Literature Collection

8581

Separate may not be equal: A preliminary investigation of clinical correlates of electronic psychiatric record accessibility in academic medical centers

Type: Journal Article

Authors: D. E. Kozubal, Q. M. Samus, A. A. Bakare, C. C. Trecker, H. W. Wong, H. Guo, J. Cheng, P. X. Allen, L. S. Mayer, K. R. Jamison, A. I. Kaplin

Year: 2012

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8582

Sequential screening to improve behavioral health needs detection in primary care

Type: Journal Article

Authors: Nicholas D. Young, Christopher R. Takala

Year: 2018

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8583

Serious mental illness and the role of primary care

Type: Journal Article

Authors: C. Planner, L. Gask, S. Reilly

Year: 2014

Publication Place: United States

Abstract: Policies and guidelines from across the international community are attempting to galvanise action to address the unacceptably high morbidity and mortality rates amongst people with a serious mental illness (SMI). Primary care has a pivotal role to play in translating policy into evidence based practice in conjunction with other providers of health care services. This paper explores the current and potential of role of primary care providers in delivering health care to people with SMI. A review of research in the following key areas of primary health care provision is provided: access, screening and preventative care, routine monitoring and follow-up, diagnosis and delivery of treatments in accordance with guidelines and delivery of interventions. There is undoubtedly a need for further research to establish the effectiveness of primary care interventions and the organisation of services. Equally, understanding how primary care services can deliver high quality care and promoting effective working at the interface with other services must be priorities.

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8584

Serious mental illness in Florida nursing homes: Need for training

Type: Journal Article

Authors: V. A. Molinari, S. S. Merritt, W. L. Mills, D. A. Chiriboga, A. Conboy, K. Hyer, M. A. Becker

Year: 2008

Publication Place: United States

Abstract: This study examined how the mental health needs of nursing home (NH) residents with serious mental illness (SMI) are addressed. Data were collected from three sources: interviews with 84 SMI stakeholders; surveys of 206 NH staff members; and focus groups at two psychiatry specialty NHs. Four common themes emerged: placement of older adults with SMI was a significant problem for discharge planners and NH admission coordinators; NH staff reported being uneasy with SMI residents and were concerned over aggressive behavior; staff in NHs with psychiatry specialty units appeared more comfortable serving SMI residents; and SMI training was a consistent recommendation of all SMI stakeholders and NH staff. Implications for training are discussed.

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8585

Sertraline and/or interpersonal psychotherapy for patients with dysthymic disorder in primary care: 6-month comparison with longitudinal 2-year follow-up of effectiveness and costs

Type: Journal Article

Authors: G. Browne, M. Steiner, J. Roberts, A. Gafni, C. Byrne, E. Dunn, B. Bell, M. Mills, L. Chalklin, D. Wallik, J. Kraemer

Year: 2002

Publication Place: Netherlands

Abstract: BACKGROUND: There is little information on the long-term effects and costs of a combination of Sertraline and interpersonal psychotherapy (IPT) for the treatment of dysthymia in primary care. METHODS: In a single-blind, randomized clinical trial, 707 adults (18-74 years of age inclusive) with DSM-IV dysthymic disorder, with or without past and/or current major depression, as an acute or chronic episode, in a community-based primary care practice in Ontario, Canada, were randomized to treatment with either Sertraline alone (50-200 mg), or IPT alone (10 sessions), or Sertraline plus IPT combined. In the acute treatment phase (first 6 months) all groups received full active treatment. This was followed by an additional 18-month naturalistic follow-up phase. Subjects were assessed for effectiveness of treatment in reducing depressive symptoms using the Montgomery Asberg Depression Rating Scale (MADRS) at 6 months and twice again during the 18-month follow-up by blind independent observers. Treatment costs and subjects' use of other health and social services were also investigated. RESULTS: At 6 months, 586 subjects completed the MADRS questionnaire. There was a significant difference (P=0.025) in mean MADRS scores: 14.3 (Group I); 14.9 (Group II); 16.8 (Group III), using analysis of covariance. Response (40% improvement) rates were 60.2% for Sertraline alone, 46.6% for IPT alone, and 57.5% for Sertraline augmented by IPT (P=0.02). At 2 years, 525 subjects were retained for follow-up. There was no statistically significant difference between Sertraline alone and Sertraline plus IPT in symptom reduction. However, both were more effective than IPT alone in reducing depressive symptoms (P=0.03). There was a statistically significant difference between groups in costs for use of health and social services. The IPT treatment groups had the lower costs for use of health and social services. CONCLUSIONS: Sertraline or Sertraline plus IPT was more effective than IPT alone after 6 months. Over the long term (2 years), all three treatments provide reasonably effective treatment for reducing symptoms of dysthymia, but Sertraline or combining Sertraline with IPT is more effective than IPT alone. Of these two more effective treatments, subjects in the Sertraline plus IPT group had less health and social service costs by $480 per person over 2 years. These findings underscore the effects of combining pharmacotherapy and psychotherapy and the economic value of this more comprehensive treatment of dysthymia in primary care.

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8586

Service delivery models for injectable opioid agonist treatment in Canada: 2 sequential environmental scans

Type: Journal Article

Authors: E. Eydt, S. Glegg, C. Sutherland, K. Meador, M. Trew, M. Perreault, M. È. Goyer, B. Le Foll, J. Turnbull, N. Fairbairn

Year: 2021

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8587

Service use and outcomes among elderly persons with low incomes being treated for depression

Type: Journal Article

Authors: P. A. Arean, A. M. Gum, L. Tang, J. Unutzer

Year: 2007

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8588

Service Use Preceding Opioid-Related Fatality

Type: Journal Article

Authors: M. Olfson, M. Wall, S. Wang, S. Crystal, C. Blanco

Year: 2018

Abstract: OBJECTIVE: This study analyzed health service patterns before opioid-related death among nonelderly individuals in the Medicaid program, focusing on decedents with and without past-year diagnoses of noncancer chronic pain. METHODS: The authors identified opioid-related decedents, age =64 years, in the Medicaid program and characterized their clinical diagnoses, filled medication prescriptions, and nonfatal poisoning events during the 30 days and 12 months before death. The study group included 13,089 opioid-related deaths partitioned by presence or absence of chronic noncancer pain diagnoses in the last year of life. RESULTS: Most decedents (61.5%) had received clinical diagnoses of chronic noncancer pain conditions in the last year of life. As compared with decedents without chronic pain diagnoses, those with these diagnoses were significantly more likely to have filled prescriptions for opioids (49.0% versus 17.2%) and benzodiazepines (52.1% versus 26.6%) during the last 30 days of life, while diagnoses of opioid use disorder during this period were uncommon in both groups (4.2% versus 4.3%). The chronic pain group was also significantly more likely than the nonpain group to receive clinical diagnoses of drug use (40.8% versus 22.1%), depression (29.6% versus 13.0%) or anxiety (25.8% versus 8.4%) disorders during the last year of life. CONCLUSIONS: Persons dying of opioid-related causes, particularly those who were diagnosed with chronic pain conditions, commonly received services related to drug use disorders and mental disorders in the last year of life, though opioid use disorder diagnoses near the time of death were rare.

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8589

Service Utilization among Persons Who Inject Drugs Attending a Syringe Exchange Program in New York State

Type: Journal Article

Authors: E. T. Beidelman, M. A. Parker, R. S. Zoh, A. H. Owora

Year: 2023

Abstract:

BACKGROUND: Epidemiologic studies commonly recommend the integration of harm reduction programs with health and social services to improve the well-being of persons who inject drugs (PWIDs). This study identified service utilization clusters for PWIDs attending a syringe exchange program (SEP) in 2017 to better understand in-house service usage. METHODS: We applied Multiple Correspondence Analysis and Hierarchical Clustering on Principal Components to classify 475 PWIDs into clusters using anonymized, SEP records data from New York. Multinomial logistic regression was used to identify sociodemographic and program engagement correlates of cluster membership. RESULTS: Only 22% of participants utilized at least one service. We identified three clusters of service utilization defined by 1) Nonuse; 2) Support, Primary Care, & Maintenance service use; and 3) HIV/STD, Support, Primary Care, & Maintenance service use. Cluster 2 members were less likely to be living alone compared to Cluster 1 (AOR = 0.08, 95% CI: 0.04, 0.17) while Cluster 3 members were less likely to be White (AOR = 0.19, 95% CI: 0.07, 0.50) or living alone (AOR = 0.16, 95% CI: 0.06, 0.44) and more likely to be Medicaid recipients (AOR = 2.89, 95% CI: 1.01, 8.36) compared to Cluster 1. Greater than one SEP interaction, lower syringe return ratios, and being a long-term client increased the odds of service utilization. DISCUSSION: Overall, PWID clients had a low prevalence of in-house service use particularly those who live alone. However, higher service utilization was observed among more vulnerable populations (i.e., non-White and LGBT). Future research is needed to profile services used outside of the SEP.

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8590

Service utilization and chronic condition outcomes among primary care patients with substance use disorders and co-occurring chronic conditions

Type: Journal Article

Authors: K. A. Stephens, I. I. West, K. A. Hallgren, B. Mollis, K. Ma, D. M. Donovan, B. Stuvek, L. M. Baldwin

Year: 2020

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8591

Service-Related Barriers and Facilitators in an Early Childhood System of Care: Comparing the Perspectives of Parents and Providers

Type: Journal Article

Authors: Robey B. Champine, Andrea H. Shaker, Katina A. Tsitaridis, Melissa L. Whitson, Joy S. Kaufman

Year: 2019

Publication Place: , <Blank>

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8592

Service-user involvement in primary care mental health: Where are we going, and where do we even begin?

Type: Journal Article

Authors: Simon Stuart, Sean Hunter, Michael Killoran Ross

Year: 2012

Publication Place: United Kingdom

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8593

Services failing on targets to deliver race equality on care

Type: Journal Article

Authors: D. Lombard

Year: 2008

Publication Place: URL

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8594

Serving Persons With Severe Mental Illness in Primary Care-Based Medical Homes

Type: Journal Article

Authors: M. E. Domino, R. Wells, J. P. Morrissey

Year: 2015

Abstract: Objective: Primary care-based medical homes are rapidly disseminating through populations with chronic illnesses. Little is known about how these models affect the patterns of care for persons with severe mental illness who typically receive much of their care from mental health specialists. This study examined whether enrollment in a primary care medical home alters the patterns of care for Medicaid enrollees with severe mental illness. Methods: The authors conducted a retrospective secondary data analysis of medication adherence, outpatient and emergency department visits, and screening services used by adult Medicaid enrollees with diagnoses of schizophrenia (N=7,228), bipolar disorder (N=13,406), or major depression (N=45,000) as recorded in North Carolina Medicaid claims from 2004-2007. Participants not enrolled in a medical home (control group) were matched by propensity score to medical home participants on the basis of demographic characteristics and comorbidities. Those dually enrolled in Medicare were excluded. Results: Results indicate that medical home enrollees had greater use of both primary and specialty mental health care, better medication adherence, and reduced use of the emergency department. Better rates of preventive lipid and cancer screening were found only for persons with major depression. Conclusions: Enrollment in a medical home was associated with substantial changes in patterns of care among persons with severe mental illness. These changes were associated with only a modest set of incentives, suggesting that medical homes can have large multiplier effects in primary care of persons with severe mental illness.

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8595

Setting Our Sails: Counseling Psychology in the Age of Integrated Health Care

Type: Journal Article

Authors: Paul B. Perrin, Timothy R. Elliott

Year: 2019

Publication Place: Thousand Oaks, California

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8596

Setting the stage for success: Implementation of developmental and behavioral screening and surveillance in primary care practice -- the North Carolina Assuring Better Child Health and Development (ABCD) Project

Type: Journal Article

Authors: M. F. Earls, S. S. Hay

Year: 2006

Abstract: Early identification of children with developmental and behavioral delays is important in primary care practice, and well-child visits provide an ideal opportunity to engage parents and perform periodic screening. Integration of this activity into office process and flow is necessary for making screening a routine and consistent part of primary care practice. In the North Carolina Assuring Better Child Health and Development Project, careful attention to and training for office process has resulted in a significant increase in screening rates to >70% of the designated well-child visits. The data from the project prompted a change in Medicaid policy, and screening is now statewide in primary practices that perform Early Periodic Screening, Diagnosis, and Treatment examinations. Although there are features of the project that are unique to North Carolina, there are also elements that are transferable to any practice or state interested in integrating child development services into the medical home. Included here are lessons learned and a listing of practical tools for implementation.

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8597

Seven Million Americans Live In Areas Where Demand For Primary Care May Exceed Supply By More Than 10 Percent

Type: Journal Article

Authors: E. S. Huang, K. Finegold

Year: 2013

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8598

Seven years of workplace drug testing in Italy: A systematic review and meta-analysis

Type: Journal Article

Authors: G. L. Rosso, C. Montomoli, L. Morini, S. M. Candura

Year: 2017

Publication Place: England

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8599

Severity alone should no longer determine therapeutic choice in the management of depression in primary care: Findings from a survey of general practitioners

Type: Journal Article

Authors: G. S. Malhi, Kristina Fritz, Carissa M. Coulston, Lisa Lampe, Danielle M. Bargh, Michael Ablett, Bill Lyndon, Rick Sapsford, Mike Theodoros, Derek Woolfall, Andrea van der Zypp, Malcolm Hopwood

Year: 2014

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8600

Severity of alcohol problems and readiness to change alcohol use in primary care

Type: Journal Article

Authors: M. Krenek, S. A. Maisto, J. S. Funderburk, R. Drayer

Year: 2011

Publication Place: England

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