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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).
11231 Results
8881
Serious mental illness and the role of primary care
Type: Journal Article
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.
Topic(s):
Healthcare Disparities
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8882
Serious mental illness in Florida nursing homes: Need for training
Type: Journal Article
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.
Topic(s):
Education & Workforce
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Reference Links: View the PubMed citation for Serious mental illness in Florida nursing homes: Need for training
8883
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
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.
Topic(s):
Financing & Sustainability
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8884
Service delivery models for injectable opioid agonist treatment in Canada: 2 sequential environmental scans
Type: Journal Article
Year: 2021
Topic(s):
Education & Workforce
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, Opioids & Substance Use
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Reference Links:
View the DOI record for Service delivery models for injectable opioid agonist treatment in Canada: 2 sequential environmental scans
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View the PubMed citation for Service delivery models for injectable opioid agonist treatment in Canada: 2 sequential environmental scans8885
Service use and outcomes among elderly persons with low incomes being treated for depression
Type: Journal Article
Year: 2007
Topic(s):
Healthcare Disparities
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Reference Links:
View the DOI record for Service use and outcomes among elderly persons with low incomes being treated for depression
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View the PubMed citation for Service use and outcomes among elderly persons with low incomes being treated for depression8886
Service Use Preceding Opioid-Related Fatality
Type: Journal Article
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.
Topic(s):
Opioids & Substance Use
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8888
Service utilization and chronic condition outcomes among primary care patients with substance use disorders and co-occurring chronic conditions
Type: Journal Article
Year: 2020
Topic(s):
Financing & Sustainability
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, Healthcare Disparities
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, Opioids & Substance Use
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8892
Serving Persons With Severe Mental Illness in Primary Care-Based Medical Homes
Type: Journal Article
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.
Topic(s):
Medical Home
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, Healthcare Disparities
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Reference Links:
View the DOI record for Serving Persons With Severe Mental Illness in Primary Care-Based Medical Homes
View DOI Record
View the PubMed citation for Serving Persons With Severe Mental Illness in Primary Care-Based Medical Homes8894
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
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.
Topic(s):
Medical Home
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, Healthcare Policy
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8896
Seven years of workplace drug testing in Italy: A systematic review and meta-analysis
Type: Journal Article
Year: 2017
Publication Place: England
Topic(s):
Healthcare Policy
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, Opioids & Substance Use
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Reference Links:
View the DOI record for Seven years of workplace drug testing in Italy: A systematic review and meta-analysis
View DOI Record
View the PubMed citation for Seven years of workplace drug testing in Italy: A systematic review and meta-analysis8898
Severity of alcohol problems and readiness to change alcohol use in primary care
Type: Journal Article
Year: 2011
Publication Place: England
Topic(s):
General Literature
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Reference Links:
View the DOI record for Severity of alcohol problems and readiness to change alcohol use in primary care
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View the PubMed citation for Severity of alcohol problems and readiness to change alcohol use in primary care8899
Severity of dependence scale as a diagnostic tool for heroin and cocaine dependence
Type: Journal Article
Year: 2009
Publication Place: Switzerland
Abstract: AIMS: Our aim was to further assess the Severity of Dependence Scale (SDS) validity and to identify the cut-off score for a DSM-IV diagnosis of heroin and cocaine dependence through a cross-sectional survey in Barcelona, Spain. METHODS: The Psychiatric Research Interview for Substance and Mental Disorders (PRISM) was used as the gold standard. 146 young (18-30 years old) heroin users were recruited from outside the healthcare context, 135 of whom were also current cocaine users. SDS scores were correlated to quantity, frequency and length of drug use. RESULTS: The SDS cut-off point at which there was optimal discrimination of a DSM-IV diagnosis presence was found to be 3 (i.e., a score of 3 or more) for heroin dependence and 4 for cocaine dependence. CONCLUSIONS: The study gives further support to SDS dimensional properties and to its validity for rapid assessment of current heroin and cocaine dependence.
Topic(s):
Opioids & Substance Use
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, Measures
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Reference Links:
View the DOI record for Severity of dependence scale as a diagnostic tool for heroin and cocaine dependence
View DOI Record
View the PubMed citation for Severity of dependence scale as a diagnostic tool for heroin and cocaine dependence8900
Severity of mental health concerns in pediatric primary care and the role of child psychiatry access programs
Type: Journal Article
Year: 2018
Publication Place: United States
Topic(s):
HIT & Telehealth
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Reference Links: View the PubMed citation for Severity of mental health concerns in pediatric primary care and the role of child psychiatry access programs