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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
101 to 125 of 710 Research Studies DisplayedValentine KD, Lipstein EA, Vo H
Pediatric caregiver version of the Shared Decision Making Process Scale: validity and reliability for ADHD treatment decisions.
This study’s goal was to examine the validity and reliability of a scale for a shared decision making (SDM) Process scale in attention-deficit/hyperactivity disorder (ADHD) treatment decisions. This cross-sectional survey included 498 caregivers of children aged 5-13 diagnosed with ADHD who had made a decision about ADHD medication in the last 2 years. Surveys included the adapted SDM Process scale, decisional conflict, decision regret, and decision involvement. The scale was found to be acceptable and reliable. Scores demonstrated convergent validity, as they were higher for those without decisional conflict than those with decisional conflict and higher for caregivers who stated they made the decision with the provider than those who made the decision themselves. Higher scores were related to less regret, though the magnitude of the relationship was small.
AHRQ-funded; HS025718.
Citation: Valentine KD, Lipstein EA, Vo H .
Pediatric caregiver version of the Shared Decision Making Process Scale: validity and reliability for ADHD treatment decisions.
Acad Pediatr 2022 Nov-Dec;22(8):1503-09. doi: 10.1016/j.acap.2022.07.014..
Keywords: Children/Adolescents, Behavioral Health, Shared Decision Making, Patient-Centered Healthcare
Eliason Gordon, Gordon SH
The association between postpartum insurance instability and access to postpartum mental health services: evidence from Colorado.
This study assessed the association between postpartum insurance instability and access to postpartum mental health services. The authors used data from the 2018-2019 Colorado Health eMoms survey, which sampled mothers from the 2018 birth certificate files at 3-6 months and 12-14 months postpartum. Respondents were classified at each time point as stably insured or unstable insured based on postpartum insurance status. Of respondents with public coverage at childbirth, 33.2% experienced postpartum insurance changes compared with 9.5% with private coverage. Respondents were more likely to experience unstable postpartum insurance if they were younger, had incomes of less than $50,000, and were of Hispanic ethnicity. Respondents who experienced postpartum insurance instability had lower odds of reporting that they discussed mental health at a postpartum check-up and received postpartum mental health services.
AHRQ-funded; HS000011.
Citation: Eliason Gordon, Gordon SH .
The association between postpartum insurance instability and access to postpartum mental health services: evidence from Colorado.
Womens Health Issues 2022 Nov-Dec;32(6):550-56. doi: 10.1016/j.whi.2022.06.010..
Keywords: Maternal Care, Access to Care, Women, Behavioral Health, Health Insurance
Mackie TI, Schaefer AJ, Palatucci JS
The role of formal policy to promote informed consent of psychotropic medications for youth in child welfare custody: a national examination.
The purpose of this sequential multi-method study was to propose a classification for the procedural elements of informed consent policies based upon existing child welfare policies and then explored whether formal state policies across the United States authorized these elements. The researchers conducted interviews with 58 key informants primarily from state child welfare agencies to identify a classification of procedural elements for informed consent of psychotropic medications. A legislative review of the 50 states and D.C. was then conducted to characterize whether formal policies endorsed each procedural element. Key informants reported five procedural elements in policy, and 23 states endorsed relevant legislation. Only two states specified all five procedural elements, and the content of any procedural elements varied considerably across policies.
AHRQ-funded; HS02198501; HS026001
Citation: Mackie TI, Schaefer AJ, Palatucci JS .
The role of formal policy to promote informed consent of psychotropic medications for youth in child welfare custody: a national examination.
Adm Policy Ment Health 2022 Nov;49(6):986-1003. doi: 10.1007/s10488-022-01212-3..
Keywords: Children/Adolescents, Vulnerable Populations, Medication, Behavioral Health, Policy
Hoopes AJ, Brandzel SD, Luce C
What do adolescents and their parents need from mental health integration in primary care? A qualitative exploration of design insights.
The purpose of this study was to 1) explore the challenges of primary care-based mental health and substance use screening and care for adolescents and 2) identify program design solutions. The researchers conducted interviews and focus groups with adolescents receiving care at Kaiser Permanente Washington in 2020, and separate interviews with the parents of the participants. The study found five overarching design principle themes emerged from the 41 interviews and 10 focus groups: 1) Engagement, 2) Privacy, 3) Communication, 4) Choice, and 5) Ease.
Citation: Hoopes AJ, Brandzel SD, Luce C .
What do adolescents and their parents need from mental health integration in primary care? A qualitative exploration of design insights.
J Pediatr Health Care 2022 Nov-Dec; 36(6):570-81. doi: 10.1016/j.pedhc.2022.06.006..
Keywords: Children/Adolescents, Patient-Centered Healthcare, Behavioral Health, Primary Care
Viswanathan M, Wallace IF, Cook Middleton J
Screening for depression and suicide risk in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
The authors sought to review the evidence on screening for depression or suicide risk in children and adolescents to inform the US Preventive Services Task Force. They found indirect evidence that suggested some screening instruments were reasonably accurate for detecting depression. Further, psychotherapy and pharmacotherapy were associated with some benefits and no statistically significant harms for depression, but the evidence was limited for suicide risk screening instruments and interventions.
AHRQ-funded; 290201500011I.
Citation: Viswanathan M, Wallace IF, Cook Middleton J .
Screening for depression and suicide risk in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Oct 18;328(15):1543-56. doi: 10.1001/jama.2022.16310..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Depression, Behavioral Health, Screening, Primary Care, Guidelines, Evidence-Based Practice, Prevention
Brodney S, Valentine KD, Vo HA
Measuring shared decision making in younger and older adults with depression.
This study compared shared decision making (SDM) of younger (18-39 years) and older (40-75 years) patients for starting or stopping depression treatment. A panel of 494 respondents completed one of two versions of the SDM Process scale that differed in wording of pros and cons items, and completed measures of decisional conflict, decision regret and who made the decision (mainly the respondent, mainly the provider, or together). SDM Process scores were higher for younger respondents than older respondents. Higher scores were also associated with no decisional conflict and less decision regret.
AHRQ-funded; HS025718.
Citation: Brodney S, Valentine KD, Vo HA .
Measuring shared decision making in younger and older adults with depression.
Int J Qual Health Care 2022 Oct 12;34(4):mzac076. doi: 10.1093/intqhc/mzac076..
Keywords: Shared Decision Making, Depression, Behavioral Health
Viswanathan M, Wallace IF, Cook Middleton J
Screening for anxiety in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this paper was to review the evidence on screening for anxiety in children and adolescents to inform the US Preventive Services Task Force. Indirect evidence of findings suggested that some screening instruments were reasonably accurate. Cognitive behavioral therapy and pharmacotherapy were associated with benefits; no statistically significant association with harms was reported.
AHRQ-funded; 290201500011I, 75Q80120D00007.
Citation: Viswanathan M, Wallace IF, Cook Middleton J .
Screening for anxiety in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Oct 11;328(14):1445-55. doi: 10.1001/jama.2022.16303..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Anxiety, Behavioral Health, Primary Care, Screening, Guidelines, Evidence-Based Practice, Prevention
Wesemann DG, Wilson AC, Riley AR
Parental cannabis use, negative parenting, and behavior problems of young children.
This cross-sectional survey of parents of young children aged 1.5-5 years examined whether cannabis use is associated with increased risk for negative parenting and child emotional and behavioral problems. The parents reported on family demographics, last 6-months cannabis use, negative parenting, parent mental health, parents' adverse childhood experiences (ACEs), and child emotional/behavioral problems. Of 266 responding parents from five primary care practices in three states, 34 (13%) reported cannabis use in the last 6 months. Those parents who endorsed cannabis use reported significantly more negative parenting, ACEs, anxiety, depression, and child emotional/behavioral problems. However, parental cannabis use did not predict child emotional/behavioral problems when other risk factors were considered. The authors call for further research.
AHRQ-funded; HS022981.
Citation: Wesemann DG, Wilson AC, Riley AR .
Parental cannabis use, negative parenting, and behavior problems of young children.
Subst Use Misuse 2022;57(13):2015-19. doi: 10.1080/10826084.2022.2130001..
Keywords: Children/Adolescents, Behavioral Health, Pregnancy
Sakai-Bizmark R, Kumamaru H, Estevez D
Association between suicide attempt and previous healthcare utilization among homeless youth.
The purpose of this study was to examine the association between prior emergency department visit or hospitalization and subsequent suicide attempt among homeless youth aged 10-17 years old using New York statewide databases. Findings showed an association between prior healthcare utilization and decreased risk of suicide attempt among homeless youth.
AHRQ-funded; 900014-17-05.
Citation: Sakai-Bizmark R, Kumamaru H, Estevez D .
Association between suicide attempt and previous healthcare utilization among homeless youth.
Suicide Life Threat Behav 2022 Oct;52(5):994-1001. doi: 10.1111/sltb.12897..
Keywords: Children/Adolescents, Vulnerable Populations, Behavioral Health, Healthcare Utilization
Richmond J, Sanderson M, Shrubsole MJ
Psychosocial impact of COVID-19 among adults in the southeastern United States.
The authors investigated factors associated with depressive and anxiety symptoms during the COVID-19 pandemic. Using data from the Southern Community Cohort Study (SCCS), their results overall suggested that individuals in fair/poor health, living alone, and/or experiencing decreased physical activity and vegetable/fruit consumption have higher risk of depressive and anxiety symptoms. They recommended clinical and public health interventions to support individuals experiencing depression and anxiety during the COVID-19 pandemic.
AHRQ-funded; HS026122.
Citation: Richmond J, Sanderson M, Shrubsole MJ .
Psychosocial impact of COVID-19 among adults in the southeastern United States.
Prev Med 2022 Oct;163:107191. doi: 10.1016/j.ypmed.2022.107191..
Keywords: COVID-19, Anxiety, Depression, Behavioral Health, Public Health
Rich KM, Zubiago J, Murphy M
The association of gender with receptive and distributive needle sharing among individuals who inject drugs.
The authors sought to assess the relationship between gender and needle sharing with injection drug use. Using data from the 2010-2019 National Survey on Drug Use and Health (NSDUH) datasets, they found that women were more likely in comparison with men to share needles both through receptive and distributive means. They concluded that expansion of interventions, including syringe service programs, to increase access to sterile injection equipment, is of great importance.
AHRQ-funded; HS026008.
Citation: Rich KM, Zubiago J, Murphy M .
The association of gender with receptive and distributive needle sharing among individuals who inject drugs.
Harm Reduct J 2022 Sep 30;19(1):108. doi: 10.1186/s12954-022-00689-3..
Keywords: Human Immunodeficiency Virus (HIV), Substance Abuse, Behavioral Health, Sex Factors
Senft Everson N, Klein WMP, Lee SS
Dispositional optimism and optimistic bias: associations with cessation motivation, confidence, and attitudes.
This study tested whether 2 conceptually overlapping constructs, dispositional optimism (generalized positive expectations) and optimistic bias (inaccurately low risk perceptions), may have different implications for smoking treatment engagement. A cohort of predominantly Black, low-income Southern Community Cohort study smokers (n=880) were surveyed on their dispositional optimism and pessimism, comparative lung cancer risk, and information to calculate objective lung cancer risk. Perceived risk was categorized as accurate, optimistically-biased, or pessimistically-biased. The Life Orientation Test-Revised subscales was used with 0 = neutral, and 12 = high optimism/pessimism. Mean dispositional optimism/pessimism scores were 8.41 and 5.65 respectively. Perceived lung cancer risk was 38% accurate, with 27% optimistically-biased and 35% pessimistically-biased. Accuracy was unrelated to dispositional optimism, though optimistically biased smokers had higher dispositional pessimism. Dispositional optimism was associated with higher confidence and favorable precision treatment attitudes. Lower motivation and less favorable precision treatment attitudes were shown for those with optimistically-biased (vs. accurate) risk perception.
AHRQ-funded; HS02612.
Citation: Senft Everson N, Klein WMP, Lee SS .
Dispositional optimism and optimistic bias: associations with cessation motivation, confidence, and attitudes.
Health Psychol 2022 Sep;41(9):621-29. doi: 10.1037/hea0001184..
Keywords: Tobacco Use: Smoking Cessation, Tobacco Use, Behavioral Health
Calcaterra SL, Martin M, Bottner R
Management of opioid use disorder and associated conditions among hospitalized adults: a consensus statement from the Society of Hospital Medicine.
This paper discusses the findings of a Society of Hospital Medicine working group convened to develop a Consensus Statement on the management of opioid use disorder (OUD) and associated conditions among hospitalized adults. The statement is intended for clinicians practicing medicine in the inpatient setting (e.g., hospitalists, primary care physicians, family physicians, advanced practice nurses, and physician assistants) and is intended to apply to hospitalized adults at risk for, or diagnosed with, OUD. The first step of the working group to develop the statement was to conduct a systematic review of relevant guidelines and compose a draft statement based on extracted recommendations. In the next step the working group obtained feedback on the draft statement from external experts in addiction medicine, SHM members, professional societies, harm reduction organizations and advocacy groups, and peer reviewers. This iterative development process resulted in a final Consensus Statement consisting of 18 recommendations covering the following topics: (1) identification and treatment of OUD and opioid withdrawal, (2) perioperative and acute pain management in patients with OUD, and (3) methods to optimize care transitions at hospital discharge for patients with OUD.
AHRQ-funded; HS026215.
Citation: Calcaterra SL, Martin M, Bottner R .
Management of opioid use disorder and associated conditions among hospitalized adults: a consensus statement from the Society of Hospital Medicine.
J Hosp Med 2022 Sep;17(9):744-56. doi: 10.1002/jhm.12893..
Keywords: Opioids, Substance Abuse, Behavioral Health, Evidence-Based Practice, Guidelines, Inpatient Care
Calcaterras SL, Bottner R, Martin M
Management of opioid use disorder, opioid withdrawal, and opioid overdose prevention in hospitalized adults: a systematic review of existing guidelines.
This study evaluated the quality and content of existing guidelines for in-hospital opioid use disorder (OUD) treatment and management. A literature search was done on several databases, websites of relevant societies and advocacy organizations, and selected international search engines. Nineteen guidelines published between January 2010 and June 2020 met the selection criteria. The majority of guidelines were based on observational studies or expert consensus. They recommended the use of nonstigmatizing language among patients with OUD; to assess patients with unhealthy opioid use for OUD using the Diagnostic Statistical Manual of Diseases-5th Edition criteria; use of methadone or buprenorphine to treat OUD and opioid withdrawal; use of multimodal, nonopioid therapy, and when needed, short-acting opioid analgesics in addition to buprenorphine or methadone, for acute pain management; ensuring linkage to ongoing methadone or buprenorphine treatment; referring patients to psychosocial treatment; and ensuring access to naloxone for opioid overdose reversal.
AHRQ-funded; HS026215.
Citation: Calcaterras SL, Bottner R, Martin M .
Management of opioid use disorder, opioid withdrawal, and opioid overdose prevention in hospitalized adults: a systematic review of existing guidelines.
J Hosp Med 2022 Sep;17(9):679-92. doi: 10.1002/jhm.12908..
Keywords: Opioids, Substance Abuse, Behavioral Health, Evidence-Based Practice, Guidelines, Inpatient Care
Shankar LG, Habich M, Rosenman M
Mental health emergency department visits by children before and during the COVID-19 pandemic.
Investigators described pediatric mental health emergency department (ED) visit rates and visit characteristics before and during the COVID-19 pandemic. They found that mental health ED visit rates by children increased during the COVID-19 pandemic.
AHRQ-funded; HS026385.
Citation: Shankar LG, Habich M, Rosenman M .
Mental health emergency department visits by children before and during the COVID-19 pandemic.
Acad Pediatr 2022 Sep-Oct;22(7):1127-32. doi: 10.1016/j.acap.2022.05.022..
Keywords: COVID-19, Children/Adolescents, Emergency Department, Behavioral Health, Healthcare Utilization, Public Health
Beetham T, Fiellin DA, Busch SH
Physician response to COVID-19-driven telehealth flexibility for opioid use disorder.
This study surveyed physicians who provide opioid use disorder (OUD) treatment on their preferences and practices regarding telehealth that have evolved during the COVID-19 pandemic. A total of 1141 physicians who were publicly listed buprenorphine-prescribing physicians were surveyed. Most respondents found telehealth to be effective, with 54% who found it more effective than expected. Overall, 85% were in favor of temporary telehealth flexibility being permanently extended, and 77% would be likely to use telehealth after the COVID-19 pandemic is over.
AHRQ-funded; HS017589.
Citation: Beetham T, Fiellin DA, Busch SH .
Physician response to COVID-19-driven telehealth flexibility for opioid use disorder.
Am J Manag Care 2022 Sep;28(9):456-63. doi: 10.37765/ajmc.2022.89221..
Keywords: COVID-19, Telehealth, Health Information Technology (HIT), Opioids, Substance Abuse, Behavioral Health, Medication
Bowden CF, Simmel C, Mendez A
The complexity of psychotropic medication prescription and treating trauma among youth in foster care: perspectives from the lived experience.
The purpose of this study was to examine stakeholders' perspectives of the relationship between psychotropic medications and trauma informed care (TIC) for youth in foster care. The researchers recruited foster caseworkers, prescribing clinicians, caregivers, and alumni of the foster care system and conducted semi-structured individual and group interviews. Data were recorded and transcribed verbatim and analyzed using a directed content analysis approach. Five themes emerged across the recorded and transcribed data within stakeholder groups: 1) acknowledging trauma; 2) role of psychotropic medication; 3) psychosocial resources; 4) additional supports; and, 5) training and education. Stakeholders identified TIC as an important component of mental health services for youth in foster care. Most stakeholders felt that psychotropic medication was overused in treating trauma. Respondents suggested including additional supportive team members to help guide youth through the mental health treatment system and stated the importance of support from individuals with common lived experiences. The study concluded that there is a need for: improved training and education for stakeholders, additional sources of support for youth in foster care, and an overall system that emphasizes trauma-sensitive clinical interactions and psychosocial supports.
AHRQ-funded; HS02600101A1.
Citation: Bowden CF, Simmel C, Mendez A .
The complexity of psychotropic medication prescription and treating trauma among youth in foster care: perspectives from the lived experience.
Adm Policy Ment Health 2022 Sep;49(5):821-33. doi: 10.1007/s10488-022-01203-4..
Keywords: Children/Adolescents, Vulnerable Populations, Behavioral Health, Trauma, Medication
Huffstetler AN, Epling J, Krist AH
The need for electronic health records to support delivery of behavioral health preventive services.
In this article the authors discuss adaptations to electronic health records to improve behavioral health preventive services. They recommend a refocus in digital health away from best business practices that help EHR vendors and toward best health-related practice in order to improve patient care and make work easier for clinicians.
AHRQ-funded; HS027077.
Citation: Huffstetler AN, Epling J, Krist AH .
The need for electronic health records to support delivery of behavioral health preventive services.
JAMA 2022 Aug 23;328(8):707-08. doi: 10.1001/jama.2022.13391..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Behavioral Health, Prevention, Healthcare Delivery
Hails KA, Petts RA, Hostutler CA
COVID-19 distress, negative parenting, and child behavioral problems: the moderating role of parent adverse childhood experiences.
This study’s objective was to test a moderated mediation model to determine whether families’ COVID-19-related distress is associated with young children's emotional/behavioral functioning via negative parenting, and whether these relationships vary based on parents' adverse childhood experiences (ACEs). Participants were 267 parents recruited from five primary care sites across the United States with children ages 1.5-5 years. Internet questionnaires were completed on measures including demographics, parent ACEs, negative parenting, parent mental health, and COVID-19 distress. Negative parenting significantly mediated the relationship between COVID-19 distress and child emotional/behavioral problems. The model accounted for 42% variance in child emotional/behavioral problems.
AHRQ-funded; HS022981.
Citation: Hails KA, Petts RA, Hostutler CA .
COVID-19 distress, negative parenting, and child behavioral problems: the moderating role of parent adverse childhood experiences.
Child Abuse Negl 2022 Aug;130(Pt 1):105450. doi: 10.1016/j.chiabu.2021.105450..
Keywords: Children/Adolescents, COVID-19, Behavioral Health, Stress
Newton H, Busch SH, Brunette MF
Innovations in care delivery for patients with serious mental illness among accountable care organizations.
The objective of this study was to examine whether and how organizations participating in accountable care organization (ACO) contracts integrate primary care and treatment for patients with serious mental illness. The study used the 2017-2018 National Survey of ACOs to measure ACO-reported use of three integrated care strategies. Of the 399 respondents who answered the survey, 76% reported using at least one integrated care strategy in at least one location. Use of care managers was most common followed by use of patient registry and colocation of a primary care clinician in a specialty mental health setting. Respondents with the largest Medicaid contract or largest commercial contract included quality measures specific to serious mental illness were more likely to use the integrated care delivery strategies.
AHRQ-funded; HS024075.
Citation: Newton H, Busch SH, Brunette MF .
Innovations in care delivery for patients with serious mental illness among accountable care organizations.
Psychiatr Serv 2022 Aug;73(8):889-96. doi: 10.1176/appi.ps.202000484..
Keywords: Healthcare Delivery, Behavioral Health
Cutler GJ, Bergmann KR, Doupnik SK
Pediatric mental health emergency department visits and access to Inpatient care: a crisis worsened by the COVID-19 pandemic.
The purpose of this study was to explore the author’s previous research findings on trends in pediatric emergency department (ED) visits for mental health (MH) vs non-mental health in light of more recent related data corresponding with the COVID-19 pandemic. The study found that recent research supports the dramatic increase in pediatric MH ED visits found in the author’s previous research and provides additional evidence that the increase has been driven by specific MH diagnoses. The researchers conclude that depressive disorders, self-harm behavior, and non-alcohol substance use disorders should be prioritized for the development of ED- and hospital-based strategies, and that EDs, hospitals, health systems, and the government urgently need to increase capacity for MH services and identify innovative solutions to improve access to high quality MH care for children.
AHRQ-funded; HS026385.
Citation: Cutler GJ, Bergmann KR, Doupnik SK .
Pediatric mental health emergency department visits and access to Inpatient care: a crisis worsened by the COVID-19 pandemic.
Acad Pediatr 2022 Aug;22(6):889-91. doi: 10.1016/j.acap.2022.03.015..
Keywords: Children/Adolescents, COVID-19, Behavioral Health, Emergency Department, Access to Care, Public Health, Inpatient Care
Khouja T, Zhou J, Gellad WF
Serious opioid-related adverse outcomes associated with opioids prescribed by dentists.
This study’s objective was to evaluate adverse outcomes and persistent opioid use (POU) after opioid prescriptions by dentists, based on whether opioids were overprescribed or within recommendations. A cross-sectional analysis of adults with dental visit and corresponding opioid prescription from 2011 to 2017 within a nationwide commercial claims database was conducted. As per CDC guidelines, opioid overprescribing was defined as >120 morphine milligram equivalents. Of 633,387 visits, 16.6% had POU and 2.6% experienced an adverse outcome. POU was higher when opioids were overprescribed with visits associated with mild pain and those with substance use disorders having the highest risk of both outcomes.
AHRQ-funded; HS025177.
Citation: Khouja T, Zhou J, Gellad WF .
Serious opioid-related adverse outcomes associated with opioids prescribed by dentists.
Pain 2022 Aug 1;163(8):1571-80. doi: 10.1097/j.pain.0000000000002545..
Keywords: Opioids, Dental and Oral Health, Substance Abuse, Behavioral Health, Practice Patterns, Pain, Medication, Adverse Drug Events (ADE), Adverse Events
Marks MR, Dux MC, Rao V
Treatment patterns of anxiety and posttraumatic stress disorder following traumatic brain injury.
Investigators examined psychotropic medication use and psychotherapy patterns among individuals diagnosed with anxiety disorders and PTSD post-traumatic brain injury (TBI). They found that receipt of pharmacotherapy pre- and post-TBI was considerably more common than receipt of psychotherapy. Individuals diagnosed with anxiety were 66% less likely to receive psychotherapy compared with individuals diagnosed with PTSD. Overall, psychotropic medication use and rates of antidepressant prescription use in the anxiety group were higher compared to those in the PTSD group.
AHRQ-funded; HS024560.
Citation: Marks MR, Dux MC, Rao V .
Treatment patterns of anxiety and posttraumatic stress disorder following traumatic brain injury.
J Neuropsychiatry Clin Neurosci 2022 Summer;34(3):247-53. doi: 10.1176/appi.neuropsych.21040104..
Keywords: Anxiety, Behavioral Health, Trauma, Brain Injury, Treatments, Practice Patterns, Medication
Kagarmanova A, Sparkman H, Laiteerapong N
Improving the management of chronic pain, opioid use, and opioid use disorder in older adults: study protocol for i-cope study.
This article describes a protocol for an upcoming study on the planned implementation and evaluation of I-COPE (Improving Chicago Older Adult Opioid and Pain Management through Patient-centered Clinical Decision Support and Project ECHO®) to improve care for older adults with chronic pain, opioid use, and opioid use disorder (OUD). The study will be implemented in 35 clinical sites across the metropolitan Chicago area for patients aged ≥ 65 with chronic pain, opioid use, or OUD who receive primary care at one of the clinics. I-COPE includes the integration of patient-reported data on symptoms and preferences, clinical decision support tools and shared decision making into routine primary care. Primary care providers will be trained on the tools through web-based videos and an optional Project ECHO® course, entitled "Pain Management and OUD in Older Adults." A framework called RE-AIM will be used to assess the I-COPE implementation. Outcomes considered effective include an increased variety of recommended pain treatments, decreased prescriptions of higher-risk pain treatments, and decreased patient pain scores. Outcomes will be evaluated at 6 and 12 months after implementation, and PCPs participating in Project ECHO® will be evaluated on changes in knowledge, attitudes, and self-efficacy using pre- and post-course surveys.
AHRQ-funded; HS027910.
Citation: Kagarmanova A, Sparkman H, Laiteerapong N .
Improving the management of chronic pain, opioid use, and opioid use disorder in older adults: study protocol for i-cope study.
Trials 2022 Jul 27;23(1):602. doi: 10.1186/s13063-022-06537-w..
Keywords: Elderly, Pain, Chronic Conditions, Opioids, Medication, Substance Abuse, Behavioral Health, Clinical Decision Support (CDS), Shared Decision Making, Health Information Technology (HIT)
Jakubowski A, Rath C, Harocopos A
Implementation of buprenorphine services in NYC syringe services programs: a qualitative process evaluation.
This article discusses a study that investigated the barriers to and facilitators of implementing syringe service programs (SSPs) for providing buprenorphine treatment access to people with opioid use disorder (OUD) who are reluctant to seek care elsewhere. The study looked at the program ran by the New York City Department of Health and Mental Hygiene (DOHMH) that funded the creation of nine SSPs that developed “low-threshold” buprenorphine services as part of a multipronged initiative to lower opioid-related overdose rates. Barriers identified included gaps in staff knowledge and comfort communicating with participants about buprenorphine, difficulty hiring buprenorphine providers, managing tension between harm reduction and traditional OUD treatment philosophies, and financial constraints. Implementation facilitators included receiving technical assistance from DOHMH, having designated buprenorphine coordinators, offering other supportive services to participants, and telehealth to bridge gaps in provider availability. Three key recommendations were made including: (1) health departments should provide support for SSPs in training staff, building health service infrastructure, and developing policies and procedures, (2) SSPs should designate a buprenorphine coordinator and ensure regular training on buprenorphine for frontline staff, and (3) buprenorphine providers should be selected or supported to use a harm reduction approach to buprenorphine treatment.
AHRQ-funded; HS026396.
Citation: Jakubowski A, Rath C, Harocopos A .
Implementation of buprenorphine services in NYC syringe services programs: a qualitative process evaluation.
Harm Reduct J 2022 Jul 10;19(1):75. doi: 10.1186/s12954-022-00654-0..
Keywords: Opioids, Substance Abuse, Behavioral Health, Medication