persons in the United States inject opioids, methamphetamine, cocaine, or ketamine, and that number is increasing because of the current opioid epidemic. Persons who inject drugs (PWID) are at higher risk of infectious and noninfectious skin, pulmonary, cardiac, neurologic, and other causes of morbidity and mortality. Nonjudgmental inquiries about current drug use can uncover information about readiness for addiction treatment and identify modifiable risk factors for complications of injection drug use. All PWID should be screened for human immunodeficiency virus infection, latent tuberculosis, and hepatitis B and C, and receive vaccinations for hepatitis A and B, tetanus, and pneumonia if indicated. Pre-exposure prophylaxis for human immunodeficiency virus infection should also be offered. Naloxone should be prescribed to those at risk of opioid overdose. Skin and soft tissue infections are the most common medical complication in PWID and the top reason for hospitalization in these patients. Signs of systemic infection require hospitalization, blood cultures, and a comprehensive history and physical examination to determine the source of infection. PWID have a higher incidence of community-acquired pneumonia and are at risk of other pulmonary complications, including opioid-associated pulmonary edema, asthma, and foreign body granulomatosis. Infectious endocarditis is the most common cardiac complication associated with injection drug use and more often involves the right-sided heart valves, which may not present with heart murmurs or peripheral signs and symptoms, in PWID. Injections increase the risk of osteomyelitis, as well as subdural and epidural abscesses.
Topic(s):
Opioids & Substance Use
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