Literature Collection

BACKGROUND: Patients with schizophrenia have a significantly shorter life expectancy, emphasizing the need for better interventions for physical illness. Limited knowledge, unclear responsibilities, and insufficient collaboration between psychiatric and primary care services increase the risk of inadequate, uncoordinated, and delayed treatment for this vulnerable group. Therefore, the aim of this study was to explore healthcare professionals' experiences regarding support, treatment, and interprofessional collaboration for patients with schizophrenia and physical illness. METHOD: A qualitative study with semi-structured interviews of nine psychiatric and primary care professionals. Data were analyzed using qualitative content analysis. RESULTS: The analysis generated in an overall theme, Insufficient care coordination for patients with schizophrenia and physical illness of three categories, each with two subcategories. The first category, Inadequate internal clinical protocol, included the subcategories: difficulties in identifying physical illness and differing use of guidelines among healthcare institutions involved. The second category, Deficient division of responsibility included the subcategories: unclear defined division of responsibility for coordinating support and treatment and consequences of shared responsibility for pharmacotherapy. The third category, Lack of common clinical protocols included the subcategories: difficult to get in contact with one another and concrete suggestions concerning common clinical protocols. CONCLUSION: To counteract fragmented care for patient group, a more integrated care model is needed. The study highlights the importance of clearer allocation of responsibility, improved communication, standardized routines, and the implementation of coordinated individual care plans (CIP), as well as more user-friendly screening tools to enhance care quality and reduce the risk of treatment errors.

BACKGROUND AND OBJECTIVES: Because deaths from opioid overdoses have increased in the United States, family physicians are needed who can provide integrated care for a patient with HIV, hepatitis C, and opioid use disorder. We sought to describe the individual and residency characteristics of graduating family medicine residents who intend to practice such integrated care. METHODS: We used 2017-2021 data from the American Board of Family Medicine Initial Certification Questionnaire. Our primary outcomes were individual and residency characteristics of resident graduates who intended to provide integrated care. We used logistic regression to assess independent associations with providing integrated care. RESULTS: The response rate was 100% with 18,479 total respondents. After exclusions, our final sample size was 10,660 (57.7%) respondents. Of those, 782 (7.3%) respondents intended to practice integrated care. Using regression analyses, we found that resident graduates who intended to provide integrated care were more likely to be male, non-Hispanic or Latinx. After residency, they were more likely to intend to practice at a federally qualified health center, Indian Health Service, or nonfederal government clinic. CONCLUSIONS: Only 7% of residency graduates reported their intention to provide integrated care for people with opioid use disorder after residency. In response to a surging opioid crisis, policymakers, residency educators, and residency funders/sponsors should increase the workforce of family physicians who can provide this integrated care.