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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).
12262 Results
822
Accuracy of diagnosing depression in primary care: the impact of chronic somatic and psychiatric co-morbidity
Type: Journal Article
Year: 2005
Publication Place: England
Abstract: BACKGROUND: Depression is highly co-morbid with both psychiatric and chronic somatic disease. These types of co-morbidity have been shown to exert opposite effects on underdiagnosis of depression by general practitioners (GPs). However, past research has not addressed their combined effect on underdiagnosis of depression. METHOD: Co-morbidity data on 191 depressed primary-care patients selected by a two-stage sampling procedure were analysed. Diagnoses of major depression and/or dysthymia in the last 12 months were assessed using a standardized psychiatric interview (CIDI) and compared with depression diagnoses registered by GPs in patient contacts during the same period. Presence of psychiatric and chronic somatic co-morbidity was determined using the CIDI and contact registration, respectively. RESULTS: Regression analysis showed a significant interaction effect between psychiatric and chronic somatic co-morbidity on GPs' diagnosis of depression, while taking into account the effects of sociodemographic variables, depression severity and number of GP contacts. Subsequent stratified analysis revealed that in patients without chronic somatic co-morbidity, a lower educational level, a less severe depression, and fewer GP contacts all significantly increased the likelihood of not being diagnosed as depressed. In contrast, in patients with chronic somatic co-morbidity, only having no psychiatric co-morbidity significantly decreased the likelihood of receiving a depression diagnosis. CONCLUSIONS: Our results indicate that the effects of psychiatric co-morbidity and other factors on underdiagnosis of depression by GPs differ between depressed patients with and without chronic somatic co-morbidity. Efforts to improve depression diagnosis by GPs seem to require different strategies for depressed patients with and without chronic somatic co-morbidity.
Topic(s):
Medically Unexplained Symptoms
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Reference Links: View the PubMed citation for Accuracy of diagnosing depression in primary care: the impact of chronic somatic and psychiatric co-morbidity
823
Accuracy of electronic patient record registration in chronic psychosis--a case study of a group practice
Type: Journal Article
Year: 2003
Publication Place: Netherlands
Topic(s):
HIT & Telehealth
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Reference Links: View the PubMed citation for Accuracy of electronic patient record registration in chronic psychosis--a case study of a group practice
824
Accuracy of Electronically Reported "Meaningful Use" Clinical Quality Measures: A Cross-sectional Study
Type: Journal Article
Year: 2013
Publication Place: United States
Abstract: Chinese translation BACKGROUND: The federal Electronic Health Record Incentive Program requires electronic reporting of quality from electronic health records, beginning in 2014. Whether electronic reports of quality are accurate is unclear. OBJECTIVE: To measure the accuracy of electronic reporting compared with manual review. DESIGN: Cross-sectional study. SETTING: A federally qualified health center with a commercially available electronic health record. PATIENTS: All adult patients eligible in 2008 for 12 quality measures (using 8 unique denominators) were identified electronically. One hundred fifty patients were randomly sampled per denominator, yielding 1154 unique patients. MEASUREMENTS: Receipt of recommended care, assessed by both electronic reporting and manual review. Sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, and absolute rates of recommended care were measured. RESULTS: Sensitivity of electronic reporting ranged from 46% to 98% per measure. Specificity ranged from 62% to 97%, positive predictive value from 57% to 97%, and negative predictive value from 32% to 99%. Positive likelihood ratios ranged from 2.34 to 24.25 and negative likelihood ratios from 0.02 to 0.61. Differences between electronic reporting and manual review were statistically significant for 3 measures: Electronic reporting underestimated the absolute rate of recommended care for 2 measures (appropriate asthma medication [38% vs. 77%; P < 0.001] and pneumococcal vaccination [27% vs. 48%; P < 0.001]) and overestimated care for 1 measure (cholesterol control in patients with diabetes [57% vs. 37%; P = 0.001]). LIMITATION: This study addresses the accuracy of the measure numerator only. CONCLUSION: Wide measure-by-measure variation in accuracy threatens the validity of electronic reporting. If variation is not addressed, financial incentives intended to reward high quality may not be given to the highest-quality providers. PRIMARY FUNDING SOURCE: Agency for Healthcare Research and Quality.
Topic(s):
HIT & Telehealth
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Reference Links:
View the DOI record for Accuracy of Electronically Reported "Meaningful Use" Clinical Quality Measures: A Cross-sectional Study
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View the PubMed citation for Accuracy of Electronically Reported "Meaningful Use" Clinical Quality Measures: A Cross-sectional Study826
Accuracy of Primary Care Medical Home Designation in a Specialty Mental Health Clinic
Type: Journal Article
Year: 2020
Publication Place: United States
Abstract:
To assess whether primary care medical homes (PCMHs) are accurately identified for patients receiving care in a specialty mental health clinic within an integrated public delivery system. This study reviewed the electronic records of patients in a large urban mental health clinic. The study defined 'matching PCMH' if the same primary care clinic was listed in both the mental health and medical electronic records. This study designated all others as 'PCMH unknown.' This study assessed whether demographic factors predicted PCMH status using chi-square tests. Among 229 patients (66% male; mean age 49; 36% White, 30% Black, and 17% Asian), 72% had a matching PCMH. Sex, age, race, psychiatric diagnosis, and psychotropic medication use were not associated with matching PCMH. To improve care coordination and health outcomes for people with severe mental illness, greater efforts are needed to ensure the accurate designation of PCMHs in all mental health patient electronic records.
Topic(s):
Healthcare Disparities
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, Medical Home
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Reference Links:
View the DOI record for Accuracy of Primary Care Medical Home Designation in a Specialty Mental Health Clinic
View DOI Record
View the PubMed citation for Accuracy of Primary Care Medical Home Designation in a Specialty Mental Health Clinic827
Accuracy of Primary Care Medical Home Designation in a Specialty Mental Health Clinic
Type: Journal Article
Year: 2021
Abstract:
To assess whether primary care medical homes (PCMHs) are accurately identified for patients receiving care in a specialty mental health clinic within an integrated public delivery system. This study reviewed the electronic records of patients in a large urban mental health clinic. The study defined 'matching PCMH' if the same primary care clinic was listed in both the mental health and medical electronic records. This study designated all others as 'PCMH unknown.' This study assessed whether demographic factors predicted PCMH status using chi-square tests. Among 229 patients (66% male; mean age 49; 36% White, 30% Black, and 17% Asian), 72% had a matching PCMH. Sex, age, race, psychiatric diagnosis, and psychotropic medication use were not associated with matching PCMH. To improve care coordination and health outcomes for people with severe mental illness, greater efforts are needed to ensure the accurate designation of PCMHs in all mental health patient electronic records.
Topic(s):
Healthcare Disparities
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, Medical Home
See topic collection
Reference Links:
View the DOI record for Accuracy of Primary Care Medical Home Designation in a Specialty Mental Health Clinic
View DOI Record
View the PubMed citation for Accuracy of Primary Care Medical Home Designation in a Specialty Mental Health Clinic828
Accuracy of referring psychiatric diagnosis on a consultation-liaison service
Type: Journal Article
Year: 2003
Publication Place: United States
Abstract: The authors determined the accuracy of the initial psychiatric diagnosis of primary medical providers requesting psychiatric consultation in a general medical inpatient setting. A retrospective review of 346 consecutive psychiatric consultations was conducted in which the initial diagnostic impression of primary medical providers was compared with the final psychiatric diagnosis. Accuracy rates for cognitive disorders, substance use disorders, and depressive disorders were 100%, 88.9%, and 53.6%, respectively. Thus, initial diagnoses of a cognitive or substance use disorder by primary medical providers are likely to be accurate, whereas an initial diagnosis of a depressive disorder will be inaccurate in approximately half of the cases.
Topic(s):
Medically Unexplained Symptoms
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Reference Links: View the PubMed citation for Accuracy of referring psychiatric diagnosis on a consultation-liaison service
832
Achieving cost control, care coordination, and quality improvement through incremental payment system reform
Type: Journal Article
Year: 2010
Publication Place: United States
Abstract: The healthcare reform goal of increasing eligibility and coverage cannot be realized without simultaneously achieving control over healthcare costs. The reform of existing payment systems can provide the financial incentive for providers to deliver care in a more coordinated and efficient manner with minimal changes to existing payer and provider infrastructure. Pay for performance, best practice pricing, price discounting, alignment of incentives, the medical home, payment by episodes, and provider performance reports are a set of payment reforms that can result in lower costs, better coordination of care, improved quality of care, and increased consumer involvement. These reforms can produce immediate Medicare annual savings of $10 billion and create the framework for future savings by establishing financial incentives for long-term provider behavior changes that can lead to lower costs.
Topic(s):
Financing & Sustainability
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, Healthcare Policy
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Reference Links:
View the DOI record for Achieving cost control, care coordination, and quality improvement through incremental payment system reform
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View the PubMed citation for Achieving cost control, care coordination, and quality improvement through incremental payment system reform833
Achieving same-day access in integrated primary care
Type: Journal Article
Year: 2018
Publication Place: United States
Topic(s):
General Literature
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835
Achieving the promise through workforce transformation: A view from the Center for Mental Health Services
Type: Journal Article
Year: 2005
Publication Place: United States
Topic(s):
Education & Workforce
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Reference Links: View the PubMed citation for Achieving the promise through workforce transformation: A view from the Center for Mental Health Services
837
Achieving universal health coverage for mental disorders
Type: Journal Article
Year: 2019
Publication Place: England
Topic(s):
Financing & Sustainability
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, Healthcare Disparities
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Reference Links: View the PubMed citation for Achieving universal health coverage for mental disorders
839
ACOG Committee Opinion No. 524: Opioid abuse, dependence, and addiction in pregnancy
Type: Journal Article
Year: 2012
Publication Place: United States
Abstract: Opioid use in pregnancy is not uncommon, and the use of illicit opioids during pregnancy is associated with an increased risk of adverse outcomes. The current standard of care for pregnant women with opioid dependence is referral for opioid-assisted therapy with methadone, but emerging evidence suggests that buprenorphine also should be considered. Medically supervised tapered doses of opioids during pregnancy often result in relapse to former use. Abrupt discontinuation of opioids in an opioid-dependent pregnant woman can result in preterm labor, fetal distress, or fetal demise. During the intrapartum and postpartum period, special considerations are needed for women who are opioid dependent to ensure appropriate pain management, to prevent postpartum relapse and a risk of overdose, and to ensure adequate contraception to prevent unintended pregnancies. Patient stabilization with opioid-assisted therapy is compatible with breastfeeding. Neonatal abstinence syndrome is an expected and treatable condition that follows prenatal exposure to opioid agonists.
Topic(s):
Opioids & Substance Use
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Reference Links:
View the DOI record for ACOG Committee Opinion No. 524: Opioid abuse, dependence, and addiction in pregnancy
View DOI Record
View the PubMed citation for ACOG Committee Opinion No. 524: Opioid abuse, dependence, and addiction in pregnancy