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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).

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11231 Results
8901
Severity of mental health impairment and trajectories of improvement in an integrated primary care clinic
Type: Journal Article
Authors: C. J. Bryan, M. L. Corso, K. A. Corso, C. E. Morrow, K. E. Kanzler, B. Ray-Sannerud
Year: 2012
Publication Place: United States
Abstract: Objective: To model typical trajectories for improvement among patients treated in an integrated primary care behavioral health service, multilevel models were used to explore the relationship between baseline mental health impairment level and eventual mental health functioning across follow-up appointments. Method: Data from 495 primary care patients (61.1% female, 60.7% Caucasian, 37.141 +/- 12.21 years of age) who completed the Behavioral Health Measure (Kopta & Lowry, 2002) at each primary care appointment were used for the analysis. Three separate models were constructed to identify clinical improvement in terms of number of appointments attended, baseline impairment severity level, and the interaction of these 2 variables. Results: The data showed that 71.5% of patients improved across appointments, 56.8% of which (40.5% of the entire sample) was clinically meaningful and reliable. Number of appointments and baseline severity of impairment significantly accounted for variability in clinical outcome, with trajectories of change varying across appointments as a function of baseline severity. Patients with more severe impairment at baseline improved faster than patients with less severe baseline impairment. Conclusions: Patients treated within an integrated primary care behavioral health service demonstrate significant improvements in clinical status, even those with the most severe levels of distress at baseline. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
Topic(s):
General Literature See topic collection
8903
Sex differences in comorbid mental and substance use disorders among primary care patients with opioid use disorder
Type: Journal Article
Authors: Jordan M. Braciszewski, Abisola E. Idu, Bobbi Jo H. Yarborough, Scott P. Stumbo, Jennifer F. Bobb, Katharine A. Bradley, Rebecca C. Rossom, Mark T. Murphy, Ingrid A. Binswanger, Cynthia I. Campbell, Joseph E. Glass, Theresa E. Matson, Gwen T. Lapham, Amy M. Loree, Celestina Barbosa-Leiker, Mary A. Hatch, Judith I. Tsui, Julia H. Arnsten, Angela Stotts, Viviana Horigian, Rebecca Hutcheson, Gavin Bart, Andrew J. Saxon, Manu Thakral, Deborah Ling Grant, Chaya Mangel Pflugeisen, Ingrid Usaga, Lawrence T. Madziwa, Angela Silva, Denise M. Boudreau
Year: 2022
Topic(s):
Healthcare Disparities See topic collection
8904
Sex-specific disease outcomes of HIV-positive and HIV-negative drug users admitted to an opioid substitution therapy program in Spain: a cohort study
Type: Journal Article
Authors: R. Muga, I. Rivas, E. Faure, D. Fuster, P. Zuluaga, M. Rubio, T. Munoz, M. Torrens, J. Tor, A. Sanvisens
Year: 2014
Publication Place: England
Abstract: BACKGROUND: Opioid substitution therapy has improved the survival of heroin users with and without HIV infection. We aimed to analyze sex differences in mortality rates and predictors of death among those admitted to a methadone treatment program (MTP). METHODS: Longitudinal study of patients enrolled in a MTP from 1992 to 2010. Socio-demographic and drug use characteristics, and markers of viral infections were assessed at entry. Vital status was ascertained by clinical charts and the mortality register. Four calendar periods were defined according to the introduction of preventive and treatment interventions in Spain. Predictors of death were analyzed by Cox regression models. RESULTS: 1,678 patients (82.8% men) were included; age at first heroin use was 18.6 years (IQR: 16-23 years), and age at first entry into a MTP was 30.7 years (IQR: 26-36 years). A total of 441 (26.3%) deaths occurred during 15,124 person-years (p-y) of follow-up (median: 9.2 years, IQR: 4-13 years). HIV infection was the main predictor of death in men (HR = 3.5, 95% CI: 2.1-5.7) and women (HR = 3.2, 95% CI: 1.2-8.7 ) and main cause of death was HIV/AIDS. Overall mortality rate was 2.9 per 100 p-y (95% CI: 2.7-3.2 per 100 p-y) and death rates decreased over time: 7.4 per 100 p-y (95% CI: 6.3-8.8 per 100 p-y) for the 1992-1996 period to 1.9 per 100 p-y (95% CI: 1.6-2.4 per 100 p-y) for the 2007-2010 period. In women, a slightly increase in mortality was observed in recent periods specifically among HIV-positive women (3.7 per 100 p-y in period 2002-2006 and 4.5 per 100 p-y in 2007-2010). CONCLUSIONS: Significant reductions in mortality of patients in MTP are observed after nineteen years of observation. However, HIV infection shows a great impact on survival, particularly among HIV-infected women.
Topic(s):
Opioids & Substance Use See topic collection
8905
Sex, drugs, and coercive control: Gendered narratives of methamphetamine use, relationships, and violence
Type: Journal Article
Authors: Heith Copes, Fiona Brookman, Jared Ragland, Blake Beaton
Year: 2022
Topic(s):
Healthcare Disparities See topic collection
,
Opioids & Substance Use See topic collection
8906
Sexual behaviors among methadone maintenance patients in a mountainous area in northern Vietnam
Type: Journal Article
Authors: V. L. Boggiano, H. L. T. Nguyen, L. H. Nguyen, T. D. Tran, H. Van Nguyen, H. T. Le, H. Q. Le, C. D. Hoang, C. T. Nguyen, B. X. Tran, C. A. Latkin, N. Zary, T. M. T. Vu
Year: 2017
Publication Place: England
Topic(s):
Opioids & Substance Use See topic collection
8907
Sexual Desire in Opiate-Dependent Men Receiving Methadone-Assisted Treatment
Type: Journal Article
Authors: A. Yee, H. S. Loh, C. G. Ng, A. H. Sulaiman
Year: 2018
Publication Place: United States
Abstract: Low sexual desire (SD) is not life threatening, but its negative impact on the quality of life and intimacy of a relationship among the patients on methadone maintenance therapy (MMT) is significant. This cross-sectional study involved 183 men on MMT who were interviewed and who completed the Malay version of the SDI-2 (SDI-2-BM), the Malay version of the self-rated Montgomery-Asberg Depression Rating Scale (MADRS-BM) and World Health Organization Quality of Life-BREF Scale (WHOQOL-BREF) questionnaires. Findings showed 32.8% ( n = 60) participants had low SD. Those who were older, had sexual partners, and were smokers achieved lower scores in both dyadic SD (
Topic(s):
Measures See topic collection
,
Opioids & Substance Use See topic collection
8908
Sexual orientation differences among men in a randomized clinical trial of extended-release naltrexone and bupropion for methamphetamine use disorder
Type: Journal Article
Authors: J. D. Kidd, S. L. Smiley, P. O. Coffin, T. J. Carmody, F. R. Levin, E. V. Nunes, S. J. Shoptaw, M. H. Trivedi
Year: 2023
8909
Sexuality of children and adolescents with developmental disabilities
Type: Journal Article
Authors: N. A. Murphy, E. R. Elias
Year: 2006
Publication Place: United States
Abstract: Children and adolescents with developmental disabilities, like all children, are sexual persons. However, attention to their complex medical and functional issues often consumes time that might otherwise be invested in addressing the anatomic, physiologic, emotional, and social aspects of their developing sexuality. This report discusses issues of puberty, contraception, psychosexual development, sexual abuse, and sexuality education specific to children and adolescents with disabilities and their families. Pediatricians, in the context of the medical home, are encouraged to discuss issues of sexuality on a regular basis, ensure the privacy of each child and adolescent, promote self-care and social independence among persons with disabilities, advocate for appropriate sexuality education, and provide ongoing education for children and adolescents with developmental disabilities and their families.
Topic(s):
Medical Home See topic collection
8910
Shaping and delivering services in primary care: benzodiazepine and opiate withdrawal service
Type: Journal Article
Authors: Jeff Fernandez
Year: 2021
Topic(s):
Education & Workforce See topic collection
,
Opioids & Substance Use See topic collection
8911
Shaping the Future of Social Work Practice in Healthcare: Addressing COVID-19 Needs through Integrated Primary Care
Type: Journal Article
Authors: Lauren Dennelly, Cindy Sousa, Kate Roberts
Year: 2022
Topic(s):
Education & Workforce See topic collection
8912
Sharable EHR systems in Finland
Type: Journal Article
Authors: K. Harno, P. Ruotsalainen
Year: 2006
Publication Place: Netherlands
Abstract: In Finland, the shared record is a virtual electronic health record (EHR). It consists of health data generated, maintained and preserved by different health care service providers. Two different kinds of technologies for integrating regional EHR-systems are applied, but mainly by using a common middleware. Services provided by this middleware are EHR location services using a link repository and combining EHR-viewing services with security management services including consent management and identification services for health professionals. The Regional Health Information Organization (UUMA) approach is based on a stepwise implementation of integrated regional healthcare services to create a virtually borderless healthcare organization--a patient centered virtual workspace. In the virtual workspace multi-professional teams and patients collaborate and share information regardless of time and place. Presently the regional health information network (RHIN) is comprised of three integrated services between primary, secondary and tertiary care within the county of Uusimaa. The regional healthcare modules consist of an (1) eReferral network, (2) integrated EHR service between health care professionals and (3) PACS system. The eReferral between primary and secondary care not only speeds up the transfer, but also offers an option for communication in the form of eConsultation between general practitioners and hospital specialists. By sharing information and knowledge remote eConsultations create a new working environment for integrated delivery of eServices between the health care providers. Over 100,000 eReferral messages (40 %) were transferred between health care providers. Interactive eConsultations enable supervised care leading to the reduction of outpatient visits and more timely appointments. One third (10/31) of the municipal health centers are connected to the clinics in the Helsinki University Central Hospital by the eReferral system. The link directory service extends the dimensions of networking between organizations by combining legacy systems within regional primary and secondary care. The link directory is an interface to diverse patient information systems, like HUSpacs, containing links pointing to the actual patient data located in remote information systems. The original data including images can be viewed with a web browser, but data can be accessed only with the patient's informed consent. Currently the reference data base includes 9.5 million links from 1.4 million patients with over 2.000 daily users. We aim to create a new working environment for professionals by incorporation of innovative information and communication technology, new organization of work and re-engineering of workflows. In the near-future, the citizen will have an active role participating in decisions on his care, carrying out guided self-care and taking steps of pro-active prevention.
Topic(s):
HIT & Telehealth See topic collection
8913
Shared care across the interface between primary and specialty care in management of long term conditions
Type: Journal Article
Authors: S. M. Smith, G. Cousins, B. Clyne, S. Allwright, T. O'Dowd
Year: 2017
Publication Place: England
Abstract: BACKGROUND: Shared care has been used in the management of many chronic conditions with the assumption that it delivers better care than primary or specialty care alone; however, little is known about the effectiveness of shared care. OBJECTIVES: To determine the effectiveness of shared care health service interventions designed to improve the management of chronic disease across the primary/specialty care interface. This is an update of a previously published review.Secondary questions include the following:1. Which shared care interventions or portions of shared care interventions are most effective?2. What do the most effective systems have in common? SEARCH METHODS: We searched MEDLINE, Embase and the Cochrane Library to 12 October 2015. SELECTION CRITERIA: One review author performed the initial abstract screen; then two review authors independently screened and selected studies for inclusion. We considered randomised controlled trials (RCTs), non-randomised controlled trials (NRCTs), controlled before-after studies (CBAs) and interrupted time series analyses (ITS) evaluating the effectiveness of shared care interventions for people with chronic conditions in primary care and community settings. The intervention was compared with usual care in that setting. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data from the included studies, evaluated study quality and judged the certainty of the evidence using the GRADE approach. We conducted a meta-analysis of results when possible and carried out a narrative synthesis of the remainder of the results. We presented the results in a 'Summary of findings' table, using a tabular format to show effect sizes for all outcome types. MAIN RESULTS: We identified 42 studies of shared care interventions for chronic disease management (N = 18,859), 39 of which were RCTs, two CBAs and one an NRCT. Of these 42 studies, 41 examined complex multi-faceted interventions and lasted from six to 24 months. Overall, our confidence in results regarding the effectiveness of interventions ranged from moderate to high certainty. Results showed probably few or no differences in clinical outcomes overall with a tendency towards improved blood pressure management in the small number of studies on shared care for hypertension, chronic kidney disease and stroke (mean difference (MD) 3.47, 95% confidence interval (CI) 1.68 to 5.25)(based on moderate-certainty evidence). Mental health outcomes improved, particularly in response to depression treatment (risk ratio (RR) 1.40, 95% confidence interval (CI) 1.22 to 1.62; six studies, N = 1708) and recovery from depression (RR 2.59, 95% CI 1.57 to 4.26; 10 studies, N = 4482) in studies examining the 'stepped care' design of shared care interventions (based on high-certainty evidence). Investigators noted modest effects on mean depression scores (standardised mean difference (SMD) -0.29, 95% CI -0.37 to -0.20; six studies, N = 3250). Differences in patient-reported outcome measures (PROMs), processes of care and participation and default rates in shared care services were probably limited (based on moderate-certainty evidence). Studies probably showed little or no difference in hospital admissions, service utilisation and patient health behaviours (with evidence of moderate certainty). AUTHORS' CONCLUSIONS: This review suggests that shared care improves depression outcomes and probably has mixed or limited effects on other outcomes. Methodological shortcomings, particularly inadequate length of follow-up, may account in part for these limited effects. Review findings support the growing evidence base for shared care in the management of depression, particularly stepped care models of shared care. Shared care interventions for other conditions should be developed within research settings, with account taken of the complexity of such interventions and awareness of the need to carry out longer studies to test effectiveness and sustainability over time.
Topic(s):
General Literature See topic collection
8914
Shared care and gender identity support in Primary Care: The perspectives and experiences of parents/carers of young trans people
Type: Journal Article
Authors: Z. Davy, J. Benson, A. Barras
Year: 2024
Abstract:

This article addresses the complex issues surrounding trans youths' shared care perceived by parents in primary care settings in the UK. The analyses in this article draws on qualitative data derived from an online survey of 153 parents with trans children. Through the conceptual framework of healthcare assemblages, findings suggest that quality shared care for trans youth is based upon transient service relationships inherent in their healthcare-primary care, gender identity services, endocrinologists, and Adolescent Mental Health Services (CAHMS)-and, as such, this complexity must be understood better by GPs in order for quality shared care to be administered. We explored various blockages to quality shared care within primary care surgeries that produced limit situations, such as lack of knowledge, training, or experience with trans healthcare. One other key factor was that there were strong external forces that were limiting trans youths' quality shared care in the form of abject depictions from beyond the consultation, which all produced negative effects. Despite these blockages, we also demonstrate how and where quality shared care is received. For instance, we show that continuity of care or treatment after an initial diagnosis or assessment contributes to quality shared care as too does personalized care to those youths receiving it. Overall, this research provides insights into the complex perceptions of parents about what quality shared care is and ought to be for trans youth.

Topic(s):
Healthcare Disparities See topic collection
8915
Shared care arrangements for specialist drugs in the UK: the challenges facing GP adherence
Type: Journal Article
Authors: S. Crowe, J. A. Cantrill, M. P. Tully
Year: 2010
Publication Place: England
Abstract: OBJECTIVE: To explore the challenges facing GPs' adherence to shared care arrangements for specialist drugs. DESIGN: A qualitative study using semistructured interviews; data analysed using the 'framework' approach aided by QSR N-Vivo 2.0. SETTING: Three Primary Care Trusts (PCTs) within one Strategic Health Authority (SHA) in the North West of England. PARTICIPANTS: 47 semistructured interviews were conducted with a range of Practice, PCT and SHA staff and other relevant stakeholders. RESULTS: GPs faced multiple challenges in adhering to shared care arrangements for specialist drugs. Psychiatric patients were given as an example where such arrangements were perceived as particularly difficult to maintain, with patient non-compliance a contributory factor. GP uncertainty and confusion surrounded the sharing of test results between primary and secondary care, and was felt to give rise to test duplication and omission. Of particular concern to GPs was the lack of compliance of practice and hospital colleagues with these arrangements, and the dependence they placed on specialists' responses to requests for advice. CONCLUSION: This study provides evidence of the numerous challenges facing GP adherence to shared care arrangements. Such challenges need to be overcome if the issues of test duplication and omission are to be addressed, and GPs' future acceptance of shared care arrangements encouraged.
Topic(s):
General Literature See topic collection
8916
Shared care between specialised psychiatric services and primary care: The experiences and expectations of General Practitioners in Ireland
Type: Journal Article
Authors: V. I. Agyapong, F. Jabbar, C. Conway
Year: 2012
Abstract: Objective. The study aims to explore the views of General Practitioners in Ireland on shared care between specialised psychiatric services and primary care. Method. A self-administered questionnaire was designed and posted to 400 randomly selected General Practitioners working in Ireland. Results. Of the respondents, 189 (94%) reported that they would support a general policy on shared care between primary care and specialised psychiatric services for patients who are stable on their treatment. However, 124 (61.4%) reported that they foresaw difficulties for patients in implementing such a policy including: a concern that primary care is not adequately resourced with allied health professionals to support provision of psychiatric care (113, 53.2%); a concern this would result in increased financial burden on some patients (89, 48.8%); a lack of adequate cooperation between primary care and specialised mental health services (84, 41.8%); a concern that some patients may lack confidence in GP care (55, 27.4%); and that primary care providers are not adequately trained to provide psychiatric care (29, 14.4% ). Conclusion. The majority of GPs in Ireland would support a policy of shared care of psychiatric patients; however they raise significant concerns regarding practical implications of such a policy in Ireland.
Topic(s):
Education & Workforce See topic collection
8917
Shared care between specialized psychiatric services and primary care: the experiences and expectations of consultant psychiatrists in Ireland
Type: Journal Article
Authors: V. I. Agyapong, C. Conway, A. Guerandel
Year: 2011
Publication Place: United States
Abstract: BACKGROUND: Internationally, there has been a growing interest in the pursuit of collaborative forms of care for patients with enduring mental health difficulties. OBJECTIVE: The study aims to explore the views of consultant psychiatrists in Ireland on shared care between specialized psychiatric services and primary care for patients with mental health difficulties. METHOD: A self-administered questionnaire was designed and posted to 470 consultant psychiatrists who are members of the College of Psychiatry of Ireland. Stamped self-addressed envelopes were included for the return of completed questionnaires. RESULTS: Overall, 213 questionnaires were returned, giving a response rate of 45%. Of the respondents, 194 (91%) reported that they would support a general policy on shared care between primary care and specialized psychiatric services for patients who are stable on their treatment. However, 181 (85%) reported that they foresaw difficulties for patients in implementing such a policy including: increased financial burden on some patients (141, 66%); some patients may lack confidence in GP care (100, 47%); primary care is not adequately resourced with allied health professionals to support provision of psychiatric care (128, 60%); primary care providers are not adequately trained to provide psychiatric care (111, 52%); and lack of adequate cooperation between primary care and specialized mental health services (96, 45%). CONCLUSION: The Irish government and the Colleges of General Practitioners and Psychiatrists in Ireland need to work together to remove the bottlenecks that hinder the active involvement of primary care in the management of patients with enduring mental health difficulties. Also, the health care systems need to be organized along a shared care model to facilitate effective collaboration between primary and specialized psychiatric services.
Topic(s):
Education & Workforce See topic collection
8918
Shared care in mental illness: A rapid review to inform implementation
Type: Journal Article
Authors: B. Kelly, D. Perkins, J. Fuller, S. Parker
Year: 2011
Abstract: BACKGROUND: While integrated primary healthcare for the management of depression has been well researched, appropriate models of primary care for people with severe and persistent psychotic disorders are poorly understood. In 2010 the NSW (Australia) Health Department commissioned a review of the evidence on "shared care" models of ambulatory mental health services. This focussed on critical factors in the implementation of these models in clinical practice, with a view to providing policy direction. The review excluded evidence about dementia, substance use and personality disorders. METHODS: A rapid review involving a search for systematic reviews on The Cochrane Database of Systematic Reviews and Database of Abstracts of Reviews of Effects (DARE). This was followed by a search for papers published since these systematic reviews on Medline and supplemented by limited iterative searching from reference lists. RESULTS: Shared care trials report improved mental and physical health outcomes in some clinical settings with improved social function, self management skills, service acceptability and reduced hospitalisation. Other benefits include improved access to specialist care, better engagement with and acceptability of mental health services. Limited economic evaluation shows significant set up costs, reduced patient costs and service savings often realised by other providers. Nevertheless these findings are not evident across all clinical groups. Gains require substantial cross-organisational commitment, carefully designed and consistently delivered interventions, with attention to staff selection, training and supervision. Effective models incorporated linkages across various service levels, clinical monitoring within agreed treatment protocols, improved continuity and comprehensiveness of services. CONCLUSIONS: "Shared Care" models of mental health service delivery require attention to multiple levels (from organisational to individual clinicians), and complex service re-design. Re-evaluation of the roles of specialist mental health staff is a critical requirement. As expected, no one model of "shared" care fits diverse clinical groups. On the basis of the available evidence, we recommended a local trial that examined the process of implementation of core principles of shared care within primary care and specialist mental health clinical services.
Topic(s):
General Literature See topic collection
8919
Shared care: Lessons from one model of shared care nursing in primary care
Type: Journal Article
Authors: Elisabeth Smith, Willm Mistral
Year: 2003
Publication Place: United Kingdom: Taylor & Francis
Topic(s):
Healthcare Disparities See topic collection
8920
Shared Decision Making
Type: Report
Authors: National Learning Consortium
Year: 2013
Topic(s):
Grey Literature See topic collection
Disclaimer:

This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.