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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).
11202 Results
1542
Behavioral intervention to reduce opioid overdose among high-risk persons with opioid use disorder: A pilot randomized controlled trial
Type: Journal Article
Year: 2017
Publication Place: United States
Abstract:
OBJECTIVE: The United States is amidst an opioid epidemic, including synthetic opioids that may result in rapid death, leaving minimal opportunity for bystander rescue. We pilot tested a behavioral intervention to reduce the occurrence of opioid overdose among opioid dependent persons at high-risk for subsequent overdose. MATERIALS AND METHODS: We conducted a single-blinded randomized-controlled trial of a repeated dose motivational interviewing intervention (REBOOT) to reduce overdose versus treatment as usual, defined as information and referrals, over 16 months at the San Francisco Department of Public Health from 2014-2016. Participants were 18-65 years of age, had opioid use disorder by Structured Clinical Interview, active opioid use, opioid overdose within 5 years, and prior receipt of naloxone kits. The intervention was administered at months 0, 4, 8, and 12, preceded by the assessment which was also administered at month 16. Dual primary outcomes were any overdose event and number of events, collected by computer-assisted personal interview, as well as any fatal overdose events per vital records. RESULTS: A total of 78 persons were screened and 63 enrolled. Mean age was 43 years, 67% were born male, 65% White, 17% African-American, and 14% Latino. Ninety-two percent of visits and 93% of counseling sessions were completed. At baseline, 33.3% of participants had experienced an overdose in the past four months, with a similar mean number of overdoses in both arms (p = 0.95); 29% overdosed during follow-up. By intention-to-treat, participants assigned to REBOOT were less likely to experience any overdose (incidence rate ratio [IRR] 0.62 [95%CI 0.41-0.92, p = 0.019) and experienced fewer overdose events (IRR 0.46, 95%CI 0.24-0.90, p = 0.023), findings that were robust to sensitivity analyses. There were no differences between arms in days of opioid use, substance use treatment, or naloxone carriage. CONCLUSIONS: REBOOT reduced the occurrence of any opioid overdose and the number of overdoses. TRIAL REGISTRATION: clinicaltrials.gov NCT02093559.
Topic(s):
Healthcare Disparities
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, Measures
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, Opioids & Substance Use
See topic collection
1543
Behavioral interventions for office-based care: interventions in the family medicine setting
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: The practice of family medicine includes the care of many patients with mental health or behavior change needs. Patients in mild to moderate distress may benefit from brief interventions performed in the family physician's office. Patients in more extreme distress may be helped by referral to behavioral health clinicians for short-term or open-ended therapies. Electronic therapy programs and bibliotherapy are also useful resources. The transition to the patient-centered medical home model may allow for more widespread integration of behavioral health care clinicians into primary care, in person and through telemental health care. Integrated care holds the promise of improved access, greater effectiveness of behavioral health service provision, and enhanced efficiency of primary care for patients with behavioral health care needs.
Topic(s):
Medical Home
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Reference Links: View the PubMed citation for Behavioral interventions for office-based care: interventions in the family medicine setting
1545
Behavioral interventions in acute COVID-19 recovery: A new opportunity for integrated care
Type: Journal Article
Year: 2020
Topic(s):
Healthcare Disparities
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Reference Links:
View the DOI record for Behavioral interventions in acute COVID-19 recovery: A new opportunity for integrated care
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View the PubMed citation for Behavioral interventions in acute COVID-19 recovery: A new opportunity for integrated care1546
Behavioral Interventions Targeting Chronic Pain, Depression, and Substance Use Disorder in Primary Care
Type: Journal Article
Year: 2016
Publication Place: United States
Topic(s):
Opioids & Substance Use
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Reference Links:
View the DOI record for Behavioral Interventions Targeting Chronic Pain, Depression, and Substance Use Disorder in Primary Care
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View the PubMed citation for Behavioral Interventions Targeting Chronic Pain, Depression, and Substance Use Disorder in Primary Care1547
Behavioral medicine in medical education: Report of a survey
Type: Journal Article
Year: 2000
Publication Place: UNITED STATES
Abstract: Behavioral medicine has become increasingly important in medical education over the past two decades, but adoption of its principles and methods has been slow. Behavioral medicine stresses the effects of human behavior on health and illness using a biopsychosocial approach. It also focuses on the use of the doctor-patient relationship, which, if developed using appropriate communication skills, can result in greater patient satisfaction and increased compliance. The authors surveyed all 124 American medical schools to assess both national trends and specific efforts in the teaching of behavioral medicine principles and methods. A review of the types of behavioral medicine programs offered reveals that eight percent of U.S. medical schools had integrated programs of behavioral medicine. Several successful and effective programs were identified, as were a number of specific curricular components. There are several options available to medical schools to integrate behavioral medicine into medical education. The authors conclude that medical education must include behavioral medicine in order to improve the health of the public and to meet the demands of a changing health care system.
Topic(s):
Education & Workforce
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Reference Links: View the PubMed citation for Behavioral medicine in medical education: Report of a survey
1549
Behavioral Science Rounds: Identifying and Addressing the Challenging Issues That Residents Face on a Family Medicine Inpatient Service
Type: Journal Article
Year: 2019
Publication Place: United States
Topic(s):
Education & Workforce
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1551
Behaviors of children following a randomized controlled treatment program for their abused mothers
Type: Journal Article
Year: 2005
Topic(s):
General Literature
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Reference Links:
View the DOI record for Behaviors of children following a randomized controlled treatment program for their abused mothers
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View the PubMed citation for Behaviors of children following a randomized controlled treatment program for their abused mothers1552
Behavioural health consultants in integrated primary care teams: a model for future care
Type: Journal Article
Year: 2016
Publication Place: England
Abstract: BACKGROUND: Significant challenges exist within primary care services in the United Kingdom (UK). These include meeting current demand, financial pressures, an aging population and an increase in multi-morbidity. Psychological services also struggle to meet waiting time targets and to ensure increased access to psychological therapies. Innovative ways of delivering effective primary care and psychological services are needed to improve health outcomes. In this article we argue that integrated care models that incorporate behavioural health care are part of the solution, which has seldom been argued in relation to UK primary care. Integrated care involves structural and systemic changes to the delivery of services, including the co-location of multi-disciplinary primary care teams. Evidence from models of integrated primary care in the United States of America (USA) and other higher-income countries suggest that embedding continuity of care and collaborative practice within integrated care teams can be effective in improving health outcomes. The Behavioural Health Consultant (BHC) role is integral to this, working psychologically to support the team to improve collaborative working, and supporting patients to make changes to improve their health across management of long-term conditions, prevention and mental wellbeing. Patients' needs for higher-intensity interventions to enable changes in behaviour and self-management are, therefore, more fully met within primary care. The role also increases accessibility of psychological services, delivers earlier interventions and reduces stigma, since psychological staff are seen as part of the core primary care service. Although the UK has trialled a range of approaches to integrated care, these fall short of the highest level of integration. A single short pilot of integrated care in the UK showed positive results. Larger pilots with robust evaluation, as well as research trials are required. There are clearly challenges in adopting such an approach, especially for staff who must adapt to working more collaboratively with each other and patients. Strong leadership is needed to assist in this, particularly to support organisations to adopt the shift in values and attitudes towards collaborative working. CONCLUSIONS: Integrated primary care services that embed behavioural health as part of a multi-disciplinary team may be part of the solution to significant modern day health challenges. However, developing this model is unlikely to be straight-forward given current primary care structures and ways of working. The discussion, developed in this article, adds to our understanding of what the BHC role might consist off and how integrated care may be supported by such behavioural health expertise. Further work is needed to develop this model in the UK, and to evaluate its impact on health outcomes and health care utilisation, and test robustly through research trials.
Topic(s):
Education & Workforce
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Reference Links:
View the DOI record for Behavioural health consultants in integrated primary care teams: a model for future care
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View the PubMed citation for Behavioural health consultants in integrated primary care teams: a model for future care1553
Behavioural health interventions in the Johns Hopkins Community Health Partnership: Integrated care as a component of health systems transformation
Type: Journal Article
Year: 2014
Publication Place: England
Abstract: Health systems in the USA have received a mandate to improve quality while reining in costs. Several opportunities have been created to stimulate this transformation. This paper describes the design, early implementation and lessons learned for the behavioural components of the John Hopkins Community Health Partnership (J-CHiP) programme. J-CHiP is designed to improve health outcomes and reduce the total healthcare costs of a group of high healthcare use patients who are insured by the government-funded health insurance programmes, Medicaid and Medicare. These patients have a disproportionately high prevalence of depression, other psychiatric conditions, and unhealthy behaviours that could be addressed with behavioural interventions. The J-CHiP behavioural intervention is based on integrated care models, which include embedding mental health professionals into primary sites. A four-session behaviour-based protocol was developed to motivate self-efficacy through illness management skills. In addition to staff embedded in primary care, the programme design includes expedited access to specialist psychiatric services as well as a community outreach component that addresses stigma. The progress and challenges involved with developing this programme over a relatively short period of time are discussed.
Topic(s):
Healthcare Policy
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, Healthcare Disparities
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, Financing & Sustainability
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1557
Beliefs about the causes of health complaints: a study in primary care
Type: Journal Article
Year: 2009
Publication Place: United States
Abstract: In public and interpersonal health communication, a need exists to explore the nature of lay beliefs about health complaints to achieve effective communication. Beliefs of patients visiting their family physician/general practitioner (GP) may give insight into this matter. The aim of this study was to investigate the spectrum of causes attributed to different categories of health complaints presented at the GP office. Before visiting their GP, 2,253 individuals completed a questionnaire about their health complaint and the cause they attributed to this complaint. The spectrum of causes attributed to all health complaints was compared between distinct categories of health complaints. Sixty-two percent of the GP patients attributed at least 1 cause to health complaints they presented at the GP office. Thirty-eight percent of GP patients did not attribute a cause to the health complaint they presented at the GP office. Patient beliefs differed across distinct health problems. Lay beliefs seemed to differ from basic notions of illness because patients attributed different causes to different health complaints. These differences in beliefs, when patients choose to share them with their GP, may serve as a starting point for the communication between the patients and the GP to achieve an effective communication. A need seems to emerge to discriminate between lay beliefs regarding the nature of specific illnesses and those regarding basic notions. GPs are therefore advised to attend to, or at least ask for, their patients' views specifically.
Topic(s):
Medically Unexplained Symptoms
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Reference Links:
View the DOI record for Beliefs about the causes of health complaints: a study in primary care
View DOI Record
View the PubMed citation for Beliefs about the causes of health complaints: a study in primary care1558
Beliefs and attitudes about opioid prescribing and chronic pain management: Survey of primary care providers
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: OBJECTIVE: There is growing concern of medication misuse and noncompliance among patients with chronic pain prescribed opioids for pain. The aim of this survey was to obtain information from primary care providers (PCPs) about their perception of prescribing opioids for patients with chronic pain. METHODS: PCPs were invited to complete a packet of questionnaires about attitudes and concerns about opioids for chronic pain. These questionnaires included 1) General Health Questionnaire, 2) Test of Opioid Knowledge (TOK), 3) Opioid Therapy Provider Survey, and 4) Concerns About Analgesic Prescription Questionnaire. RESULTS: Fifty-six (N = 56) PCPs from eight centers participated in this study. In general, the PCPs showed adequate opioid knowledge on the KOT and their general health was unrelated to prescription attitudes. Most expressed concern about medication misuse (89 percent) and felt that managing patients with chronic pain was stressful (84 percent). Most were worried about addiction (82 percent) and less than half felt that they were sufficiently trained in prescribing opioids (46 percent). Younger providers felt more reluctant to prescribe opioids, experienced more stress in managing patients with pain, had less overall confidence in managing patients with pain, and worried more about opioid dependence than older providers (p < 0.05). Younger providers were also less knowledgeable about opioids, but opioid knowledge was not found to be related to concerns about analgesic prescriptions. CONCLUSION: This study indicates a general concern and reluctance of primary care physicians to manage the prescribing of opioids among their patients with chronic pain and younger providers expressed more concern about opioids than older providers.
Topic(s):
Education & Workforce
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, Opioids & Substance Use
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Reference Links:
View the DOI record for Beliefs and attitudes about opioid prescribing and chronic pain management: Survey of primary care providers
View DOI Record
View the PubMed citation for Beliefs and attitudes about opioid prescribing and chronic pain management: Survey of primary care providers