Literature Collection

INTRODUCTION: Patients with opioid use disorder (OUD) have a heightened need for quality health care, including access to evidence-based medications to reduce cravings and prevent overdose. However, primary care providers (PCPs) are reluctant to work with patients with OUD and implement medication prescribing into primary care practice. Previous studies have sought to identify potential ways to overcome these barriers, but often utilize interventions that facilitate both positive contact with as well as empathy for patients with OUD. In this study, we jointly assess positive contact and empathy to determine their unique impact on treatment attitudes and behaviors among PCPs, after controlling for other known predictors. METHODS: We surveyed 409 PCPs currently practicing in Ohio in 2022. Our primary dependent variables were willingness to work with patients with OUD, receipt of an X-waiver to prescribe buprenorphine, and interest in receiving an X-waiver. Our primary independent variables were positive contact and empathy toward patients with OUD. We computed bivariate correlations and multivariable linear regression (for continuous dependent variables) and logistic regression (for binary dependent variables) to understand the relationship between positive contact, empathy, and our outcome variables while accounting for other known predictors and relevant participant demographics. RESULTS: Positive contact was positively correlated with willingness to work with patients with OUD, receipt of the X-waiver, an interest in receiving the X-waiver, more frequent checking with patients about the need for naloxone, and higher odds of naloxone prescribing. These relationships held after accounting for PCP demographics, explicit bias toward patients with OUD, and overall levels of contact with patients with OUD. Empathy, conversely, was not a significant predictor of any treatment outcomes in the fully adjusted models. CONCLUSION: Interventions and medical education programs aimed at improving treatment outcomes for patients with OUD should facilitate positive contact between PCPs and patients with OUD.

OBJECTIVES: To explore the views and perspectives of British South Asian (BSA) women and Positive Health Programme (PHP) facilitators on the usefulness and experiences of the PHP intervention for managing postnatal depression (PND) in primary care settings. DESIGN: Qualitative study with semi-structured interviews to explore perceptions of acceptability and implementation. A patient and public involvement group provided their insights and feedback on study topic guides, analysis and outcomes. SETTING AND PARTICIPANTS: We sampled trial participants from the PHP intervention database to ensure variation in geographic setting, age, socioeconomic status and ethnicity. PHP facilitators involved in the trial were also invited to participate in an interview.Interviews with study participants were conducted at participants' homes, and community centres, or via phone. Interviews with PHP facilitators were conducted via phone or online. Interview recordings were transcribed verbatim and analysed using thematic analysis and subsequently the Theoretical Framework of Acceptability (TFA) was applied. Recruitment took place between February 2017 and March 2020. RESULTS: Thirty interviews were conducted-19 trial participants and 11 PHP facilitators. The PHP intervention was viewed positively, with appreciation of its therapeutic content and components such as childcare and refreshments that facilitated engagement. Participants reported improved confidence and well-being and supported their needs. Participants understood the intervention's purpose. Both intervention participants and facilitators noted strengthened self-efficacy.Some participants experienced difficulties balancing childcare and attendance, implying a need for logistical assistance. Stigma about mental health in the BSA community was viewed as persistent, recommending future programmes efforts on strategies to reduce stigma and develop supportive environment. CONCLUSION: This study demonstrates the possibility of PHP intervention being integrated into routine care by providing culturally tailored support for BSA women with PND, primarily through family engagement and facilitator support. Future research on scalability, alongside community engagement efforts, will strengthen its acceptability and broader applicability. TRIAL REGISTRATION NUMBER: ISRCTN10697380.

Coronavirus disease 2019 (COVID-19) is increasingly recognized as having significant long-term impact on physical and mental health. The Primary Care Wellbeing Service (PCWBS) in Bradford District Care NHS Foundation Trust (BDCFT) is a psychology-led specialist interdisciplinary team of health professionals specializing in persistent physical symptoms (PPS) and Chronic Fatigue Syndrome (CFS)/Myalgic Encephalomyelitis (ME) with an emphasis on holistic integrated care. The PCWBS quickly recognized the risk of the long-term effects of COVID-19, particularly for social, health and care staff, and developed a 7-week virtual rehabilitation course which was piloted in October 2020. The "Recovering from COVID" course takes a whole system, biopsychosocial approach to understanding COVID-19 and post-viral fatigue (PVF) and is delivered by an interdisciplinary team consisting of a clinical psychologist, physiotherapist, occupational therapist, dietitian, speech and language therapist, assistant psychologist, and a personal support navigator with support from a team administrator. The course focuses on understanding PVF, sleep optimization, nutrition, swallowing, activity management, energy conservation, stress management, breathing optimization, managing setbacks, and signposting to appropriate resources and services. Since the pilot, PCWBS has delivered 7 courses to support over 200 people suffering from post-COVID-19 syndrome. One hundred and forty-nine individuals that enrolled on the "Recovering from COVID" course completed the EQ-5D-5L to assess Health-related quality of life (HRQoL) across 5 dimensions, including problems with mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Subsequently, 76 individuals completed these measures at the end of the rehabilitation course showing that patient ratings were significantly improved. In response to the NIHR recommendation for rapid evaluation of different service models for supporting people with post-COVID-19 syndrome, this data offers hope that rehabilitation is effective in reversing some of the problems faced by people living with the long-term effects of COVID-19.

PURPOSE: The management of anorectal malformations (ARM) and Hirschsprung Disease (HD) involves multiple interventions and lifelong follow-up. This study aimed to determine the prevalence of Post-Traumatic Stress Disorder (PTSD) in patients with ARM and HD. METHODS: After IRB approval, a total of 30 patients with ARM and HD met inclusion criteria and completed the DSM-5 PTSD Checklist (PCL-5), a validated 20-item questionnaire assessing PTSD symptoms. PCL-5 scores between 31 and 33 suggest probable PTSD. Participants were eligible if they were aged 12 years or older and had a diagnosis of ARM or HD. Exclusion criteria included concurrent neurological or chromosomal anomalies, age under 12, and refusal to participate. RESULTS: All 30 participants (median age: 12-64 years, 76.6 % White) completed the survey, with an even gender distribution. Educational attainment varied: 30 % held a bachelor's degree, and 20 % had less than a high school education. Three participants (10 %) were unable to work. ARM diagnosis was present in 27 patients (90 %). Twelve respondents (44.4 %) scored >31 on the PCL-5, with 62.9 % reporting "moderate" or greater symptoms across all domains. The most frequently reported stressors were anal dilation/enema treatments (43.2 %) and the effects of the diagnosis on body image and social life (39.9 %). CONCLUSIONS: The high prevalence of PTSD symptoms among patients with ARM and HD underscores the urgent need for psychological support. Nearly half of the participants met the provisional criteria for PTSD, with a significant number exhibiting moderate to severe symptoms. Early integration of mental health care could be beneficial and potentially improve outcomes in this population. LEVEL OF EVIDENCE: III.