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Opioids & SU
The Literature Collection contains over 10,000 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).
10858 Results
162
A 2019 evaluation of opioid use disorder treatment resources in rural Utah counties
Type: Journal Article
Year: 2021
Publication Place: United States
Topic(s):
Education & Workforce
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, Healthcare Disparities
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, Opioids & Substance Use
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Reference Links: 
View the DOI record for A 2019 evaluation of opioid use disorder treatment resources in rural Utah counties
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View the PubMed citation for A 2019 evaluation of opioid use disorder treatment resources in rural Utah counties164
A behavioral weight-loss intervention in persons with serious mental illness
Type: Journal Article
Year: 2013
Publication Place: United States
Abstract: BACKGROUND: Overweight and obesity are epidemic among persons with serious mental illness, yet weight-loss trials systematically exclude this vulnerable population. Lifestyle interventions require adaptation in this group because psychiatric symptoms and cognitive impairment are highly prevalent. Our objective was to determine the effectiveness of an 18-month tailored behavioral weight-loss intervention in adults with serious mental illness. METHODS: We recruited overweight or obese adults from 10 community psychiatric rehabilitation outpatient programs and randomly assigned them to an intervention or a control group. Participants in the intervention group received tailored group and individual weight-management sessions and group exercise sessions. Weight change was assessed at 6, 12, and 18 months. RESULTS: Of 291 participants who underwent randomization, 58.1% had schizophrenia or a schizoaffective disorder, 22.0% had bipolar disorder, and 12.0% had major depression. At baseline, the mean body-mass index (the weight in kilograms divided by the square of the height in meters) was 36.3, and the mean weight was 102.7 kg (225.9 lb). Data on weight at 18 months were obtained from 279 participants. Weight loss in the intervention group increased progressively over the 18-month study period and differed significantly from the control group at each follow-up visit. At 18 months, the mean between-group difference in weight (change in intervention group minus change in control group) was -3.2 kg (-7.0 lb, P=0.002); 37.8% of the participants in the intervention group lost 5% or more of their initial weight, as compared with 22.7% of those in the control group (P=0.009). There were no significant between-group differences in adverse events. CONCLUSIONS: A behavioral weight-loss intervention significantly reduced weight over a period of 18 months in overweight and obese adults with serious mental illness. Given the epidemic of obesity and weight-related disease among persons with serious mental illness, our findings support implementation of targeted behavioral weight-loss interventions in this high-risk population. (Funded by the National Institute of Mental Health; ACHIEVE ClinicalTrials.gov number, NCT00902694.).
Topic(s):
General Literature
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View the DOI record for A behavioral weight-loss intervention in persons with serious mental illness
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View the PubMed citation for A behavioral weight-loss intervention in persons with serious mental illness167
A blueprint for integrated mental health care: Commentary for "Costs of using evidence-based implementation strategies for behavioral health integration in a large primary care system"
Type: Journal Article
Year: 2020
Topic(s):
Financing & Sustainability
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, Healthcare Disparities
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168
A Boost for Behavioral Health: New State Programs
Type: Journal Article
Year: 2020
Publication Place: United States
Abstract:
The Child Psychiatric Access Network (CPAN) plans to start operations in May, giving pediatricians and family physicians across Texas free telemedicine-based consultation and training on community psychiatry. CPAN is a key part of a much larger mental health initiative created by the 2019 Texas Legislature called the Texas Child Mental Health Care Consortium. Aside from CPAN, the consortium also will help public schools respond to mental health needs among students; expand the psychiatric workforce by paying for psychiatric positions and fellowships; and provide money for research on mental health in Texas.
Topic(s):
Education & Workforce
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, Healthcare Disparities
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175
A broad diagnostic framework to simplify the approach to mental disorders in primary care
Type: Journal Article
Year: 2014
Publication Place: South Africa
Abstract: Overemphasis on detailed classification of a psychiatic disorder at a primary level assessment may be unhelpful and prone to error. True rigour demands a continuous process of hypothesis formation that guides further enquiry. A simple categorisation of priority conditions provides a useful framework for a process. This approach has been set out by the World Health Organization (WHO) Mental Health Gap Action Program (MHGAP) Intervention Guide, which can then be adapted for use in the South African context. This then provides the basis for further enquiry and risk assessment at the initial consultation.
Topic(s):
General Literature
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Reference Links: View the PubMed citation for A broad diagnostic framework to simplify the approach to mental disorders in primary care
176
A budget impact analysis of telemedicine-based collaborative care for depression
Type: Journal Article
Year: 2011
Publication Place: United States
Abstract: BACKGROUND: Patients with depression use more health services than patients without depression. However, when depression symptoms respond to treatment, use of health services declines. Most depression quality improvement studies increase total cost in the short run, which if unevenly distributed across stakeholders, could compromise buy-in and sustainability. The objective of this budget impact analysis was to examine patterns of utilization and cost associated with telemedicine-based collaborative care, an intervention that targets patients treated in small rural primary care clinics. METHODS: Patients with depression were recruited from VA Community-based Outpatient Clinics, and 395 patients were enrolled and randomized to telemedicine-based collaborative care or usual care. Dependent variables representing utilization and cost were collected from administrative data. Independent variables representing clinical casemix were collected from self-report at baseline. RESULTS: There were no significant group differences in the total number or cost of primary care encounters. However, as intended, patients in the intervention group had significantly greater depression-related primary care encounters (marginal effect=0.34, P=0.004) and cost (marginal effect=$61.4, P=0.013) to adjust antidepressant therapy for nonresponders. There were no significant group differences in total mental health encounters or cost. However, as intended, the intervention group had significantly higher depression-related mental health costs (marginal effect=$107.55, P=0.03) due to referrals of treatment-resistant patients. Unexpectedly, patients in the intervention group had significantly greater specialty physical health encounters (marginal effect =0.42, P=0.001) and cost (marginal effect =$490.6, P=0.003), but not depression-related encounters or cost. Overall, intervention patients had a significantly greater total outpatient cost compared with usual care (marginal effect=$599.28, P=0.012). CONCLUSIONS: Results suggest that telemedicine-based collaborative care does not increase total workload for primary care or mental health providers. Thus, there is no disincentive for mental health providers to offer telemedicine-based collaborative care or for primary care providers to refer patients to telemedicine-based collaborative care.
Topic(s):
Financing & Sustainability
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Reference Links:
View the DOI record for A budget impact analysis of telemedicine-based collaborative care for depression
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View the PubMed citation for A budget impact analysis of telemedicine-based collaborative care for depression177
A Budget Impact Analysis of the Collaborative Care Model for Treating Opioid Use Disorder in Primary Care
Type: Journal Article
Year: 2019
Topic(s):
Education & Workforce
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, Financing & Sustainability
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, Opioids & Substance Use
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Reference Links:
View the DOI record for A Budget Impact Analysis of the Collaborative Care Model for Treating Opioid Use Disorder in Primary Care
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View the PubMed citation for A Budget Impact Analysis of the Collaborative Care Model for Treating Opioid Use Disorder in Primary Care178
A buprenorphine education and training program for primary care residents: Implementation and evaluation
Type: Journal Article
Year: 2013
Publication Place: United States
Abstract: BACKGROUND: Although substance use disorders are highly prevalent, resident preparation to care for patients with these disorders is frequently insufficient. With increasing rates of opioid abuse and dependence, and the availability of medication-assisted treatment, one strategy to improve resident skills is to incorporate buprenorphine treatment into training settings. METHODS: In this study, esidency faculty delivered the BupEd education and training program to 71 primary care residents. BupEd included (1) a didactic session on buprenorphine, (2) an interactive motivational interviewing session, (3) monthly case conferences, and (4) supervised clinical experience providing buprenorphine treatment. To evaluate BupEd, the authors assessed (1) residents' provision of buprenorphine treatment during residency, (2) residents' provision of buprenorphine treatment after residency, and (3) treatment retention among patients treated by resident versus attending physicians. RESULTS: Of 71 residents, most served as a covering or primary provider to at least 1 buprenorphine-treated patient (84.5 and 66.2%, respectively). Of 40 graduates, 27.5% obtained a buprenorphine waiver and 17.5% prescribed buprenorphine. Treatment retention was similar between patients cared for by resident PCPs versus attending PCPs (90-day retention: 63.6% [n = 35] vs. 67.9% [n = 152]; P = .55). CONCLUSION: These results show that BupEd is feasible, provides residents with supervised clinical experience in treating opioid-dependent patients, and can serve as a model to prepare primary care physicians to care for patients with opioid dependence.
Topic(s):
Education & Workforce
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, Opioids & Substance Use
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Reference Links:
View the DOI record for A buprenorphine education and training program for primary care residents: Implementation and evaluation
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View the PubMed citation for A buprenorphine education and training program for primary care residents: Implementation and evaluation179
A call to maximize impact of the SUPPORT for Patients and Communities Act through standard inclusion of opioid use disorder treatment curricula in medical schools
Type: Journal Article
Year: 2019
Abstract:
Physicians who want to prescribe buprenorphine to treat opioid use disorder require a waiver established by the Drug Addiction Treatment Act (DATA) of 2000, often through completion of an eight-hour training course. This is an issue for a number of reasons, including that opioid overdose deaths continue to rise nationally. However, on October 24, 2018, the SUPPORT (Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment) for Patients and Communities Act was signed into law. This bill allows any physician who graduates in good standing from an allopathic or osteopathic medical school in the United States that incorporates necessary material around opioid misuse in their standard curriculum, without need for any additional training, to prescribe buprenorphine. This perspective piece describes why this is an important first step and what more needs to be done within medical education to combat the opioid epidemic.
Topic(s):
Education & Workforce
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, Healthcare Policy
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, Opioids & Substance Use
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