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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).
12771 Results
1143
Alcohol-Related Nurse Care Management in Primary Care: A Randomized Clinical Trial
Type:
Journal Article
Year:
2018
Publication Place:
United States
Abstract:
Importance: Experts recommend that alcohol use disorders (AUDs) be managed in primary care, but effective approaches are unclear. Objective: To test whether 12 months of alcohol care management, compared with usual care, improved drinking outcomes among patients with or at high risk for AUDs. Design, Setting, and Participants: This randomized clinical trial was conducted at 3 Veterans Affairs (VA) primary care clinics. Between October 11, 2011, and September 30, 2014, the study enrolled 304 outpatients who reported heavy drinking (>/=4 drinks per day for women and >/=5 drinks per day for men). Interventions: Nurse care managers offered outreach and engagement, repeated brief counseling using motivational interviewing and shared decision making about treatment options, and nurse practitioner-prescribed AUD medications (if desired), supported by an interdisciplinary team (CHOICE intervention). The comparison was usual primary care. Main Outcomes and Measures: Primary outcomes, assessed by blinded telephone interviewers at 12 months, were percentage of heavy drinking days in the prior 28 days measured by timeline follow-back interviews and a binary good drinking outcome, defined as abstinence or drinking below recommended limits in the prior 28 days (according to timeline follow-back interviews) and no alcohol-related symptoms in the past 3 months as measured by the Short Inventory of Problems. Results: Of 304 participants, 275 (90%) were male, 206 (68%) were white, and the mean (SD) age was 51.4 (13.8) years. At baseline, both the CHOICE intervention (n = 150) and usual care (n = 154) groups reported heavy drinking on 61% of days (95% CI, 56%-66%). During the 12-month intervention, 137 of 150 patients in the intervention group (91%) had at least 1 nurse visit, and 77 of 150 (51%) had at least 6 nurse visits. A greater proportion of patients in the intervention group than in the usual care group received alcohol-related care: 42% (95% CI, 35%-49%; 63 of 150 patients) vs 26% (95% CI, 19%-35%; 40 of 154 patients). Alcohol-related care included more AUD medication use: 32% (95% CI, 26%-39%; 48 of 150 patients in the intervention group) vs 8% (95% CI, 5%-13%; 13 of 154 patients in the usual care group). No significant differences in primary outcomes were observed at 12 months between patients in both groups. The percentages of heavy drinking days were 39% (95% CI, 32%-47%) and 35% (95% CI, 28%-42%), and the percentages of patients with a good drinking outcome were 15% (95% CI, 9%-22%; 18 of 124 patients) and 20% (95 % CI, 14%-28%; 27 of 134 patients), in the intervention and usual care groups, respectively (P = .32-.44). Findings at 3 months were similar. Conclusions and Relevance: The CHOICE intervention did not decrease heavy drinking or related problems despite increased engagement in alcohol-related care. Trial Registration: clinicaltrials.gov Identifier: NCT01400581.
Topic(s):
Opioids & Substance Use
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Reference Links:
View the DOI record for Alcohol-Related Nurse Care Management in Primary Care: A Randomized Clinical Trial
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View the PubMed citation for Alcohol-Related Nurse Care Management in Primary Care: A Randomized Clinical Trial
1144
Alcohol, Cannabis, and Opioid Use Disorders, and Disease Burden in an Integrated Health Care System
Type:
Journal Article
Year:
2017
Publication Place:
United States
Abstract:
OBJECTIVES: We examined prevalence of major medical conditions and extent of disease burden among patients with and without substance use disorders (SUDs) in an integrated health care system serving 3.8 million members. METHODS: Medical conditions and SUDs were extracted from electronic health records in 2010. Patients with SUDs (n = 45,461; alcohol, amphetamine, barbiturate, cocaine, hallucinogen, and opioid) and demographically matched patients without SUDs (n = 45,461) were compared on the prevalence of 19 major medical conditions. Disease burden was measured as a function of 10-year mortality risk using the Charlson Comorbidity Index. P-values were adjusted using Hochberg's correction for multiple-inference testing within each medical condition category. RESULTS: The most frequently diagnosed SUDs in 2010 were alcohol (57.6%), cannabis (14.9%), and opioid (12.9%). Patients with these SUDs had higher prevalence of major medical conditions than non-SUD patients (alcohol use disorders, 85.3% vs 55.3%; cannabis use disorders, 41.9% vs 23.0%; and opioid use disorders, 44.9% vs 26.1%; all P < 0.001). Patients with these SUDs also had higher disease burden than non-SUD patients; patients with opioid use disorders (M = 0.48; SE = 1.46) had particularly high disease burden (M = 0.23; SE = 0.09; P < 0.001). CONCLUSIONS: Common SUDs, particularly opioid use disorders, are associated with substantial disease burden for privately insured individuals without significant impediments to care. This signals the need to explore the full impact SUDs have on the course and outcome of prevalent conditions and initiate enhanced service engagement strategies to improve disease burden.
Topic(s):
Opioids & Substance Use
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Reference Links:
View the DOI record for Alcohol, Cannabis, and Opioid Use Disorders, and Disease Burden in an Integrated Health Care System
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View the PubMed citation for Alcohol, Cannabis, and Opioid Use Disorders, and Disease Burden in an Integrated Health Care System
1145
Aligning health information technologies with effective service delivery models to improve chronic disease care
Type:
Journal Article
Year:
2014
Publication Place:
United States
Topic(s):
HIT & Telehealth
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Reference Links:
View the DOI record for Aligning health information technologies with effective service delivery models to improve chronic disease care
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View the PubMed citation for Aligning health information technologies with effective service delivery models to improve chronic disease care
1151
All Hands on Deck: Addressing Adolescent Depression in Pediatric Primary Care
Type:
Journal Article
Year:
2021
Topic(s):
Healthcare Disparities
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, Measures
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Reference Links:
View the DOI record for All Hands on Deck: Addressing Adolescent Depression in Pediatric Primary Care
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View the PubMed citation for All Hands on Deck: Addressing Adolescent Depression in Pediatric Primary Care
1152
All together now? Staff views and experiences of a pre-qualifying interprofessional curriculum
Type:
Journal Article
Year:
2007
Publication Place:
England
Abstract:
An interprofessional pre-qualifying curriculum for health and social care professionals was introduced at an English university in September 2000. This study explored the experiences of academic staff from a range of professional backgrounds involved in this interprofessional initiative. Data were collected via questionnaires, individual interviews and focus groups and were analysed using Interpretative Phenomenological Analysis. Sixty-one questionnaires were returned out of a possible two hundred (response rate 30.5%); twenty-nine respondents participated in interviews and focus groups. Four main themes emerged from the data: (i) Huge: Size does matter; (ii) Isolation: Together but separate; (iii) Facilitation: Anything but easy; and (iv) Faculty: Do we walk the talk? The study found a cross-Faculty commitment to interprofessional education, but revealed considerable difficulties for those staff responsible for the management and delivery of the curriculum. The vast scale, the complex nature of interprofessional education delivery, the logistics and organizational challenges created significant difficulties for staff, who could at times feel overwhelmed and isolated. Attitudinal barriers to interprofessional education were identified, although the interprofessional curriculum had enhanced interprofessional working within the Faculty. In order to optimize the success of interprofessional education, the significant challenges that exist for academic staff must be addressed, and ownership by staff enabled.
Topic(s):
Education & Workforce
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Reference Links:
View the DOI record for All together now? Staff views and experiences of a pre-qualifying interprofessional curriculum
View DOI Record
View the PubMed citation for All together now? Staff views and experiences of a pre-qualifying interprofessional curriculum