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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
26 to 50 of 710 Research Studies DisplayedPlummer N, Guardado R, Ngassa Y
Racial differences in self-report of mental illness and mental illness treatment in the community: an analysis of jail intake data.
This cross-sectional study evaluated the frequency of racial/ethnic differences in the self-report of mental illness and psychiatric medication use at jail entry. The authors used data from the "Offender Management System," the administrative database used by the jail containing data on people who are incarcerated, and COREMR, the electronic medical record (EMR) used in the Middlesex Jail & House of Correction, located in Billerica, MA. They evaluated two primary outcomes: (1) self-reported mental illness history and (2) self-reported use of psychiatric medication, with the primary indicator of interest as race/ethnicity. At intake over half (57%) in the sample self-reported a history of mental illness, with 20% reporting the use of psychiatric medications. Among people who self-reported a history of mental illness, non-White inmates all had decreased odds of reporting psychiatric medication. Only 20% reported receiving medications in the community prior to incarceration.
AHRQ-funded; HS026008.
Citation: Plummer N, Guardado R, Ngassa Y .
Racial differences in self-report of mental illness and mental illness treatment in the community: an analysis of jail intake data.
Adm Policy Ment Health 2023 Nov; 50(6):966-75. doi: 10.1007/s10488-023-01297-4..
Keywords: Racial and Ethnic Minorities, Behavioral Health, Vulnerable Populations
Dopp AR, Hunter SB, Godley MD
Comparing organization-focused and state-focused financing strategies on provider-level reach of a youth substance use treatment model: a mixed-method study.
This study’s goal was to compare organization-focused and state-focused financing strategies on their provider-level reach of a youth substance use treatment model. The authors evaluated financing strategies for the Adolescent Community Reinforcement Approach (A-CRA) EBP by comparing the two US federal grant mechanisms on organization-level A-CRA reach outcomes. Implementation of these A-CRA grants took place from 2006 to 2021. They used a quasi-experimental, mixed-method design to compare reach between treatment organizations funded by organization-focused versus state-focused grants (164 organizations, 35 states). Using administrative training records, they calculated reach as the per-organization proportion of trained individuals who received certification in A-CRA clinical delivery and/or supervision by the end of grant funding and also tested differences in certification rate by grant type. They also drew on interviews and surveys collected from the treatment organizations and (when relevant) interviews with state administrators to identify factors that influenced reach. Overall certification rates were 27 percentage points lower in state-focused versus organization-focused grants. They did not identify significant quantitative moderators of reach outcomes, but qualitative findings suggested certain facilitating factors were more influential for organization-focused grants (e.g., strategic planning) and certain barrier factors were more impactful for state-focused grants (e.g., states finding it difficult to execute grant activities).
AHRQ-funded; HS000046.
Citation: Dopp AR, Hunter SB, Godley MD .
Comparing organization-focused and state-focused financing strategies on provider-level reach of a youth substance use treatment model: a mixed-method study.
Implement Sci 2023 Oct 12; 18(1):50. doi: 10.1186/s13012-023-01305-z..
Keywords: Children/Adolescents, Substance Abuse, Behavioral Health
Hughes PM, Ramage M, Gigli KH
Assessing the cost-effectiveness of removing supervision requirements for nurse practitioners prescribing buprenorphine for opioid use disorder.
The purpose of this study was to evaluate the cost-effectiveness of full practice authority relative to restricted scope of practice for nurse practitioners (NPs) who intend to prescribe buprenorphine for opioid use disorder before implementation of the Mainstreaming Addiction Treatment Act and the Medication Access and Training Expansion Act (MAT/MATE) Acts. The study also examined scenarios modeling various implementations of MAT/MATE. A simulated cohort of 10,000 NPs went through a decision tree model with a 1-year time horizon. The results indicated that adoption of full practice authority for NPs may be cost-effective for increasing the available workforce for substance use treatment and for increasing the number of patients receiving buprenorphine.
AHRQ-funded; HS000032.
Citation: Hughes PM, Ramage M, Gigli KH .
Assessing the cost-effectiveness of removing supervision requirements for nurse practitioners prescribing buprenorphine for opioid use disorder.
J Nurs Regul 2023 Oct; 14(3):44-54. doi: 10.1016/S2155-8256(23)00112-6..
Keywords: Opioids, Substance Abuse, Behavioral Health, Provider: Nurse, Policy, Healthcare Costs
Kornfield R, Lattie EG, Nicholas J
"Our job is to be so temporary": designing digital tools that meet the needs of care managers and their patients with mental health concerns.
The purpose of this study was to improve understanding of how to integrate digital tools in routine healthcare, especially for patients with both physical and mental health needs. The researchers conducted interviews and design workshops with 1. a group of care managers who support patients with complex health needs, and 2. their patients whose health needs include mental health concerns. The researchers examined both groups' views of potential applications of digital tools within care management. The study found that care managers felt underprepared to addressing mental health issues on an ongoing basis and had concerns about the burden and confusion of providing support through new digital channels. Patients envisioned benefiting from ongoing mental health support from care managers, including support in using digital tools. The needs of patients and care managers may be so different that meeting both through the same tools represents a substantial challenge, and could require altering these professionals' roles in mental health support.
AHRQ-funded; HS028003.
Citation: Kornfield R, Lattie EG, Nicholas J .
"Our job is to be so temporary": designing digital tools that meet the needs of care managers and their patients with mental health concerns.
Proc ACM Hum Comput Interact 2023 Oct; 7(CSCW2):302. doi: 10.1145/3610093..
Keywords: Behavioral Health, Health Information Technology (HIT), Care Coordination
Pederson CA, Dir AL, Schwartz K
Associations between outpatient treatment and the use of intensive psychiatric healthcare services.
This study examined concurrent and longitudinal associations between the utilization of outpatient and intensive psychiatric services among Medicaid-enrolled youth. Using an administrative dataset of Medicaid claims from 2007 to 2017, youth were included if they were between the ages of 10-18 (median = 13.4) and had a psychiatric Medicaid claim (N = 33,590). Outcome was use of psychiatric services coded as outpatient, emergency department (ED), inpatient, or residential based on Medicaid codes. Logistical regression analyses by the authors indicated that the receipt of even one outpatient visit significantly reduced the odds of having an ED, inpatient, and residential visit within 60-, 90-, and 120-day windows. Most youth did not have any ED, inpatient, or residential visit following their first outpatient visit. The authors found that for remaining youth, having an outpatient visit significantly increased the risk of having an ED, inpatient, and residential visit following their initial appointment, which may suggest these youth are being triaged to a more appropriate level of care.
AHRQ-funded; HS022681; HS023318
Citation: Pederson CA, Dir AL, Schwartz K .
Associations between outpatient treatment and the use of intensive psychiatric healthcare services.
Clin Child Psychol Psychiatry 2023 Oct; 28(4):1380-92. doi: 10.1177/13591045231154106..
Keywords: Behavioral Health, Healthcare Utilization
Acolin J, Cadigan JM, Fleming CB
Trajectory of depressive symptoms in the context of romantic relationship breakup: characterizing the “natural course” of response and recovery in young adults.
This study’s objective was to characterize the trajectory of depressive symptoms before, during, and after relationship breakup in young adults and to examine subjective appraisal and sense of control. The authors used the PHQ-2 survey to screen for depressive symptoms. In their sample of participants reporting a single breakup during the 2-year study period (N = 156), breakup was associated with a temporary increase in depressive symptoms that returned to pre-breakup levels within 3 months. They observed increased symptoms among negatively appraised, but not positive or neutral, events. The lower the sense of control, the more depressive symptoms were demonstrated at all time points.
AHRQ-funded; HS013853.
Citation: Acolin J, Cadigan JM, Fleming CB .
Trajectory of depressive symptoms in the context of romantic relationship breakup: characterizing the “natural course” of response and recovery in young adults.
Emerging Adulthood 2023 Oct; 11(5):1211-22. doi: 10.1177/21676968231184922..
Keywords: Depression, Young Adults, Behavioral Health
Narindrarangkura P, Alafaireet PE, Khan U
Association rule mining of real-world data: uncovering links between race, glycemic control, lipid profiles, and suicide attempts in individuals with diabetes.
The objective of this study was to use the association rule mining (ARM) technique to identify a high-risk group of suicide attempts among patients with diabetes. Cerner Real-World Data™ was mined using this technique. The study results indicated that patients with diabetes who were never married and had average blood glucose levels below 150 mg/dl were more likely to attempt suicide, while patients aged 60 and older who had diabetes for less than five years were less likely to attempt suicide. The authors concluded that ARM showed the potential for knowledge discovery in large multi-center electronic health records data, and the results could be used by providers during outpatient clinic visits.
Citation: Narindrarangkura P, Alafaireet PE, Khan U .
Association rule mining of real-world data: uncovering links between race, glycemic control, lipid profiles, and suicide attempts in individuals with diabetes.
Inform Med Unlocked 2023; 42. doi: 10.1016/j.imu.2023.101345..
Keywords: Diabetes, Behavioral Health, Risk
Holland JE, Rettew DC, Varni SE
Associations between mental and physical illness comorbidity and hospital utilization.
The purpose of this study was to describe the prevalence of chronic physical illness types and mental illness and their comorbidity among adolescents and young adults (AYA) and evaluate the relationship of comorbidity on hospital use. The sample analyzed was 50% female, 63% Medicaid, and 43% had 1 or more chronic illness. The study found that mental illness was common (31%) and highly comorbid with multiple physical illnesses. In AYA with pulmonary illness, those with comorbid mental illness had 1.74-times higher odds of ED use and 2.9-times higher odds of hospitalization than those without mental illness. Comorbid endocrine and mental illness had 1.84-times higher odds of ED use and 2.1-times higher odds of hospitalization, comorbid neurologic and mental illness had 1.36-times higher odds of ED use and 2.4-times higher odds of hospitalization and comorbid musculoskeletal and mental illness had 1.38-times higher odds of ED use and 2.1-times higher odds of hospitalization.
AHRQ-funded; HS024575.
Citation: Holland JE, Rettew DC, Varni SE .
Associations between mental and physical illness comorbidity and hospital utilization.
Hosp Pediatr 2023 Sep; 13(9):841-48. doi: 10.1542/hpeds.2022-006984..
Keywords: Behavioral Health, Chronic Conditions, Hospitalization
Franklin MK, Karpyn A, Christofferson J
Barriers and facilitators to discussing parent mental health within child health care: perspectives of parents raising a child with congenital heart disease.
This study’s objective was to identify barriers and facilitators to the discussion of parental mental health within child health care for children with congenital heart disease (CHD). Participants were parents of young children with CHD who received care across 40 hospitals in the US. They responded to questions about discussing their mental health with their child's health care providers and described multiple barriers including perceived expectation to "stay strong," and fear of negative judgment or repercussions. Facilitators included care team ability to provide support and personal connections with health care providers. The authors concluded that is important that health care providers normalize the impact of child illness on the family and create an environment in which parents feel comfortable discussing mental health challenges.
AHRQ-funded; HS026393.
Citation: Franklin MK, Karpyn A, Christofferson J .
Barriers and facilitators to discussing parent mental health within child health care: perspectives of parents raising a child with congenital heart disease.
J Child Health Care 2023 Sep; 27(3):360-73. doi: 10.1177/13674935211058010..
Keywords: Children/Adolescents, Behavioral Health, Heart Disease and Health, Cardiovascular Conditions
Eddelbuettel JCP, Barry CL, Kennedy-Hendricks A
High-deductible health plans and nonfatal opioid overdose.
This study examined whether an employer offering a high-deductible health plan (HDHP) had an impact on nonfatal opioid overdose among commercially insured individuals with opioid use disorder (OUD) in the United States. The authors used deidentified insurance claims data from 2007 to 2017 with 97,788 person-years. They estimated the change in the probability of a nonfatal opioid overdose among enrollees with OUD whose employers began offering an HDHP insurance option during the study period compared with the change among those whose employer never offered an HDHP. Across both groups, 2% of the sample experienced a nonfatal opioid overdose during the study period. They found no association of HDHP with an observed increase in the probability of nonfatal opioid overdose among commercially insured person-years with OUD.
AHRQ-funded; HS000029.
Citation: Eddelbuettel JCP, Barry CL, Kennedy-Hendricks A .
High-deductible health plans and nonfatal opioid overdose.
Med Care 2023 Sep; 61(9):601-04. doi: 10.1097/mlr.0000000000001886..
Keywords: Healthcare Costs, Health Insurance, Opioids, Substance Abuse, Behavioral Health
Lewis A, Howland RE, Horwitz LI
Medicaid value-based payments and health care use for patients with mental illness.
This retrospective cohort study’s objective was to investigate if New York State's Medicaid value-based payment reform was associated with improved utilization patterns for patients with mental illness (major depression disorder, bipolar disorder, and/or schizophrenia). The cohort included Medicaid 306,290 individuals with depression (67.4% female; mean age, 38.6 years), 85,105 patients with bipolar disorder (59.6% female; mean age, 38.0 years), and 71,299 patients with schizophrenia (45.1% female mean age, 40.3 years). After adjustment, the analysis estimated a statistically significant, positive association between value-based payments and behavioral health visits for patients with depression (0.91 visits) and bipolar disorder (1.01 visits). There were no statistically significant changes to primary care visits for patients with depression and bipolar disorder, but value-based payments were associated with reductions in primary care visits for patients with schizophrenia (-1.31 visits). In every diagnostic population, value-based payment was associated with significant reductions in mental health emergency department visits (population with depression: -0.01 visits; population with bipolar disorder: -0.02 visits; population with schizophrenia: -0.04 visits).
AHRQ-funded; HS026980; HS026120.
Citation: Lewis A, Howland RE, Horwitz LI .
Medicaid value-based payments and health care use for patients with mental illness.
JAMA Health Forum 2023 Sep; 4(9):e233197. doi: 10.1001/jamahealthforum.2023.3197..
Keywords: Medicaid, Behavioral Health, Payment, Depression
Somohano VC, Smith CL, Saha S
Patient-provider shared decision-making, trust, and opioid misuse among US veterans prescribed long-term opioid therapy for chronic pain.
This article examined the role that trust in a prescribing provider has on shared decision-making and opioid misuse in opioid-specific pain management. A secondary analysis of data from a prospective cohort study was conducted of US Veterans (N = 1273) prescribed long-term opioid therapy (LTOT) for chronic non-cancer pain. Patient-provider shared decision-making had a total significant effect on opioid misuse, in the absence of the mediator, such that higher levels of shared decision-making were associated with lower levels of reported opioid misuse. When trust in provider was added to the mediation model, the indirect effect of shared decision-making on opioid misuse through trust in provider remained significant.
AHRQ-funded; HS026370.
Citation: Somohano VC, Smith CL, Saha S .
Patient-provider shared decision-making, trust, and opioid misuse among US veterans prescribed long-term opioid therapy for chronic pain.
J Gen Intern Med 2023 Sep; 38(12):2755-60. doi: 10.1007/s11606-023-08212-5..
Keywords: Shared Decision Making, Opioids, Medication, Substance Abuse, Behavioral Health, Pain, Chronic Conditions
Button D, Levander XA, Cook RR
Substance use disorder treatment and technology access among people who use drugs in rural areas of the United States: a cross-sectional survey.
This study evaluated how technology access (cell phone use and access to the Internet) affected substance use disorder (SUD) treatment prior to COVID-19 for people who use drugs in rural areas. The authors used data from the Rural Opioid Initiative (January 2018-March 2020), which was a cross-sectional study of people with prior 30-day injection drug or nonprescribed opioid use from rural areas of 10 states. They found that out of 3,026 participants, 71% used heroin and 76% used methamphetamine with 35% having no cell phone and 10% having no prior 30-day Internet use. Having both a cell phone and the internet was associated with increased days of medication for opioid use disorder (MOUD) use and a higher likelihood of SUD counseling in the prior 30 days. Lack of cell phone was associated with decreased days of MOUD and a lower likelihood of prior 30-day SUD counseling.
AHRQ-funded; HS026370.
Citation: Button D, Levander XA, Cook RR .
Substance use disorder treatment and technology access among people who use drugs in rural areas of the United States: a cross-sectional survey.
J Rural Health 2023 Sep; 39(4):772-79. doi: 10.1111/jrh.12737..
Keywords: Substance Abuse, Behavioral Health, Rural Health, Telehealth, Health Information Technology (HIT), Opioids, Rural/Inner-City Residents
Overhage L, Hailu R, Busch AB
Trends in acute care use for mental health conditions among youth during the COVID-19 pandemic.
This study’s objective was to examine youth acute mental health care use (emergency department [ED], boarding, and subsequent inpatient care) during the second year of the COVID-19 pandemic. This cross-sectional analysis used data from national, deidentified commercial health insurance claims of youth mental health ED and hospital care that took place between March 2019 and February 2022. Among 4.1 million commercial insurance enrollees aged 5 to 17 years, 17,614 in the baseline year (March 2019-February 2020) and 16,815 youth in pandemic year 2 (March 2021-February 2022) had at least 1 mental health ED visit. Comparing baseline to pandemic year 2, there was a 6.7% increase in youth with any mental health ED visits. Among adolescent females, there was a larger increase (22.1%). The fraction of ED visits that resulted in a psychiatric admission increased by 8.4%. Mean length of inpatient psychiatric stay increased 3.8%. The fraction of episodes with prolonged boarding increased 76.4%.
AHRQ-funded; HS026503.
Citation: Overhage L, Hailu R, Busch AB .
Trends in acute care use for mental health conditions among youth during the COVID-19 pandemic.
JAMA Psychiatry 2023 Sep; 80(9):924-32. doi: 10.1001/jamapsychiatry.2023.2195..
Keywords: COVID-19, Behavioral Health, Children/Adolescents
Held P, Splaine CC, Smith DL
Examining trauma cognition change trajectories among initial PTSD treatment non-optimal responders: a potential avenue to guide subsequent treatment selection.
The purpose of this study was to examine negative post-trauma cognitions (NPCs) change trajectories in individuals who were determined to be non-optimally responsive to intensive PTSD treatment. The researchers utilized a 3-week Cognitive Processing Therapy-based intensive PTSD treatment (ITP) sample of 243 participants. Analyses were replicated in a separate 2-week ITP sample of 215 participants. The study found that in both non-optimal responder samples, two trajectories emerged; a no NPC change group which represented those with an overall lack of NPC change throughout treatment and an NPC change group which represented those with an overall reduction of NPCs occurring primarily later in treatment. Changes in PTSD symptom severity during treatment was the only consistent predictor of NPC change trajectory group membership among treatment non-optimal responders across ITPs.
AHRQ-funded; HS028511.
Citation: Held P, Splaine CC, Smith DL .
Examining trauma cognition change trajectories among initial PTSD treatment non-optimal responders: a potential avenue to guide subsequent treatment selection.
Eur J Psychotraumatol 2023; 14(2):2237361. doi: 10.1080/20008066.2023.2237361..
Keywords: Trauma, Behavioral Health, Stress
Bongiovanni T, Pletcher MJ, Lau C
A behavioral intervention to promote use of multimodal pain medication for hospitalized patients: a randomized controlled trial.
Administration of nonsteroidal anti-inflammatory drugs (NSAIDs) has become a foundational strategy to decrease the use of opioids, but data is lacking to describe recommending utilization when admitting patients using electronic health record systems. The purpose of this study was to assess an electronic health record system to increase ordering of NSAIDs for hospitalized adults. The researchers conducted a cluster randomized controlled trial of clinicians admitting adult patients to a health system over a period of 9-months. Clinicians in the intervention arm were required to actively order or decline NSAIDs; the control arm was provided the same order but without a required response. A total of 20,085 hospitalizations were included. The study found that among the hospitalizations, 52% were admitted by a clinician randomized to the intervention arm. NSAIDs were ordered in 22% of the interventions and 22% of the control admissions. There were no statistically significant differences in NSAID administration, pain scores, or opioid prescribing. There were no differences in clinical harms, with average pain scores of 3.36 in the control group and 3.39 in the intervention group, on a scale of 0-5.
AHRQ-funded; HS026383.
Citation: Bongiovanni T, Pletcher MJ, Lau C .
A behavioral intervention to promote use of multimodal pain medication for hospitalized patients: a randomized controlled trial.
J Hosp Med 2023 Aug; 18(8):685-92. doi: 10.1002/jhm.13153..
Keywords: Pain, Opioids, Medication, Behavioral Health, Practice Patterns
Anan YH, Kahn NF, Garrison MM
Associations between sleep duration and positive mental health screens during adolescent preventive visits in primary care.
The objective of this paper was to understand associations between low sleep duration and positive mental health screens among adolescents seen for preventive visits in primary care. Data were taken from two randomized controlled trials that tested the efficacy of an electronic health risk behavior screening and feedback tool for adolescent preventive visits. The results showed that low sleep duration was associated with greater odds of positive depression screen, but not with a positive anxiety or co-occurring positive depression and anxiety screens. The authors concluded that, as pediatric primary care guidelines for sleep continue to evolve, further research, training, and support for sleep screening are necessary to ensure effective early intervention for adolescent sleep and mental health problems.
AHRQ-funded; HS023383.
Citation: Anan YH, Kahn NF, Garrison MM .
Associations between sleep duration and positive mental health screens during adolescent preventive visits in primary care.
Acad Pediatr 2023 Aug; 23(6):1242-46. doi: 10.1016/j.acap.2023.02.013..
Keywords: Children/Adolescents, Sleep Problems, Primary Care, Behavioral Health, Screening
Miller-Rosales C, Busch SH, Meara ER
Internal and environmental predictors of physician practice use of screening and medications for opioid use disorders.
This study examined the extent of screening for opioid use and availability of medications for opioid use disorder (MOUD) in a national cross-section of multi-physician primary care and multispecialty practices. The authors found that a total of 26.2% of practices offered MOUD, while 69.4% of practices screened for opioid use. Offering of MOUD in a practice was associated with having advanced HIT functionality, while access to on-site behavioral clinicians was positively associated with offering MOUD in adjusted models.
AHRQ-funded; HS024075.
Citation: Miller-Rosales C, Busch SH, Meara ER .
Internal and environmental predictors of physician practice use of screening and medications for opioid use disorders.
Med Care Res Rev 2023 Aug; 80(4):410-22. doi: 10.1177/10775587231162681..
Keywords: Opioids, Substance Abuse, Behavioral Health, Screening, Medication, Practice Patterns
Slade EP, Wu RJ, Meiselbach MK
Psychiatrist and nonpsychiatrist physician network breadth in dual eligible special needs plans.
This study’s purpose was to compare the breadths of psychiatrist and nonpsychiatrist provider networks in Dual Eligible Special Needs Plans (D-SNPs) and other Medicare and Medicaid Advantage (MA) plans. D-SNP is a type of Medicare Advantage (MA) plan for individuals who have both Medicare and Medicaid coverage. The authors examined MA plan provider network data that was merged with plan service areas and a nationwide provider database to form a data set with 843 observations on networks subclassified by state and network type (D-SNP or other MA) covering 42 U.S. states and Washington, D.C. Mean psychiatrist network breadth was 0.319 in D-SNPs and 0.299 in other MA plans. Nonpsychiatrist network breadth was 0.346 in D-SNPs and 0.358 in other MA plans. Psychiatrist networks were narrower than nonpsychiatrist networks (0.303 vs. 0.355), but mean psychiatrist network breadth did not differ between D-SNPs and other MA plans. In regression analyses, the psychiatrist-nonpsychiatrist breadth difference was smaller in D-SNPs (-0.031) than in other MA plans (-0.060).
AHRQ-funded; HS000029.
Citation: Slade EP, Wu RJ, Meiselbach MK .
Psychiatrist and nonpsychiatrist physician network breadth in dual eligible special needs plans.
Psychiatr Serv 2023 Aug; 74(8):816-22. doi: 10.1176/appi.ps.20220239..
Keywords: Behavioral Health, Medicare, Provider: Physician
Bunting AM, Schwartz RP, Wu LT
A brief screening and assessment tool for opioid use in adults: results from a validation study of the Tobacco, Alcohol, Prescription Medication, and Other Substances Tool.
The objective of this secondary analysis was to evaluate opioid-specific validation results of the Tobacco, Alcohol, Prescription Medication, and Other Substances (TAPS) tool for screening in primary care The findings showed that TAPS opioid items could be used in primary care settings for a spectrum of unhealthy opioid use; however, self-disclosure remains an issue in primary care settings. The researchers noted that further testing in a larger population sample might be warranted, given the brevity, simplicity, and accuracy of self-administration.
AHRQ-funded; HS026120.
Citation: Bunting AM, Schwartz RP, Wu LT .
A brief screening and assessment tool for opioid use in adults: results from a validation study of the Tobacco, Alcohol, Prescription Medication, and Other Substances Tool.
J Addict Med 2023 Jul-Aug; 17(4):471-73. doi: 10.1097/adm.0000000000001139..
Keywords: Opioids, Screening, Substance Abuse, Behavioral Health, Primary Care
Levander XA, Carmody T, Cook RR
A gender-based secondary analysis of the ADAPT-2 combination naltrexone and bupropion treatment for methamphetamine use disorder trial.
This study’s objective was to determine if there were gender-based differences in treatment for methamphetamine use disorder (MUD) in general comparing treatment with placebo and due to use of a hormonal method of contraception (HMC). This research was a secondary analysis of ADAPT-2, a randomized, double-blind, placebo-controlled, multicenter, two-stage sequential parallel comparison design trial. This cohort study comprised 126 women (403 total participants); average age of 40.1 years with moderate to severe MUD. At baseline, women used methamphetamine intravenously fewer days than men [15.4 versus 23.1% days] and more women than men had anxiety (59.5 versus 47.6%). Of the 113 women capable of becoming pregnant, 31 used HMC. Treatment response for women was 29% in Stage 1 and 5.6% in Stage 2 compared with 3.2% and 0% on placebo, respectively. A treatment effect was found independently for females and males; with no between-gender treatment effect (0.144 females versus 0.100 males). Treatment effect did not differ by HMC use (0.156 HMC versus 0.128 none).
AHRQ-funded; HS026370.
Citation: Levander XA, Carmody T, Cook RR .
A gender-based secondary analysis of the ADAPT-2 combination naltrexone and bupropion treatment for methamphetamine use disorder trial.
Addiction 2023 Jul; 118(7):1320-28. doi: 10.1111/add.16163..
Keywords: Substance Abuse, Medication, Behavioral Health, Sex Factors
Bushnell G, Lloyd J, Olfson M
Antipsychotic medication use in Medicaid-insured children decreased substantially between 2008 And 2016.
In the early 2000s there was a rapid growth of pediatric antipsychotic prescribing, especially in the Medicaid population, and concerns grew about the safety and appropriateness of such prescribing. Numerous states implemented policy and educational programs focused on safer and more stringent utilization of antipsychotics. Antipsychotic utilization leveled off toward the end of the 2000s, but no recent national trend estimates of antipsychotic utilization in children enrolled in Medicaid exist. The authors of this study report a substantial decrease in antipsychotic use among children ages 2-17 between 2008 and 2016. Declines existed across foster care status, age, sex, and racial and ethnic groups studied. The rate of children with an antipsychotic prescription who received any diagnosis related to a pediatric indication that was approved by the Food and Drug Administration increased from 38 percent in 2008 to 45 percent in 2016.
AHRQ-funded; HS02600.
Citation: Bushnell G, Lloyd J, Olfson M .
Antipsychotic medication use in Medicaid-insured children decreased substantially between 2008 And 2016.
Health Aff 2023 Jul; 42(7):973-80. doi: 10.1377/hlthaff.2022.01625..
Keywords: Children/Adolescents, Medication, Medicaid, Behavioral Health
Titus AR, Mezuk B, Hirschtick JL
Patterns and predictors of depressive and anxiety symptoms within a population-based sample of adults diagnosed with COVID-19 in Michigan.
Researchers examined the intersection of demographic, economic, and illness-related predictors of depressive and anxiety symptoms within a population-based sample of adults diagnosed with COVID-19 in Michigan. Data were taken from a population-based survey of Michigan adults who experienced a COVID-19 diagnosis prior to August 2020. Results indicated that relative risks for experiencing poor mental health outcomes varied by race/ethnicity, sex, age, and income. Symptom severity was associated with a higher burden of comorbid depressive/anxiety symptoms. "Long COVID" was associated with all outcomes. The researchers concluded that because of overlapping risk factors, integrated approaches to treating depressive/anxiety symptoms among COVID-19 survivors is warranted.
AHRQ-funded; HS026120.
Citation: Titus AR, Mezuk B, Hirschtick JL .
Patterns and predictors of depressive and anxiety symptoms within a population-based sample of adults diagnosed with COVID-19 in Michigan.
Soc Psychiatry Psychiatr Epidemiol 2023 Jul; 58(7):1099-108. doi: 10.1007/s00127-023-02453-9..
Keywords: COVID-19, Depression, Anxiety, Behavioral Health
Narindrarangkura P, Alafaireet PE, Khan U
Predicting suicide attempts among people with diabetes using a large multicenter electronic health records dataset.
This study’s goal was to determine the risk factors for suicidal behaviors of people with diabetes as they have a higher risk than the general population. The authors investigated risk factors and predicted suicide attempts in people with diabetes using the Least Absolute Shrinkage and Selection Operator (LASSO) regression. They used data from Cerner Real-World Data™ and included over 3 million diabetes patients in the study. They analyzed gender-, diabetes-type, and depression-specific LASSO regression models. The study included 7764 subjects diagnosed with suicide attempts with an average age of 45. They found risk factors for suicide attempts in diabetes patients, such as being an American Indian or Alaska Native, atypical agents, benzodiazepines, and antihistamines. Amyotrophy had a negative coefficient for suicide attempts with males with diabetes but had a positive coefficient for females. Using MAOI had a negative coefficient for suicide attempts in T1DM patients. Patients less than 20 years of age had a positive coefficient for suicide in depressed and non-depressed patients with diabetes.
AHRQ-funded; HS028032.
Citation: Narindrarangkura P, Alafaireet PE, Khan U .
Predicting suicide attempts among people with diabetes using a large multicenter electronic health records dataset.
Int J Psychiatry Med 2023 Jul; 58(4):302-24. doi: 10.1177/00912174231162477..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Behavioral Health, Diabetes, Chronic Conditions
Zhu JM, Meiselbach MK, Drake C C
Psychiatrist networks In Medicare Advantage plans are substantially narrower than in Medicaid and ACA Markets.
The authors used a novel data set that linked insurance network service areas, plans, and providers across Medicare Advantage, Medicaid managed care, and Affordable Care Act plan markets to compare psychiatrist network breadth; their purpose was to assess the percentage of providers in a given area considered in network for a plan. They found that nearly two-thirds of psychiatrist networks in Medicare Advantage contained fewer than 25 percent of providers in a network's service area. They concluded that these findings suggest a certain “narrowness” in psychiatrist networks in Medicare Advantage, which may disadvantage enrollees attempted to obtain mental health services.
AHRQ-funded; HS000029.
Citation: Zhu JM, Meiselbach MK, Drake C C .
Psychiatrist networks In Medicare Advantage plans are substantially narrower than in Medicaid and ACA Markets.
Health Aff 2023 Jul; 42(7):909-18. doi: 10.1377/hlthaff.2022.01547..
Keywords: Elderly, Medicare, Behavioral Health, Access to Care