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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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11202 Results
10621
Trends in Geographic Proximity to Substance Use Disorder Treatment
Type: Journal Article
Authors: K. A. Kapinos, M. DeYoreo, T. Gracner, B. D. Stein, J. Cantor
Year: 2023
Topic(s):
Opioids & Substance Use See topic collection
,
Healthcare Disparities See topic collection
,
Financing & Sustainability See topic collection
10622
Trends in Indicators of Injection Drug Use, Indian Health Service, 2010-2014: A Study of Health Care Encounter Data
Type: Journal Article
Authors: Mary E. Evans, Marissa Person, Brigg Reilley, Jessica Leston, Richard Haverkate, Jeffrey T. McCollum, Andria Apostolou, Michele K. Bohm, Michelle Van Handel, Danae Bixler, Andrew J. Mitsch, Dana L. Haberling, Sarah M. Hatcher, Thomas Weiser, Kim Elmore, Eyasu H. Teshale, Paul J. Weidle, Philip J. Peters, Kate Buchacz
Year: 2020
Publication Place: Thousand Oaks, California
Topic(s):
Education & Workforce See topic collection
,
Healthcare Disparities See topic collection
,
Opioids & Substance Use See topic collection
10623
Trends in Mental Health and Substance Abuse Services at the Nation's Community Health Centers: 1998-2003
Type: Journal Article
Authors: B. G. Druss, T. Bornemann, Y. W. Fry-Johnson, H. G. McCombs, R. M. Politzer, G. Rust
Year: 2006
Publication Place: United States
Abstract: OBJECTIVE: We examined trends in delivery of mental health and substance abuse services at the nation's community health centers. METHODS: Analyses used data from the Health Resources and Services Administration (HRSA), Bureau of Primary Care's (BPHC) 1998 and 2003 Uniform Data System, merged with county-level data. RESULTS: Between 1998 and 2003, the number of patients diagnosed with a mental health/substance abuse disorder in community health centers increased from 210,000 to 800,000. There was an increase in the number of patients per specialty mental health/substance abuse treatment provider and a decline in the mean number of patient visits, from 7.3 visits per patient to 3.5 by 2003. Although most community health centers had some on-site mental health/substance abuse services, centers without on-site services were more likely to be located in counties with fewer mental health/substance abuse clinicians, psychiatric emergency rooms, and inpatient hospitals. CONCLUSIONS: Community health centers are playing an increasingly central role in providing mental health/substance abuse treatment services in the United States. It is critical both to ensure that these centers have adequate resources for providing mental health/substance abuse care and that they develop effective linkages with mental health/substance abuse clinicians in the communities they serve.
Topic(s):
Financing & Sustainability See topic collection
,
Healthcare Disparities See topic collection
10626
Trends in Opioid Agonist Therapy in the Veterans Health Administration: Is Supply Keeping up with Demand?
Type: Journal Article
Authors: Elizabeth M. Oliva, Jodie A. Trafton, Alex H. S. Harris, Adam J. Gordon
Year: 2013
Topic(s):
Opioids & Substance Use See topic collection
,
Education & Workforce See topic collection
10627
Trends in Opioid Use Disorder Among Older Adults: Analyzing Medicare Data, 2013-2018
Type: Journal Article
Authors: C. Shoff, T. C. Yang, B. A. Shaw
Year: 2021
Abstract:

INTRODUCTION: Opioid use disorder has grown rapidly over the years and is a public health crisis in the U.S. Although opioid use disorder is widely studied, relatively little is known about it among older adults. The goal of this study is to gain a better understanding of opioid use disorder among older Medicare beneficiaries over time and across several sociodemographic dimensions. METHODS: Data from the 2013-2018 Centers for Medicare & Medicaid Services Master Beneficiary Summary Files were analyzed in 2020 to examine the trends in opioid use disorder prevalence among Fee-for-Service Medicare beneficiaries aged ≥65 years. Utilizing the overarching opioid use disorder flag, trends in opioid use disorder prevalence were examined for the following sociodemographic dimensions: age, sex, race/ethnicity, and dual eligibility status (i.e., enrolled in both Medicare and Medicaid owing to low income). Chi-square tests were used to compare opioid use disorder prevalence across groups. RESULTS: Since 2013, estimated rates of opioid use disorder among older adults have increased by >3-fold overall in the U.S. Estimated opioid use disorder is more prevalent among the young-old (i.e., ages 65-69 years) beneficiaries than among other older adults, and dually eligible beneficiaries have consistently shared a heavier burden of opioid use disorder than Medicare-only beneficiaries. Regarding race/ethnicity, Blacks and American Indians/Alaskan Natives are more vulnerable to opioid use disorder than other groups. CONCLUSIONS: The descriptive trends between 2013 and 2018 indicate that estimated opioid use disorder prevalence has increased greatly over the study period in all sociodemographic subgroups of older adults, highlighting an urgent challenge for public health professionals and gerontologists.

Topic(s):
Financing & Sustainability See topic collection
,
Healthcare Disparities See topic collection
,
Opioids & Substance Use See topic collection
10629
Trends in Opioid Use Disorder Outpatient Treatment and Telehealth Utilization Before and During the COVID-19 Pandemic
Type: Journal Article
Authors: K. N. Tormohlen, M. D. Eisenberg, M. I. Fingerhood, J. Yu, A. D. McCourt, E. A. Stuart, L. Rutkow, L. Quintero, S. A. White, E. E. McGinty
Year: 2024
Abstract:

OBJECTIVE: The authors examined trends in opioid use disorder treatment and in-person and telehealth modalities before and after COVID-19 pandemic onset among patients who had received treatment prepandemic. METHODS: The sample included 13,113 adults with commercial insurance or Medicare Advantage and receiving opioid use disorder treatment between March 2018 and February 2019. Trends in opioid use disorder outpatient treatment, treatment with medications for opioid use disorder (MOUD), and in-person and telehealth modalities were examined 1 year before pandemic onset and 2 years after (March 2019-February 2022). RESULTS: From March 2019 to February 2022, the proportion of patients with opioid use disorder outpatient and MOUD visits declined by 2.8 and 0.3 percentage points, respectively. Prepandemic, 98.6% of outpatient visits were in person; after pandemic onset, at least 34.9% of patients received outpatient care via telehealth. CONCLUSIONS: Disruptions in opioid use disorder outpatient and MOUD treatments were marginal during the pandemic, possibly because of increased telehealth utilization.

Topic(s):
Opioids & Substance Use See topic collection
,
HIT & Telehealth See topic collection
,
Financing & Sustainability See topic collection
10630
Trends in Opioid Use Disorder Outpatient Treatment and Telehealth Utilization Before and During the COVID-19 Pandemic
Type: Journal Article
Authors: K. N. Tormohlen, M. D. Eisenberg, M. I. Fingerhood, J. Yu, A. D. McCourt, E. A. Stuart, L. Rutkow, L. Quintero, S. A. White, E. E. McGinty
Year: 2023
Abstract:

OBJECTIVE: The authors examined trends in opioid use disorder treatment and in-person and telehealth modalities before and after COVID-19 pandemic onset among patients who had received treatment prepandemic. METHODS: The sample included 13,113 adults with commercial insurance or Medicare Advantage and receiving opioid use disorder treatment between March 2018 and February 2019. Trends in opioid use disorder outpatient treatment, treatment with medications for opioid use disorder (MOUD), and in-person and telehealth modalities were examined 1 year before pandemic onset and 2 years after (March 2019-February 2022). RESULTS: From March 2019 to February 2022, the proportion of patients with opioid use disorder outpatient and MOUD visits declined by 2.8 and 0.3 percentage points, respectively. Prepandemic, 98.6% of outpatient visits were in person; after pandemic onset, at least 34.9% of patients received outpatient care via telehealth. CONCLUSIONS: Disruptions in opioid use disorder outpatient and MOUD treatments were marginal during the pandemic, possibly because of increased telehealth utilization.

Topic(s):
HIT & Telehealth See topic collection
,
Opioids & Substance Use See topic collection
10632
Trends in Pediatric Primary Care Visits During the COVID-19 Pandemic: Opportunity to Address Adolescent Behavioral Health Through Telemedicine
Type: Journal Article
Authors: G. Hong, J. Less, B. Masoudian, A. Cruz, S. Sifuentes, J. Vue, A. Yanamandra, A. Sattler, S. Lin
Year: 2023
Abstract:

BACKGROUND AND OBJECTIVES: The COVID-19 pandemic impacted the volume and nature of pediatric primary care visits nationwide. This study aimed to identify trends in pediatric visits at our institution during the pandemic to reveal opportunities to improve care of children and adolescents. METHODS: We performed a retrospective chart review of all pediatric visits conducted at a single family medicine clinic within a large academic medical center in Northern California from January 1, 2019, through September 30, 2021. Data collected for each visit included age, sex, type of visit (preventive or problem-focused), reason for visit (if problem-focused), and mode of visit (in-person or telehealth). We analyzed data using descriptive statistics and χ2 tests. RESULTS: A total of 4,844 pediatric visits occurred during the study period. Visit volume dropped 9% from 2019 to 2020 and recovered to prepandemic levels in 2021. During the study period from 2019 to 2021, the percentage of problem-focused visits increased from 30% to 37% (P=.008) among adolescents, driven largely by an increase in the percentage of behavioral health visits from 14% to 29% (P< .001). We found no significant changes in the age or sex of patients seen. Telemedicine visit volume decreased from 2020 to 2021 in all age categories except for adolescents, which remained stable at 43% of all visits. CONCLUSIONS: A sharp increase in behavioral health concerns among adolescents stands out as the most notable impact of COVID-19 on pediatric care at our institution. Our findings raise questions about how behavioral health care can be optimized for adolescents in the postpandemic era.

Topic(s):
HIT & Telehealth See topic collection
,
Healthcare Disparities See topic collection
10633
Trends in primary care encounters across professional roles in PCMH
Type: Journal Article
Authors: A. M. Annis, M. Harris, H. M. Kim, A. M. Rosland, S. L. Krein
Year: 2018
Publication Place: United States
Abstract: OBJECTIVES: Team-based care models, including the patient-centered medical home (PCMH), are increasingly promoted to improve the delivery of primary care. However, evaluation measures are often reported at a clinic or primary care provider (PCP) level, creating challenges in describing and analyzing the use and impact of non-PCP clinician team members. Thus, we aimed to measure clinician-specific care delivery trends and determine whether trends were responsive to systemwide PCMH implementation. STUDY DESIGN: Interrupted time-series analysis of 57 million primary care encounters among 5 million veterans at 764 Veterans Health Administration primary care clinics from 2009 to 2013. METHODS: Retrospective data identified patient encounters attributable to 12 types of clinicians, yielding an encounters-by-clinician metric. Negative binomial regression modeled the monthly clinic-level rates of encounters for each type of clinician, before and during PCMH implementation. RESULTS: Over 5 years, the percentage of encounters by non-PCP clinicians increased from 29% to 35%. Monthly encounter rates for nurses and social workers significantly increased by 0.5% and 1.3%, respectively, after the introduction of PCMH, whereas PCP encounter rates significantly decreased over time. Encounter trends for pharmacists, nutritionists, and behavioral health clinicians did not significantly change. CONCLUSIONS: This study demonstrated the feasibility of capturing care delivered by a full complement of team members using routinely collected data. Findings suggest that the proportions of care delivered by non-PCP clinicians were sensitive to a change in care delivery model. As team-based care models expand, availability and use of metrics that account for care by all team members are critical for inferring clinician-related effects on outcomes.
Topic(s):
Medical Home See topic collection
10634
Trends in primary care encounters across professional roles in PCMH
Type: Journal Article
Authors: A. M. Annis, M. Harris, H. M. Kim, A. M. Rosland, S. L. Krein
Year: 2018
Publication Place: United States
Abstract: OBJECTIVES: Team-based care models, including the patient-centered medical home (PCMH), are increasingly promoted to improve the delivery of primary care. However, evaluation measures are often reported at a clinic or primary care provider (PCP) level, creating challenges in describing and analyzing the use and impact of non-PCP clinician team members. Thus, we aimed to measure clinician-specific care delivery trends and determine whether trends were responsive to systemwide PCMH implementation. STUDY DESIGN: Interrupted time-series analysis of 57 million primary care encounters among 5 million veterans at 764 Veterans Health Administration primary care clinics from 2009 to 2013. METHODS: Retrospective data identified patient encounters attributable to 12 types of clinicians, yielding an encounters-by-clinician metric. Negative binomial regression modeled the monthly clinic-level rates of encounters for each type of clinician, before and during PCMH implementation. RESULTS: Over 5 years, the percentage of encounters by non-PCP clinicians increased from 29% to 35%. Monthly encounter rates for nurses and social workers significantly increased by 0.5% and 1.3%, respectively, after the introduction of PCMH, whereas PCP encounter rates significantly decreased over time. Encounter trends for pharmacists, nutritionists, and behavioral health clinicians did not significantly change. CONCLUSIONS: This study demonstrated the feasibility of capturing care delivered by a full complement of team members using routinely collected data. Findings suggest that the proportions of care delivered by non-PCP clinicians were sensitive to a change in care delivery model. As team-based care models expand, availability and use of metrics that account for care by all team members are critical for inferring clinician-related effects on outcomes.
Topic(s):
Medical Home See topic collection
10636
Trends in the use of buprenorphine by office-based physicians in the United States, 2003-2013
Type: Journal Article
Authors: Lydia Turner, Stefan P. Kruszewski, Caleb Alexander
Year: 2014
Publication Place: Hoboken
Topic(s):
Opioids & Substance Use See topic collection
10637
Trends in Use of Medication to Treat Opioid Use Disorder During the COVID-19 Pandemic in 10 State Medicaid Programs
Type: Journal Article
Authors: A. E. Austin, L. Tang, J . Y. Kim, L. Allen, A. J. Barnes, C. H. Chang, S. Clark, E. S. Cole, C. P. Durrance, J. M. Donohue, A. J. Gordon, H. A. Huskamp, M. J. McDuffie, A. Mehrotra, S. Mohamoud, J. Talbert, K. A. Ahrens, M. Applegate, L. R. Hammerslag, P. Lanier, K. Tossone, K. Zivin, M. E. Burns
Year: 2023
Abstract:

IMPORTANCE: Federal and state agencies granted temporary regulatory waivers to prevent disruptions in access to medication for opioid use disorder (MOUD) during the COVID-19 pandemic, including expanding access to telehealth for MOUD. Little is known about changes in MOUD receipt and initiation among Medicaid enrollees during the pandemic. OBJECTIVES: To examine changes in receipt of any MOUD, initiation of MOUD (in-person vs telehealth), and the proportion of days covered (PDC) with MOUD after initiation from before to after declaration of the COVID-19 public health emergency (PHE). DESIGN, SETTING, AND PARTICIPANTS: This serial cross-sectional study included Medicaid enrollees aged 18 to 64 years in 10 states from May 2019 through December 2020. Analyses were conducted from January through March 2022. EXPOSURES: Ten months before the COVID-19 PHE (May 2019 through February 2020) vs 10 months after the PHE was declared (March through December 2020). MAIN OUTCOMES AND MEASURES: Primary outcomes included receipt of any MOUD and outpatient initiation of MOUD via prescriptions and office- or facility-based administrations. Secondary outcomes included in-person vs telehealth MOUD initiation and PDC with MOUD after initiation. RESULTS: Among a total of 8 167 497 Medicaid enrollees before the PHE and 8 181 144 after the PHE, 58.6% were female in both periods and most enrollees were aged 21 to 34 years (40.1% before the PHE; 40.7% after the PHE). Monthly rates of MOUD initiation, representing 7% to 10% of all MOUD receipt, decreased immediately after the PHE primarily due to reductions in in-person initiations (from 231.3 per 100 000 enrollees in March 2020 to 171.8 per 100 000 enrollees in April 2020) that were partially offset by increases in telehealth initiations (from 5.6 per 100 000 enrollees in March 2020 to 21.1 per 100 000 enrollees in April 2020). Mean monthly PDC with MOUD in the 90 days after initiation decreased after the PHE (from 64.5% in March 2020 to 59.5% in September 2020). In adjusted analyses, there was no immediate change (odds ratio [OR], 1.01; 95% CI, 1.00-1.01) or change in the trend (OR, 1.00; 95% CI, 1.00-1.01) in the likelihood of receipt of any MOUD after the PHE compared with before the PHE. There was an immediate decrease in the likelihood of outpatient MOUD initiation (OR, 0.90; 95% CI, 0.85-0.96) and no change in the trend in the likelihood of outpatient MOUD initiation (OR, 0.99; 95% CI, 0.98-1.00) after the PHE compared with before the PHE. CONCLUSIONS AND RELEVANCE: In this cross-sectional study of Medicaid enrollees, the likelihood of receipt of any MOUD was stable from May 2019 through December 2020 despite concerns about potential COVID-19 pandemic-related disruptions in care. However, immediately after the PHE was declared, there was a reduction in overall MOUD initiations, including a reduction in in-person MOUD initiations that was only partially offset by increased use of telehealth.

Topic(s):
Opioids & Substance Use See topic collection
,
Financing & Sustainability See topic collection
10638
Trends in use of telehealth for behavioral health care during the COVID-19 pandemic: Considerations for payers and employers
Type: Journal Article
Authors: Norah Mulvaney-Day, David Dean Jr., Kay Miller, Jessica Camacho-Cook
Year: 2022
Topic(s):
Opioids & Substance Use See topic collection
,
Financing & Sustainability See topic collection
10640
Trends of poly-substance use among Canadian youth
Type: Journal Article
Authors: A. M. E. Zuckermann, G. Williams, K. Battista, M. de Groh, Y. Jiang, S. T. Leatherdale
Year: 2019
Abstract:

INTRODUCTION: Poly-substance use, increasingly understood as a behaviour with uniquely adverse consequences, is on the rise among Canadian youth. High levels of e-cigarette vaping and the recent legalization of recreational cannabis use may result in an acceleration of this trend. The aim of this work was to characterise changes in youth poly-substance use over time, generate baseline data for future investigations, and highlight areas of interest for policy action. METHODS: Descriptive statistics and regression models explored patterns and trends in concurrent use of multiple substances (alcohol, cigarettes, cannabis, and e-cigarettes) among Canadian high school students taking part in the COMPASS prospective cohort study during Y2 (2013/2014; n = 45,298), Y3 (2014/2015, n = 42,355), Y4 (2015/2016; n = 40,436), Y5 (2016/2017; n = 37,060), and Y6 (2017/2018; n = 34,879). RESULTS: Poly-substance use increased significantly over time, with over 50% of students who used substance reporting past-year use of multiple substances by 2017/2018. Male and Indigenous students were significantly more likely to report poly-substance use than female and white students respectively. E-cigarette vaping doubled from Y5 to Y6 and was included in all increasingly prevalent substance use combinations. CONCLUSIONS: Youth poly-substance use, rising since 2012/2013, saw a particularly steep increase after 2016/2017. Differential effects were observed for distinct demographic subpopulations, indicating tailored interventions may be required. E-cigarette vaping surged in parallel with the observed increase, suggesting a key role for this behaviour in shaping youth poly-substance use.

Topic(s):
Education & Workforce See topic collection
,
Healthcare Disparities See topic collection
,
Opioids & Substance Use See topic collection