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Opioids & SU
The Literature Collection contains over 13,000 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).
13146 Results
8481
Patient outcomes associated with primary care behavioral health services: A systematic review; A recipe for assessing fidelity in family and health systems
Type:
Journal Article
Year:
2019
Publication Place:
United States
Topic(s):
Financing & Sustainability
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, Healthcare Disparities
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8482
Patient outcomes at 26 months in the patient-centered medical home National Demonstration Project
Type:
Journal Article
Year:
2010
Publication Place:
United States
Abstract:
PURPOSE: The purpose of this study was to evaluate patient outcomes in the National Demonstration Project (NDP) of practices' transition to patient-centered medical homes (PCMHs). METHODS: In 2006, a total of 36 family practices were randomized to facilitated or self-directed intervention groups. Progress toward the PCMH was measured by independent assessments of how many of 39 predominantly technological NDP model components the practices adopted. We evaluated 2 types of patient outcomes with repeated cross-sectional surveys and medical record audits at baseline, 9 months, and 26 months: patient-rated outcomes and condition-specific quality of care outcomes. Patient-rated outcomes included core primary care attributes, patient empowerment, general health status, and satisfaction with the service relationship. Condition-specific outcomes were measures of the quality of care from the Ambulatory Care Quality Alliance (ACQA) Starter Set and measures of delivery of clinical preventive services and chronic disease care. RESULTS: Practices adopted substantial numbers of NDP components over 26 months. Facilitated practices adopted more new components on average than self-directed practices (10.7 components vs 7.7 components, P=.005). ACQA scores improved over time in both groups (by 8.3% in the facilitated group and by 9.1% in the self-directed group, P <.0001) as did chronic care scores (by 5.2% in the facilitated group and by 5.0% in the self-directed group, P=.002), with no significant differences between groups. There were no improvements in patient-rated outcomes. Adoption of PCMH components was associated with improved access (standardized beta [Sbeta]=0.32, P = .04) and better prevention scores (Sbeta=0.42, P=.001), ACQA scores (Sbeta=0.45, P = .007), and chronic care scores (Sbeta=0.25, P =.08). CONCLUSIONS: After slightly more than 2 years, implementation of PCMH components, whether by facilitation or practice self-direction, was associated with small improvements in condition-specific quality of care but not patient experience. PCMH models that call for practice change without altering the broader delivery system may not achieve their intended results, at least in the short term.
Topic(s):
Medical Home
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Reference Links:
View the DOI record for Patient outcomes at 26 months in the patient-centered medical home National Demonstration Project
View DOI Record
View the PubMed citation for Patient outcomes at 26 months in the patient-centered medical home National Demonstration Project
8487
Patient perceptions of treatment with medication treatment for opioid use disorder (MOUD) in the Vermont hub-and-spoke system
Type:
Journal Article
Year:
2019
Publication Place:
United States
Topic(s):
Opioids & Substance Use
See topic collection
8489
Patient perspectives of an integrated program of medical care and substance use treatment
Type:
Journal Article
Year:
2014
Publication Place:
United States
Abstract:
The benefits of integrating primary care and substance use disorder treatment are well known, yet true integration is difficult. We developed and evaluated a team-based model of integrated care within the primary care setting for HIV-infected substance users and substance users at risk for contracting HIV. Qualitative data were gathered via focus groups and satisfaction surveys to assess patients' views of the program, evaluate key elements for success, and provide recommendations for other programs. Key themes related to preferences for the convenience and efficiency of integrated care; support for a team-based model of care; a feeling that the program requirements offered needed structure; the importance of counseling and education; and how provision of concrete services improved overall well-being and quality of life. For patients who received buprenorphine/naloxone for opioid dependence, this was viewed as a major benefit. Our results support other studies that theorize integrated care could be of significant value for hard-to-reach populations and indicate that having a clinical team dedicated to providing substance use disorder treatment, HIV risk reduction, and case management services integrated into primary care clinics has the potential to greatly enhance the ability to serve a challenging population with unmet treatment needs.
Topic(s):
General Literature
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Reference Links:
View the DOI record for Patient perspectives of an integrated program of medical care and substance use treatment
View DOI Record
View the PubMed citation for Patient perspectives of an integrated program of medical care and substance use treatment
8493
Patient perspectives on alcohol use disorder pharmacotherapy and integration of treatment into primary care settings
Type:
Journal Article
Year:
2019
Publication Place:
United States
Abstract:
BACKGROUND: Evidence-based pharmacotherapies for alcohol use disorders (AUDs) are underutilized. This mixed-methods study reports supplementary findings from the alcohol use disorder pharmacotherapy and treatment in primary care (ADaPT-PC) implementation study at 3 Veterans Health Administration (VHA) hospital sites to understand why prescription rates did not increase following the ADaPT-PC intervention. METHODS: Qualitative interviews (N = 30) were conducted in advance of the ADaPT-PC intervention to understand patients' pharmacotherapy attitudes among those in AUD treatment, with previous treatment experience, or who needed assistance with their alcohol use. Following the ADaPT-PC intervention, chart reviews from a random sample of patients with AUD or a most recent Alcohol Use Disorders Identification Test consumption questions (AUDIT-C) score >8, and no active AUD prescription, were conducted to determine the frequency of alcohol-related conversations (N = 455). RESULTS: Most interviewed patients welcomed a discussion about their alcohol use and pharmacotherapy. Of the 15 medication-naive patients interviewed, 6 stated that they would be willing to try pharmacotherapy, 5 stated that they were unlikely, 2 identified reservations, 1 said no, and 1 was not asked. Fifteen patients were either currently taking medications (n = 10) or had taken medication in the past (n = 7; 2 patients had past and current experience). Chart reviews indicated that although 66% of charts (n = 299) documented a discussion of their alcohol use with the provider, only 7.5% (n = 22) of individuals with an AUD diagnosis had a documented discussion of AUD pharmacotherapy, and only 5 received pharmacotherapy. CONCLUSION: Most interviewed patients were open to discussing AUD treatment, including discussions of pharmacotherapy, with their provider. From documented conversations about alcohol use to treatment options, medical records suggests a continuous narrowing of the number of patients engaged in alcohol-related consultations. Although some interviewed patients expressed reticence about initiating pharmacotherapy, these findings suggest that the treatment cascade may have a greater influence on the number of pharmacotherapy prescriptions than patients' preferences.
Topic(s):
Opioids & Substance Use
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Reference Links:
View the DOI record for Patient perspectives on alcohol use disorder pharmacotherapy and integration of treatment into primary care settings
View DOI Record
View the PubMed citation for Patient perspectives on alcohol use disorder pharmacotherapy and integration of treatment into primary care settings
8494
Patient perspectives on an opioid overdose education and naloxone distribution program in the U.S. Department of Veterans Affairs
Type:
Journal Article
Year:
2016
Publication Place:
United States
Abstract:
BACKGROUND: In an effort to prevent opioid overdose mortality among Veterans, Department of Veterans Affairs (VA) facilities began implementing opioid overdose education and naloxone distribution (OEND) in 2013 and a national program began in 2014. VA is the first national health care system to implement OEND. The goal of this study is to examine patient perceptions of OEND training and naloxone kits. METHODS: Four focus groups were conducted between December 2014 and February 2015 with 21 patients trained in OEND. Participants were recruited from a VA residential facility in California with a substance use disorder treatment program (mandatory OEND training) and a homeless program (optional OEND training). Data were analyzed using matrices and open and closed coding approaches to identify participants' perspectives on OEND training including benefits, concerns, differing opinions, and suggestions for improvement. RESULTS: Veterans thought OEND training was interesting, novel, and empowering, and that naloxone kits will save lives. Some veterans expressed concern about using syringes in the kits. A few patients who never used opioids were not interested in receiving kits. Veterans had differing opinions about legal and liability issues, whether naloxone kits might contribute to relapse, and whether and how to involve family in training. Some veterans expressed uncertainty about the effects of naloxone. Suggested improvements included active learning approaches, enhanced training materials, and increased advertisement. CONCLUSIONS: OEND training was generally well received among study participants, including those with no indication for a naloxone kit. Patients described a need for OEND and believed it could save lives. Patient feedback on OEND training benefits, concerns, opinions, and suggestions provides important insights to inform future OEND training programs both within VA and in other health care settings. Training is critical to maximizing the potential for OEND to save lives, and this study includes specific suggestions for improving the effectiveness and acceptability of training.
Topic(s):
Opioids & Substance Use
See topic collection
8500
Patient perspectives on the integration of an intensive online behavioral weight loss intervention into primary care
Type:
Journal Article
Year:
2011
Publication Place:
Ireland
Topic(s):
HIT & Telehealth
See topic collection
Reference Links:
View the DOI record for Patient perspectives on the integration of an intensive online behavioral weight loss intervention into primary care
View DOI Record
View the PubMed citation for Patient perspectives on the integration of an intensive online behavioral weight loss intervention into primary care