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Opioids & SU
The Literature Collection contains over 10,000 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).
10858 Results
9361
The current status of opioid maintenance treatment in France: a survey of physicians, patients, and out-of-treatment opioid users
Type: Journal Article
Year: 2014
Publication Place: New Zealand
Abstract: AIM: Project Access France was a national survey designed to provide real-world observations on the status of opioid dependence treatment in France. METHODS: The views of physicians (n=100), patients (n=130), and out-of-treatment opioid users (n=33) were collected via interviews and questionnaires. RESULTS: Physicians reported being moderately satisfied with treatment programs in their area (rating 6.9 out of 10). Most physicians (82%) reported being concerned about misuse and diversion of medication-assisted treatment (MAT) medications and 50% identified psychosocial/behavioral counseling as the key change that would most improve patient care. Among patients, the mean number of previous MAT episodes was low (1.5); 78% reported that it was easy to access a doctor to undergo MAT; 14% reported regularly or sometimes using heroin; misuse and diversion were reported in 15% and 39% of patients, respectively; and 57% of patients were not receiving psychosocial help. Out-of-treatment opioid users reported using drugs on a regular basis (42% regularly used heroin) and cited 'not wanting to give up drugs completely' as the most frequent reason for staying out of MAT. CONCLUSION: This survey highlights a number of positive features of the open-access, GP-based treatment model for opioid dependence in France. Challenges remain with regard to continued misuse/diversion of MAT medications and limited patient access to psychosocial support.
Topic(s):
Opioids & Substance Use
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9363
The de facto US mental and addictive disorders service system. Epidemiologic catchment area prospective 1-year prevalence rates of disorders and services
Type: Journal Article
Year: 1993
Publication Place: UNITED STATES
Abstract: After initial interviews with 20,291 adults in the National Institute of Mental Health Epidemiologic Catchment Area Program, we estimated prospective 1-year prevalence and service use rates of mental and addictive disorders in the US population. An annual prevalence rate of 28.1% was found for these disorders, composed of a 1-month point prevalence of 15.7% (at wave 1) and a 1-year incidence of new or recurrent disorders identified in 12.3% of the population at wave 2. During the 1-year follow-up period, 6.6% of the total sample developed one or more new disorders after being assessed as having no previous lifetime diagnosis at wave 1. An additional 5.7% of the population, with a history of some previous disorder at wave 1, had an acute relapse or suffered from a new disorder in 1 year. Irrespective of diagnosis, 14.7% of the US population in 1 year reported use of services in one or more component sectors of the de facto US mental and addictive service system. With some overlap between sectors, specialists in mental and addictive disorders provided treatment to 5.9% of the US population, 6.4% sought such services from general medical physicians, 3.0% sought these services from other human service professionals, and 4.1% turned to the voluntary support sector for such care. Of those persons with any disorder, only 28.5% (8.0 per 100 population) sought mental health/addictive services. Persons with specific disorders varied in the proportion who used services, from a high of more than 60% for somatization, schizophrenia, and bipolar disorders to a low of less than 25% for addictive disorders and severe cognitive impairment. Applications of these descriptive data to US health care system reform options are considered in the context of other variables that will determine national health policy.
Topic(s):
Key & Foundational
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, Medically Unexplained Symptoms
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9364
The depression care manager and mental health specialist as collaborators within primary care
Type: Journal Article
Year: 2003
Publication Place: United States
Abstract: OBJECTIVE: The authors reviewed the implications of the latest generation of health services research studies on primary care practice system changes for depression management, especially in the roles of care managers and mental health specialists. METHODS: Authors conducted a review of four large, related, multisite trials testing system changes in the delivery of care to depressed, mostly older, primary care patients. RESULTS: These studies confirm that older patients are more likely to accept collaborative mental health treatment within primary care than within mental health specialty care. The study results published to date suggest that these system changes produce better outcomes than usual care for depression in a wide range of patients and healthcare organizations. Two key partners in implementing these system changes are a care manager to assist the primary care physician in patient education, treatment, and treatment monitoring, and a mental health specialist to provide care-manager consultation and collaborative care with the primary care physician for more complex cases. CONCLUSIONS: Most patients with depression first seek attention for their symptoms in primary care, rather than in the mental health specialty sector. Since primary care visits are necessarily brief and pressured by competing demands to manage other medical problems, practice system changes are necessary. For mental health specialists, these studies emphasize the importance of joining and being integrated into primary care. Consultative and supervisory roles allow the specialist to indirectly but effectively serve a larger number of patients.
Topic(s):
Education & Workforce
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, Healthcare Disparities
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Reference Links: View the PubMed citation for The depression care manager and mental health specialist as collaborators within primary care
9366
The description and evaluation of the implementation of an integrated healthcare model
Type: Journal Article
Year: 2010
Publication Place: United States
Topic(s):
General Literature
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Reference Links:
View the DOI record for The description and evaluation of the implementation of an integrated healthcare model
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View the PubMed citation for The description and evaluation of the implementation of an integrated healthcare model9368
The design, implementation and acceptability of an integrated intervention to address multiple behavioral and psychosocial risk factors among pregnant African American women
Type: Journal Article
Year: 2008
Publication Place: England
Abstract: BACKGROUND: African American women are at increased risk for poor pregnancy outcomes compared to other racial-ethnic groups. Single or multiple psychosocial and behavioral factors may contribute to this risk. Most interventions focus on singular risks. This paper describes the design, implementation, challenges faced, and acceptability of a behavioral counseling intervention for low income, pregnant African American women which integrated multiple targeted risks into a multi-component format. METHODS: Six academic institutions in Washington, DC collaborated in the development of a community-wide, primary care research study, DC-HOPE, to improve pregnancy outcomes. Cigarette smoking, environmental tobacco smoke exposure, depression and intimate partner violence were the four risks targeted because of their adverse impact on pregnancy. Evidence-based models for addressing each risk were adapted and integrated into a multiple risk behavior intervention format. Pregnant women attending six urban prenatal clinics were screened for eligibility and risks and randomized to intervention or usual care. The 10-session intervention was delivered in conjunction with prenatal and postpartum care visits. Descriptive statistics on risk factor distributions, intervention attendance and length (i.e., with or = 4 sessions) without disruption of clinic scheduling. Specific risk factor content was delivered as prescribed in 80% or more of the sessions; 78% of sessions were fully completed (where all required risk content was covered). Ninety-three percent of the subsample of intervention women had a positive view of their relationship with their counselor. Most intervention women found the session content helpful. Implementation challenges of addressing multiple risk behaviors are discussed. CONCLUSION: While implementation adjustments and flexibility are necessary, multiple risk behavioral interventions can be implemented in a prenatal care setting without significant disruption of services, and with a majority of referred African American women participating in and expressing satisfaction with treatment sessions.
Topic(s):
Healthcare Disparities
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9371
The development and use of the assessment of dementia awareness and person-centred care training tool in long-term care
Type: Journal Article
Year: 2019
Publication Place: England
Topic(s):
General Literature
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Reference Links:
View the DOI record for The development and use of the assessment of dementia awareness and person-centred care training tool in long-term care
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View the PubMed citation for The development and use of the assessment of dementia awareness and person-centred care training tool in long-term care9372
The development and use of the assessment of dementia awareness and person-centred care training tool in long-term care
Type: Journal Article
Year: 2019
Publication Place: England
Topic(s):
General Literature
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Reference Links:
View the DOI record for The development and use of the assessment of dementia awareness and person-centred care training tool in long-term care
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View the PubMed citation for The development and use of the assessment of dementia awareness and person-centred care training tool in long-term care9374
The development of joint principles: integrating behavioral health care into the patient-centered medical home
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: This article describes the development of the Joint Principles of The Patient-Centered Medical Home (PCMH) by the Working Party Group on Integrated Behavioral Healthcare. The Joint Principles establish the primacy of integrated behavioral health care as a core principle of the PCMH.
Topic(s):
Medical Home
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Reference Links:
View the DOI record for The development of joint principles: integrating behavioral health care into the patient-centered medical home
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View the PubMed citation for The development of joint principles: integrating behavioral health care into the patient-centered medical home9375
The development of joint principles: integrating behavioral health care into the patient-centered medical home
Type: Journal Article
Year: 2014
Publication Place: United States
Topic(s):
Medical Home
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Reference Links:
View the DOI record for The development of joint principles: integrating behavioral health care into the patient-centered medical home
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View the PubMed citation for The development of joint principles: integrating behavioral health care into the patient-centered medical home9376
The development of mental health services within primary care in India: learning from oral history
Type: Journal Article
Year: 2014
Publication Place: England
Abstract: BACKGROUND: In India very few of those who need mental health care receive it, despite efforts of the 1982 National Mental Health Programme and its district-level component the District Mental Health Programme (DMHP) to improve mental health care coverage. AIMS: To explore and unpack the political, cultural and other historical reasons for the DMHP's failures and successes since 1947 (post-independence era), which may highlight issues for today's current primary mental health care policy and programme. METHODS: Oral history interviews and documentary sourcing were conducted in 2010-11 with policy makers, programme managers and observers who had been active in the creation of the NMHP and DMHP. RESULTS: The results suggest that the widely held perception that the DMHP has failed is not entirely justified, insofar that major hurdles to the implementation of the plan have impacted on mental health coverage in primary care, rather than faults with the plan itself. These hurdles have been political neglect, inadequate leadership at central, state and district levels, inaccessible funding and improperly implemented delivery of services (including poor training, motivation and retention of staff) at district and community levels. CONCLUSION: At this important juncture as the 12th Five Year Plan is in preparation, this historical paper suggests that though the model may be improved, the most important changes would be to encourage central and state governments to implement better technical support, access to funds and to rethink the programme leadership at national, state and district levels.
Topic(s):
General Literature
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Reference Links:
View the DOI record for The development of mental health services within primary care in India: learning from oral history
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View the PubMed citation for The development of mental health services within primary care in India: learning from oral history9377
The development of valid subtypes for depression in primary care settings: A preliminary study using an explanatory model approach
Type: Journal Article
Year: 2008
Publication Place: United States
Abstract: A persistent theme in the debate on the classification of depressive disorders is the distinction between biological and environmental depressions. Despite decades of research, there remains little consensus on how to distinguish between depressive subtypes. This preliminary study describes a method that could be useful, if implemented on a larger scale, in the development of valid subtypes of depression in primary care settings, using explanatory models of depressive illness. Seventeen depressed Hispanic patients at an inner city general practice participated in explanatory model interviews. Participants generated illness narratives, which included details about symptoms, cause, course, impact, health seeking, and anticipated outcome. Two distinct subtypes emerged from the analysis. The internal model subtype was characterized by internal attributions, specifically the notion of an "injured self." The external model subtype conceptualized depression as a reaction to life situations. Each subtype was associated with a distinct constellation of clinical features and health seeking experiences. Future directions for research using explanatory models to establish depressive subtypes are explored.
Topic(s):
Healthcare Disparities
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9378
The Development, Implementation, and Evaluation of a Novel Telepsychiatry Curriculum for Integrated Care Psychiatry Fellows
Type: Journal Article
Year: 2020
Publication Place: United States
Topic(s):
Education & Workforce
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, HIT & Telehealth
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9379
The diagnosis of depression and its treatment in Canadian primary care practices: an epidemiological study
Type: Journal Article
Year: 2014
Publication Place: Canada
Abstract: BACKGROUND: A diagnosis of depression is common in primary care practices, but data are lacking on the prevalence in Canadian practices. We describe the prevalence of the diagnosis among men and women, patient characteristics and drug treatment in patients diagnosed with depression in the primary care setting in Canada. METHODS: Using electronic medical record data from the Canadian Primary Care Sentinel Surveillance Network, we examined whether the prevalence of a depression diagnosis varied by patient characteristics, the number of chronic conditions and the presence of the following chronic conditions: hypertension, diabetes, chronic obstructive pulmonary disease, osteoarthritis, dementia, epilepsy and parkinsonism. We used regression models to examine whether patient characteristics and type of comorbidity were associated with a depression diagnosis. RESULTS: Of the 304 412 patients who had at least 1 encounter with their primary care provider between Jan. 1, 2011, and Dec. 31, 2012, 14% had a diagnosis of depression. Current or past smokers and women with a high body mass index had higher rates of depression. One in 4 patients with a diagnosis of depression also had another chronic condition; those with depression had 1.5 times more primary care visits. About 85% of patients with depression were prescribed medication, most frequently selective serotonin reuptake inhibitors, followed by atypical antipsychotics. INTERPRETATION: Our data provide information on the prevalence of a depression diagnosis in primary care and associations with being female, having a chronic condition, smoking history and obesity in women. Our findings may inform research and assist primary care providers with early detection and interventions in at-risk patient populations.
Topic(s):
Healthcare Disparities
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Reference Links:
View the DOI record for The diagnosis of depression and its treatment in Canadian primary care practices: an epidemiological study
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View the PubMed citation for The diagnosis of depression and its treatment in Canadian primary care practices: an epidemiological study9380
The diagnostic accuracy and validity of the teen screen questionnaire-mental health for clinical and epidemiological studies in primary-care settings
Type: Journal Article
Year: 2014
Publication Place: India
Abstract: BACKGROUND: To validate a brief, self-reported, Teen Symptom Questionnaire-Mental Health (TSQ-M), for identifying adolescents with mental ill-health, designed for conducting epidemiological studies and clinical work in primary-care settings. MATERIALS AND METHODS: In this prospective, cross-sectional study of 146 adolescents, re-cruited six rural and urban schools, the newly developed TSQ-M as the measure for validation and General Health Questionnaire-12 item (GHQ-12) as the gold standard measure were administered by independent trained raters. Tests for diagnostic accuracy and validity were conducted. RESULTS: A TSQ-M score of >/=29 (Sn=75.68%, Sp=68.06, +LR=2.37, -LR=0.36, PPV=70.9, NPV=73.1) with the AUC of 0.79, is suggested for screening use in Indian populations. Besides the adequate face and content validity, TSQ-M has moderate internal consistency (Cronbach's alpha = .64) suggesting that the construct of mental ill-health as conceptualized by TSQ-M has multiple sub-constructs. The presence of sub-constructs was demonstrated by an 8- factor structure, which explained 60% of variance. CONCLUSION: The TSQ-M is a psychometrically adequate, yet a brief measure, for clinical and research work in identifying mental ill-health among adolescents in primary-care settings in India.
Topic(s):
Healthcare Disparities
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