Literature Collection

9541

The impact of addiction medications on treatment outcomes for persons with co-occurring PTSD and opioid use disorders

Type: Journal Article

Authors: E. C. Saunders, M. P. McGovern, C. Lambert-Harris, A. Meier, B. McLeman, H. Xie

Year: 2015

Publication Place: England

Topic(s):

Reference Links:

Export Citation: RIS

View details

9542

The Impact of Alternative Payment in Chronically Ill and Older Patients in the Patient-centered Medical Home

Type: Journal Article

Authors: C. A Salzberg, A. Bitton, S. R. Lipsitz, C. Franz, S. Shaykevich, L. P. Newmark, J. Kwatra, D. W. Bates

Year: 2017

Publication Place: United States

Abstract: BACKGROUND: Patient-centered medical home (PCMH) has gained prominence as a promising model to encourage improved primary care delivery. There is a paucity of studies that evaluate the impact of payment models in the PCMH. OBJECTIVES: We sought to examine whether coupling coordinated, team-based care transformation plan with a novel reimbursement model affects outcomes related to expenditures and utilization. RESEARCH DESIGN: Interrupted time-series model with a difference-in-differences approach to assess differences between intervention and control groups, across time periods attributable to PCMH transformation and/or payment change. RESULTS: Although results were modest and mixed overall, PCMH with payment reform is associated with a reduction of $1.04 (P=0.0347) per member per month (PMPM) in pharmacy expenditures. Patients with hypertension, hyperlipidemia, diabetes, and coronary atherosclerosis enrolled in PCMH without payment reform experienced reductions in emergency department visits of 2.16 (P<0.0001), 2.42 (P<0.0001), 3.98 (P<0.0001), and 3.61 (P<0.0001) per 1000 per month. Modest increases in inpatient admission were seen among these patients in PCMH either with or without payment reform. Patients 65 and older enrolled in PMCH without payment reform experienced reductions in pharmacy expenditures $2.35 (P=0.0077) PMPM with a parallel reduction in pharmacy standardized cost of $2.81 (P=0.0174) PMPM indicative of a reduction in the intensity of drug utilization. CONCLUSIONS: We conclude that PCMH implementation coupled with an innovative payment arrangement generated mixed results with modest improvements with respect to pharmacy expenditures, but no overall financial improvement. However, we did see improvement within specific groups, especially older patients and those with chronic conditions.

Topic(s):

,

Reference Links:

Export Citation: RIS

View details

9543

The impact of an emergency department peer navigator (EDPN) program in improving clinical outcomes and healthcare utilization in an urban setting

Type: Journal Article

Authors: C. Santos, C. Ramdin, J. Becceril, Al Kik, M. Jefri, L. Nelson

Year: 2023

Reference Links:

Export Citation: RIS

View details

9544

The impact of Assertive Community Treatment on utilization of primary care and other outpatient health services: the North Carolina experience

Type: Journal Article

Authors: E. Wiley-Exley, M. E. Domino, T. C. Ricketts, G. Cuddeback, B. J. Burns, J. Morrissey

Year: 2013

Publication Place: United States

Abstract: BACKGROUND: A number of states have implemented Assertive Community Treatment (ACT) teams statewide. The extent to which team-based care in ACT programs substitutes or complements primary care and other types of health services is relatively unknown outside of clinical trials. OBJECTIVE: To analyze whether investments in ACT yield savings in primary care and other outpatient health services. DESIGN: Patterns of medical and mental health service use and costs were examined using Medicaid claims files from 2000 to 2002 in North Carolina. Two-part models and negative binomial models compared individuals on ACT (n = 1,065 distinct individuals) with two control groups of Medicaid enrollees with severe mental illness not receiving ACT services (n = 1,426 and n = 41,717 distinct individuals). RESULTS: We found no evidence that ACT affected utilization of other outpatient health services or primary care; however, ACT was associated with a decrease in other outpatient health expenditures (excluding ACT) through a reduction in the intensity with which these services were used. Consistent with prior literature, ACT also decreased the likelihood of emergency room visits and inpatient psychiatric stays. CONCLUSIONS: Given the increasing emphasis and efforts toward integrating physical health and behavioral health care, it is likely that ACT will continue to be challenged to meet the physical health needs of its consumers. To improve primary care receipt, this may mean a departure from traditional staffing patterns (e.g., the addition of a primary care doctor and nurse) and expansion of the direct services ACT provides to incorporate physical health treatments.

Topic(s):

,

Reference Links:

Export Citation: RIS

View details

9545

The impact of behavioral health consultations on medical encounter duration in pediatric primary care: A retrospective match-controlled study

Type: Journal Article

Authors: A. R. Riley, J. K. Paternostro, B. L. Walker, D. V. Wagner

Year: 2019

Publication Place: United States

Topic(s):

Reference Links:

Export Citation: RIS

View details

9546

The impact of benzodiazepine exposure on treatment retention in an open-access methadone program: A retrospective cohort study

Type: Journal Article

Authors: Kenneth L. Morford, Jeanette M. Tetrault, Bin Zhou, Fangyong Li, Brynna Gleeson, Jennifer Edelman, Michael D. Stein, Declan T. Barry, Lynn Madden

Year: 2022

Topic(s):

Reference Links:

Export Citation: RIS

View details

9547

The Impact of Brief Interventions on Functioning Among those Demonstrating Anxiety, Depressive, and Adjustment Disorder Symptoms in Primary Care: The Effectiveness of the Primary Care Behavioral Health (PCBH) Model

Type: Journal Article

Authors: K. M. Wilfong, J. L. Goodie, J. C. Curry, C. L. Hunter, P. C. Kroke

Year: 2022

Topic(s):

Reference Links:

Export Citation: RIS

View details

9548

The impact of buprenorphine on treatment of opioid dependence in a Medicaid population: Recent service utilization trends in the use of buprenorphine and methadone

Type: Journal Article

Authors: B. D. Stein, A. J. Gordon, M. Sorbero, A. W. Dick, J. Schuster, C. Farmer

Year: 2012

Publication Place: Ireland

Topic(s):

,

Reference Links:

Export Citation: RIS

View details

9549

The impact of cocaine use in patients enrolled in opioid agonist therapy in Ontario, Canada

Type: Journal Article

Authors: A. M. Franklyn, J. K. Eibl, G. J. Gauthier, D. Pellegrini, N. E. Lightfoot, D. C. Marsh

Year: 2017

Publication Place: Netherlands

Topic(s):

Reference Links:

Export Citation: RIS

View details

9550

The impact of cognitive challenges in major depression: the role of the primary care physician

Type: Journal Article

Authors: G. Mattingly, R. H. Anderson, S. G. Mattingly, E. Q. Anderson

Year: 2016

Publication Place: England

Abstract: Nearly 1 in 5 Americans will struggle with major depression in their lives; some will have recurring bouts. Recent psychiatric research has given new attention to the prevalence of cognitive deficits in major depression and the impact such deficits have on remission and overall life functioning. When depression is partially treated i.e., leaving residual symptoms, patients have higher rates of relapse and lower functional outcomes. Impaired cognitive functioning is a frequent residual symptom, persisting in about 45% of patients even when emotional symptoms have improved, and results in a disproportionate share of the functional impairment, particularly in the workplace. Patients with depression have disrupted circuitry in brain regions responsible for cognition and it is therefore important to screen depressed patients for cognitive as well as emotional symptoms. Cognitive dysfunction should be evaluated in every mood disordered patient with validated self-report scales such as the Patient Health Questionnaire-9 or the Beck Depression Inventory and objective measures of cognitive function are also very very useful. Two easily administered tests are the Trails B Test and the Digit Symbol Substitution Test. Each take less than two minutes and measure working memory, executive function, and processing speed and can track cognitive improvement in depressed patients. Treatment of cognitive dysfunction in major depression is complicated by the 'serotonin conundrum': SSRI's frequently do not treat to full remission, and can cause cognitive blunting-actually adding to cognitive problems. Based on recent data including results from a recently completed meta-analysis by McIntyre and colleagues, an evidence-based algorithm for treating cognitive symptoms in depression is presented. A hierarchy of antidepressants and augmentation strategies based on the best available evidence is discussed. In conclusion, cognitive symptoms in major depressive disorder have been recognized as a target of therapeutic improvement by the FDA and have become a focus of clinical importance.

Topic(s):

Reference Links:

Export Citation: RIS

View details

9551

The impact of comorbid psychiatric disorders on methadone maintenance treatment in opioid use disorder: A prospective cohort study

Type: Journal Article

Authors: Tea Rosic, Leen Naji, Monica Bawor, Brittany B. Dennis, Carolyn Plater, David C. Marsh, Lehana Thabane, Zainab Samaan

Year: 2017

Topic(s):

,

Reference Links:

Export Citation: RIS

View details

9552

The impact of comorbidity of mental and physical conditions on role disability in the US adult household population

Type: Journal Article

Authors: Kathleen R. Merikangas, Minnie Ames, Lihong Cui, Paul E. Stang, T. B. Ustun, Michael Von Korff, Ronald C. Kessler

Year: 2007

Topic(s):

Export Citation: RIS

View details

9553

The impact of COVID-19 on healthcare delivery for people who use opioids: a scoping review

Type: Journal Article

Authors: K. Alexander, M. Pogorzelska-Maziarz, A. Gerolamo, N. Hassen, E. L. Kelly, K. L. Rising

Year: 2021

Topic(s):

, , ,

Reference Links:

Export Citation: RIS

View details

9554

The impact of COVID-19 on opioid treatment programs in the United States

Type: Journal Article

Authors: L. A. Goldsamt, A. Rosenblum, P. Appel, P. Paris, N. Nazia

Year: 2021

Topic(s):

, , ,

Reference Links:

Export Citation: RIS

View details

9555

The Impact of Early Substance Use Disorder Treatment Response on Treatment Outcomes Among Pregnant Women With Primary Opioid Use

Type: Journal Article

Authors: M. Tuten, H. Fitzsimons, M. Hochheimer, H. E. Jones, M. S. Chisolm

Year: 2018

Publication Place: United States

Abstract: OBJECTIVES: This study examined the impact of early patient response on treatment utilization and substance use among pregnant participants enrolled in substance use disorder (SUD) treatment. METHODS: Treatment responders (TRs) and treatment nonresponders (TNRs) were compared on pretreatment and treatment measures. Regression models predicted treatment utilization and substance use. RESULTS: TR participants attended more treatment and had lower rates of substance use relative to TNR participants. Regression models for treatment utilization and substance use were significant. Maternal estimated gestational age (EGA) and baseline cocaine use were negatively associated with treatment attendance. Medication-assisted treatment, early treatment response, and baseline SUD treatment were positively associated with treatment attendance. Maternal EGA was negatively associated with counseling attendance; early treatment response was positively associated with counseling attendance. Predictors of any substance use at 1 month were maternal education, EGA, early treatment nonresponse, and baseline cocaine use. The single predictor of any substance use at 2 months was early treatment nonresponse. Predictors of opioid use at 1 month were maternal education, EGA, early treatment nonresponse, and baseline SUD treatment. Predictors of opioid use at 2 months were early treatment nonresponse, and baseline cocaine and marijuana use. Predictors of cocaine use at 1 month were early treatment nonresponse, baseline cocaine use, and baseline SUD treatment. Predictors of cocaine use at 2 months were early treatment nonresponse and baseline cocaine use. CONCLUSIONS: Early treatment response predicts more favorable maternal treatment utilization and substance use outcomes. Treatment providers should implement interventions to maximize patient early response to treatment.

Topic(s):

,

Reference Links:

Export Citation: RIS

View details

9556

The Impact of Integrated Psychological Services in a Safety Net Primary Care Clinic on Medical Utilization

Type: Journal Article

Authors: A. Lanoye, K. E. Stewart, B. D. Rybarczyk, S. M. Auerbach, E. Sadock, A. Aggarwal, R. Waller, S. Wolver, K. Austin

Year: 2017

Publication Place: United States

Topic(s):

,

Reference Links:

Export Citation: RIS

View details

9557

The impact of integrating mental and general health services on mental health's share of total health care spending in Alberta

Type: Journal Article

Authors: R. Block, M. Slomp, S. Patterson, P. Jacobs, A. E. Ohinmaa, R. Yim, C. S. Dewa

Year: 2008

Publication Place: United States

Abstract: OBJECTIVE: In April 2003 the Alberta government integrated specialized mental health services, formerly organized independently, with the health regions, which are responsible for general health services. The objective of this article is to determine whether the transfer was associated with an increase or decrease in the share of resources in the region allocated to mental health care relative to total spending for health care. METHODS: The measure of the share for mental health care is the total costs for mental health care resources as a percentage of total health care spending. Resources and spending examined were those that were actually or potentially under the regions' control. Annual costs for mental health services in the province were obtained for a seven-year period (fiscal year [FY] 2000 through FY 2006) from provincial utilization records for all residents in the province. Unit costs were assigned to each visit. The trend in the share measure was plotted for each year. RESULTS: The share for mental health care increased overall from FY 2000 (7.6%) to FY 2003 (8.2%), but returned to pre-FY 2003 levels in the three years after the transfer (7.6%). CONCLUSIONS: Despite concerns expressed before the transfer by federal and provincial reports over the level of expenditures devoted to mental health care, the integration of mental health services with other health services did not result in an increase of the share for mental health care.

Topic(s):

Reference Links:

Export Citation: RIS

View details

9558

The Impact of Integrating Physical Health into a Brief CBT Approach for Medically Ill Veterans

Type: Journal Article

Authors: C. P. Brandt, F. Deavers, N. E. Hundt, T. L. Fletcher, J. A. Cully

Year: 2020

Publication Place: United States

Abstract:

The current study explored the use and preliminary outcomes of physical health treatment elements integrated into a traditional brief cognitive behavioral therapy (bCBT) approach for medically ill veterans with depression and/or anxiety. Data were collected as part of a pragmatic randomized trial examining patient outcomes of bCBT versus an enhanced usual care condition. bCBT was delivered to participants by Veterans Health Administration (VA) mental health providers in the primary care setting. Using a skill-based approach, providers and participants selected modules from a list of intervention strategies. Modules included Taking Control of Your Physical Health, Using Thoughts to Improve Wellness, Increasing Pleasant Activities, and Learning How to Relax. Skill module use and impact on treatment completion and clinical outcomes were explored for participants randomized to bCBT who received at least one skill module (n = 127). Utilization data showed that participants and providers most commonly selected the physical health module for the first skill session. Receiving the "physical health" and "thoughts" modules earlier in treatment were associated with a higher likelihood of treatment completion (defined as four or more sessions). Preliminary outcome data suggest that the physical health skill module was equally effective or superior to other bCBT skill modules. Results suggest that incorporating physical health elements with a bCBT approach hold the potential to positively impact treatment engagement/completion and may result in improved outcomes for medically ill patient populations.

Topic(s):

Reference Links:

Export Citation: RIS

View details

9559

The impact of Medical Home on selected children's health outcome

Type: Journal Article

Authors: Michael M. O. Seipel

Year: 2011

Publication Place: United Kingdom: Taylor & Francis

Topic(s):

Reference Links:

Export Citation: RIS

View details

9560

The Impact Of Medicare ACOs On Improving Integration And Coordination Of Physical And Behavioral Health Care

Type: Journal Article

Authors: C. A. Fullerton, R. M. Henke, E. Crable, A. Hohlbauch, N. Cummings

Year: 2016

Publication Place: United States

Abstract: The accountable care organization (ACO) model holds the promise of reducing costs and improving the quality of care by realigning payment incentives to focus on health outcomes instead of service volume. One key to managing the total cost of care is improving care coordination for and treatment of people with behavioral health disorders. We examined qualitative data from ninety organizations participating in Medicare ACO demonstration programs from 2012 through 2015 to determine whether and how they focused on behavioral health care. These ACOs had mixed degrees of engagement in improving behavioral health care for their populations. The biggest challenges included a lack of behavioral health care providers, data availability, and sustainable financing models. Nonetheless, we found substantial interest in integrating behavioral health care into primary care across a majority of the ACOs.

Topic(s):

,

Reference Links:

Export Citation: RIS

View details