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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).
11231 Results
1702
Building system capacity for the integration of mental health at the level of primary care in Tunisia: a study protocol in global mental health
Type: Journal Article
Year: 2017
Publication Place: England
Abstract: BACKGROUND: In low- and middle-income countries (LMICs), addressing the high prevalence of mental disorders is a challenge given the limited number and unequal distribution of specialists, as well as scarce resources allocated to mental health. The Mental Health Gap Action Programme (mhGAP) and its accompanying Intervention Guide (IG), developed by the World Health Organization (WHO), aim to address this challenge by training non-specialists such as general practitioners (GPs) in mental health care. This trial aims to implement and evaluate an adapted version of the mhGAP-IG (version 1.0) offered to GPs in 2 governorates of Tunisia (i.e., Tunis and Sousse), in order to uncover important information regarding implementation process and study design before country-wide implementation and evaluation. METHODS/DESIGN: First, a systematic review will be conducted to explore types and effectiveness of mental health training programs offered to GPs around the world, with a specific focus on programs implemented and evaluated in LMICs. Second, a cluster randomized controlled trial (RCT) will be conducted to evaluate the effectiveness of the implemented training based on the mhGAP-IG (version 1.0). Third, multiple case study design will be used to explore how contextual factors impact the successful implementation of the training and desired outcomes. DISCUSSION: In Tunisia, an important need exists to further develop proximity health services and to address the growing mental health treatment gap. One solution is to train GPs in the detection, treatment, and management of mental health problems, given their strategic role in the healthcare system. This trial thus aims to implement and evaluate an adapted version of a training based on the mhGAP-IG (version 1.0) in Tunis and Sousse before country-wide implementation and evaluation. Several contributions are envisioned: adding to the growing evidence on the mhGAP and its accompanying guide, especially in French-speaking nations; building research capacity in Tunisia and more generally in LMICs by employing rigorous designs; evaluating an adapted version of the mhGAP-IG (version 1.0) on a sample of GPs; generating important information regarding implementation process and study design before country-wide implementation; and complimenting the trial results with implementation analysis, a priority in global mental health.
Topic(s):
Education & Workforce
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1704
Building the plane in the air...but also before and after it takes flight: considerations for training and workforce preparedness in integrated behavioural health
Type: Journal Article
Year: 2018
Publication Place: England
Abstract:
Collaborative approaches to healthcare that integrate behavioural and biomedical interventions are more likely to enhance patient outcomes as well as provider satisfaction with care delivery than siloed approaches to care. The recognition for specific and targeted training for these models is growing among all health professions, although many in the field have not received systematized, interprofessional, and competency-based training that adequately prepared them for the work of integration. This article reviews some of the fundamental principles of biopsychosocially-oriented, team-based approaches to care that integrate behavioural and biomedical perspectives and delineates the need for targeted training efforts. It describes which specific elements must be addressed within it in order to promote effective integration, and highlights the array of options for training currently in existence. This review provides an overview of current models of training offered in the US, and concludes with a discussion of the challenges and barriers that may render training either ineffective or difficult to achieve.
Topic(s):
Education & Workforce
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1706
Bupenorphine in Wisconsin Drivers: Concerns for Impairment?
Type: Journal Article
Year: 2019
Publication Place: England
Topic(s):
Opioids & Substance Use
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Reference Links: View the PubMed citation for Bupenorphine in Wisconsin Drivers: Concerns for Impairment?
1709
Buprenorphine adoption in the National Drug Abuse Treatment Clinical Trials Network
Type: Journal Article
Year: 2009
Publication Place: United States
Abstract: The National Drug Abuse Treatment Clinical Trials Network (CTN), a collaborative federal research initiative that brings together universities and community-based treatment programs (CTPs), has conducted multiple clinical trials of buprenorphine for opioid dependence. Part of the CTN's mission is to promote the adoption of evidence-based treatment technologies. Drawing on a data collected during face-to-face interviews with administrators from a panel of 206 CTPs, this research examines the adoption of buprenorphine over a 2-year period. These data indicated that the adoption of buprenorphine doubled between the baseline and 24-month follow-up interviews. Involvement in a buprenorphine protocol continued to be a strong predictor of adoption at the 2-year follow-up, although adoption of buprenorphine tripled among those CTPs without buprenorphine-specific protocol experience. For-profit CTPs and those offering inpatient detoxification services were more likely to adopt buprenorphine over time. A small percentage of programs discontinued using buprenorphine. These findings point to the dynamic nature of service delivery in community-based addiction treatment and the continued need for longitudinal studies of organizational change.
Topic(s):
Opioids & Substance Use
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Reference Links:
View the DOI record for Buprenorphine adoption in the National Drug Abuse Treatment Clinical Trials Network
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View the PubMed citation for Buprenorphine adoption in the National Drug Abuse Treatment Clinical Trials Network1713
Buprenorphine and naloxone compared with methadone treatment in pregnancy
Type: Journal Article
Year: 2015
Publication Place: United States
Abstract: OBJECTIVE: To compare neonatal abstinence syndrome prevalence and characteristics among neonates born to women prescribed buprenorphine and naloxone compared with methadone during pregnancy. METHODS: Retrospective cohort analysis of mother-neonate dyads treated with either buprenorphine and naloxone or methadone during pregnancy. Primary neonatal outcomes included diagnosis of neonatal abstinence syndrome, neonatal abstinence syndrome peak scores, total amount of morphine used to treat neonatal abstinence syndrome (mg), and duration of treatment for neonatal abstinence syndrome (days). Secondary outcomes included head circumference, birth weight, length, preterm birth, neonatal intensive care unit admission, Apgar scores, and overall length of hospitalization. RESULTS: From January 1, 2011, to November 30, 2013, we identified 62 mother-neonate dyads, 31 treated with methadone and 31 treated with buprenorphine and naloxone. Sixteen neonates (51.6%) in the methadone group were diagnosed with neonatal abstinence syndrome compared with eight (25.1%) in the buprenorphine and naloxone group (adjusted odds ratio 2.55, 95% confidence interval [CI] 1.31-4.98, P = .01). The buprenorphine and naloxone-exposed neonates had lower peak neonatal abstinence syndrome scores (9.0 +/- 4.4 compared with 10.7 +/- 3.7, multivariate-adjusted mean difference = -2.77, 95% CI -4.99 to -0.56, P = .02) and shorter overall hospitalization (5.6 +/- 5.0 compared with 9.8 +/- 7.4 days, multivariate-adjusted mean difference = -3.90, 95% CI, -7.13 to -0.67, P = .02). We found no other differences in primary or secondary outcomes. CONCLUSION: In a cohort of pregnant patients treated with either methadone or buprenorphine and naloxone in pregnancy, newborns exposed to maternal buprenorphine and naloxone had less frequent neonatal abstinence syndrome. Additionally, neonates exposed to buprenorphine and naloxone had shorter overall hospitalization lengths.
Topic(s):
Opioids & Substance Use
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, Healthcare Disparities
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Reference Links:
View the DOI record for Buprenorphine and naloxone compared with methadone treatment in pregnancy
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View the PubMed citation for Buprenorphine and naloxone compared with methadone treatment in pregnancy1719
Buprenorphine dosing choices in specific populations: review of expert opinion
Type: Journal Article
Year: 2016
Abstract: Introduction Treatment of opioid dependence with buprenorphine improves outcomes. Typical dosing ranges for all patients from clinical evidence and as defined in the product information are wide. For specific groups with complex clinical scenarios, there is no clear consensus on dosing choices to achieve best possible outcomes. Areas covered The doses of buprenorphine used in 6 European countries was reviewed. A review of published evidence supported rapid induction with buprenorphine and the benefits of higher doses but did not identify clearly useful guidance on dosing choices for groups with complex clinical scenarios. An expert group of physicians with experience in addiction care participated in a discussion meeting to share clinical practice experience and develop a consensus on dosing choices. Expert opinion There was general agreement that treatment outcomes can be improved by optimising buprenorphine doses in specific subgroups. Specific groups in whom buprenorphine doses may be too low and who could have better outcomes with optimised dosing were identified on the basis of clinical practice experience. These groups include people with severe addiction, high tolerance to opioids, and psychiatric comorbidities. In these groups it is recommended to review dosing choices to ensure buprenorphine dosing is sufficient.
Topic(s):
Opioids & Substance Use
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Reference Links:
View the DOI record for Buprenorphine dosing choices in specific populations: review of expert opinion
View DOI Record
View the PubMed citation for Buprenorphine dosing choices in specific populations: review of expert opinion1720
Buprenorphine Exposures Among Children and Adolescents Reported to US Poison Control Centers
Type: Journal Article
Year: 2018
Publication Place: United States
Topic(s):
Healthcare Disparities
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, Opioids & Substance Use
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Reference Links: View the PubMed citation for Buprenorphine Exposures Among Children and Adolescents Reported to US Poison Control Centers