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Integrated behavioral health primary care

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https://www.readbyqxmd.com/read/28337689/managing-chronic-pain-in-primary-care-it-really-does-take-a-village
#1
Karen Seal, William Becker, Jennifer Tighe, Yongmei Li, Tessa Rife
Some healthcare systems are relieving primary care providers (PCPs) of "the burden" of managing chronic pain and opioid prescribing, instead offloading chronic pain management to pain specialists. Last year the Centers for Disease Control and Prevention recommended a biopsychosocial approach to pain management that discourages opioid use and promotes exercise therapy, cognitive behavioral therapy and non-opioid medications as first-line patient-centered, multi-modal treatments best delivered by an interdisciplinary team...
March 23, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28333604/patient-preferences-for-discussing-childhood-trauma-in-primary-care
#2
Ellen Goldstein, Ninad Athale, Andrés F Sciolla, Sheryl L Catz
CONTEXT: Exposure to traumatic events is common in primary care patients, yet health care professionals may be hesitant to assess and address the impact of childhood trauma in their patients. OBJECTIVE: To assess patient preferences for discussing traumatic experiences and posttraumatic stress disorder (PTSD) with clinicians in underserved, predominantly Latino primary care patients. DESIGN: Cross-sectional study. MAIN OUTCOME MEASURE: We evaluated patients with a questionnaire assessing comfort to discuss trauma exposure and symptoms using the Adverse Childhood Experiences (ACE) Study questionnaire and the Primary Care-PTSD screen...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28333515/a-philosophy-for-behavioral-health-integration-in-primary-care
#3
Thomas R Egnew
In response to a call for a philosophy that transcends the professional boundaries that threaten behavioral health integration in primary care, this essay explores the thesis that such a philosophy exists in medicine's core purpose. Drawing on the work of Eric Cassell, a philosophy may be determined that melds the values, themes, and constructs of individual models for behavioral health integration in primary care toward a single, overriding purpose. Effecting such integration challenges current trends in medicine by refocusing medicine on its ethical core...
March 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28315760/medication-adherence-outcomes-of-771-intervention-trials-systematic-review-and-meta-analysis
#4
REVIEW
Vicki S Conn, Todd M Ruppar
Excellent medication adherence contributes to decreases in morbidity, mortality, and health care costs. Although researchers have tested many interventions to increase adherence, results are sometimes conflicting and often unclear. This systematic review applied meta-analytic procedures to integrate primary research that tested medication adherence interventions. Comprehensive searching completed in 2015 located 771 published and unpublished intervention studies with adherence behavior outcomes. Random-effects model analysis calculated standardized mean difference effect sizes...
March 16, 2017: Preventive Medicine
https://www.readbyqxmd.com/read/28292304/design-and-implementation-of-electronic-health-record-integrated-clinical-prediction-rules-icpr-a-randomized-trial-in-diverse-primary-care-settings
#5
David A Feldstein, Rachel Hess, Thomas McGinn, Rebecca G Mishuris, Lauren McCullagh, Paul D Smith, Michael Flynn, Joseph Palmisano, Gheorghe Doros, Devin Mann
BACKGROUND: Clinical prediction rules (CPRs) represent a method of determining individual patient risk to help providers make more accurate decisions at the point of care. Well-validated CPRs are underutilized but may decrease antibiotic overuse for acute respiratory infections. The integrated clinical prediction rules (iCPR) study builds on a previous single clinic study to integrate two CPRs into the electronic health record and assess their impact on practice. This article discusses study design and implementation of a multicenter cluster randomized control trial of the iCPR clinical decision support system, including the tool adaptation, usability testing, staff training, and implementation study to disseminate iCPR at multiple clinical sites across two health care systems...
March 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28290927/understanding-primary-care-behavioral-health-across-military-settings-a-preliminary-comparison-between-deployed-and-in-garrison-care
#6
Ryan R Landoll, Matthew K Nielsen, Kathryn K Waggoner
BACKGROUND: Integrated primary care behavioral health (PCBH) is a growing trend in health care delivery, particularly in the Department of Defense and the Department of Veterans Affairs. This consultative model has been applied within the U.S. Air Force for over 15 years and has demonstrated positive health impacts and patient satisfaction. With extended conflicts and engagements, including Operation Enduring Freedom and Operation Iraqi Freedom, deployment behavioral health care has expanded and positively received, but there is less empirical support of particular models of care in a deployed environment...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290063/behavioral-health-integration-in-large-multi-group-pediatric-practice
#7
REVIEW
Abigail Boden Schlesinger
There is increasing interest in methods to improve access to behavioral health services for children and adolescents. Children's Community Pediatric Behavioral Health Service (CCPBHS) is an integrated behavioral health service whose method of (a) creating a leadership team with empowered administrative and clinical stakeholders who can act on a commitment to change and (b) having a clear mission statement with integrated administrative and clinical care processes can serve as a model for implementing integration efforts within the medical home...
March 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/28276949/mental-health-measurement-among-women-veterans-receiving-co-located-collaborative-care-services
#8
Kaitlin R Lilienthal, Laura J Buchholz, Paul R King, Christina L Vair, Jennifer S Funderburk, Gregory P Beehler
Routine use of measurement to identify patient concerns and track treatment progress is critical to high quality patient care. This is particularly relevant to the Primary Care Behavioral Health model, where rapid symptom assessment and effective referral management are critical to sustaining population-based care. However, research suggests that women who receive treatment in co-located collaborative care settings utilizing the PCBH model are less likely to be assessed with standard measures than men in these settings...
February 22, 2017: Psychology, Health & Medicine
https://www.readbyqxmd.com/read/28267470/rationale-and-design-of-a-cluster-randomized-controlled-trial-to-evaluate-the-effects-of-a-community-health-worker-based-program-for-cardiovascular-risk-factor-control-in-india
#9
Aditya Khetan, Raghunandan Purushothaman, Melissa Zullo, Rishab Gupta, Vittal Hejjaji, Sushil Agarwal, Sri Krishna Madan Mohan, Richard Josephson
BACKGROUND: The increasing burden of cardiovascular disease (CVD) in low- and middle-income countries is largely driven by the increasing prevalence of hypertension, diabetes, and tobacco use. We hypothesize that the utilization of community health workers (CHWs) to screen for and manage these 3 determinants of CVD in an integrated manner would be an effective approach to favorably affecting public health. METHODS: We have designed and set up the infrastructure to implement a 2-year community-based cluster randomized controlled trial in an underserved region of West Bengal, India...
March 2017: American Heart Journal
https://www.readbyqxmd.com/read/28264792/enhancing-mhealth-technology-in-the-patient-centered-medical-home-environment-to-activate-patients-with-type-2-diabetes-a-multisite-feasibility-study-protocol
#10
Ronald Gimbel, Lu Shi, Joel E Williams, Cheryl J Dye, Liwei Chen, Paul Crawford, Eric A Shry, Sarah F Griffin, Karyn O Jones, Windsor W Sherrill, Khoa Truong, Jeanette R Little, Karen W Edwards, Marie Hing, Jennie B Moss
BACKGROUND: The potential of mHealth technologies in the care of patients with diabetes and other chronic conditions has captured the attention of clinicians and researchers. Efforts to date have incorporated a variety of tools and techniques, including Web-based portals, short message service (SMS) text messaging, remote collection of biometric data, electronic coaching, electronic-based health education, secure email communication between visits, and electronic collection of lifestyle and quality-of-life surveys...
March 6, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28229248/promoting-social-nurturance-and-positive-social-environments-to-reduce-obesity-in-high-risk-youth
#11
REVIEW
Dawn K Wilson, Allison M Sweeney, Heather Kitzman-Ulrich, Haylee Gause, Sara M St George
Nurturing environments within the context of families, schools, and communities all play an important role in enhancing youth's behavioral choices and health outcomes. The increasing prevalence rates of obesity among youth, especially among low income and ethnic minorities, highlight the need to develop effective and innovative intervention approaches that promote positive supportive environments across different contexts for at-risk youth. We propose that the integration of Social Cognitive Theory, Family Systems Theory, and Self-Determination Theory offers a useful framework for understanding how individual, family, and social-environmental-level factors contribute to the development of nurturing environments...
March 2017: Clinical Child and Family Psychology Review
https://www.readbyqxmd.com/read/28218158/influence-of-integrated-community-and-facility-based-interventions-on-select-maternal-and-neonatal-outcomes-in-northern-karnataka-india-lessons-for-implementation-and-measurement
#12
Rajaram Subramanian Potty, Mohan Harnahalli Lakkappa, Arin Kar, Mallika Bidappa, Ramesh Banadakoppa Manjappa, Krishnamurthy Jayanna
BACKGROUND: Sukshema project provided technical assistance to National Health Mission of government of Karnataka to improve maternal, newborn and child health (MNCH) outcomes in eight districts of Karnataka between 2009 and 2015. The project designed tools, processes and provided mentoring to frontline workers, community structures, and facilities to improve demand generation and quality of MNCH services. OBJECTIVES: To assess over time changes in selected MNCH care indicators among women who had delivered in the past 2 months in Bagalkot and Koppal districts...
January 2017: Indian Journal of Public Health
https://www.readbyqxmd.com/read/28193744/impact-of-the-integration-of-water-treatment-hygiene-nutrition-and-clean-delivery-interventions-on-maternal-health-service-use
#13
Kirsten Fagerli, Katherine O'Connor, Sunkyung Kim, Maureen Kelley, Aloyce Odhiambo, Sitnah Faith, Ronald Otieno, Benjamin Nygren, Mary Kamb, Robert Quick
Reducing barriers associated with maternal health service use, household water treatment, and improved hygiene is important for maternal and neonatal health outcomes. We surveyed a sample of 201 pregnant women who participated in a clinic-based intervention in Kenya to increase maternal health service use and improve household hygiene and nutrition through the distribution of water treatment products, soap, protein-fortified flour, and clean delivery kits. From multivariable logistic regression analyses, the adjusted odds of ≥ 4 antenatal care (ANC4+) visits (odds ratio [OR] = 3...
February 13, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28181702/cerebrovascular-burden-and-depressive-symptomatology-interrelate-over-18%C3%A2-years-support-for-the-vascular-depression-hypothesis
#14
Rosanna Scott, Daniel Paulson
OBJECTIVE: Potentially incongruent research literatures suggest three divergent hypotheses about depressive symptomatology: (1) symptoms are recurrent; (2) later-life depression results from high cerebrovascular burden (CVB); and (3) depressive symptoms contribute to comorbidities causing vascular burden. Past vascular depression research assumes that later-life depressive symptoms relate uniquely to high CVB and not to prior, recurrent depression. This study examines these divergent hypotheses...
February 9, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28168590/meeting-women-where-they-are-integration-of-care-as-the-foundation-of-treatment-for-at-risk-pregnant-and-postpartum-women
#15
Melanie Thomas, Margaret Hutchison, Gloria Castro, Melissa Nau, Martha Shumway, Naomi Stotland, Anna Spielvogel
Purpose In these times of rapidly changing health care policies, those involved in the health care of women, especially during the reproductive years, have a unique and daunting opportunity. There is great potential to positively impact women's health through focus on prevention, attention to addressing disparities, and new focus on the integration of behavioral health care in primary care settings. Description In this report from the field, we suggest that the integration of mental health care into other health services and addressing underlying social needs by partnering with community-based organizations should be a top priority for all settings seeking to provide excellent health care for women...
February 6, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28152186/initial-and-follow-up-evaluations-of-integrated-psychological-services-for-anxiety-and-depression-in-a-safety-net-primary-care-clinic
#16
Elizabeth Sadock, Paul B Perrin, Renée M Grinnell, Bruce Rybarczyk, Stephen M Auerbach
OBJECTIVE: Despite the recognized importance of integrated behavioral health, particularly in safety net primary care, its effectiveness in real world settings has not been extensively evaluated. This article presents 2 successive studies examining the effectiveness of integrated behavioral care in a safety net setting. METHOD: Study 1 compared the depression and anxiety scores of predominately low-income and minority patients who underwent brief interventions (N = 147) to those of patients from a demographically similar comparison clinic without integrated psychological services, matched on baseline levels of anxiety and depression and length of time between assessments (N = 139)...
February 2, 2017: Journal of Clinical Psychology
https://www.readbyqxmd.com/read/28137349/comprehensive-nicu-parental-education-beyond-baby-basics
#17
Sara L Mosher
Educating NICU families during their child's hospitalization and prior to hospital discharge is an integral task for staff from the moment an infant is admitted to the unit. Staff has the responsibility of providing parents with a myriad of education regarding the intensive care environment and information concerning their child's medical condition. With first-time parents, staff teaching topics extend to also include training on how to perform basic newborn care such as diapering, bathing, feeding, and numerous other primary parenting responsibilities...
January 1, 2017: Neonatal Network: NN
https://www.readbyqxmd.com/read/28115833/collaborative-care-in-real-world-settings-barriers-and-opportunities-for-sustainability
#18
Katherine Sanchez
Patient-centered care and self-management of chronic disease are optimally characterized by distinct adjunct services such as education, and support for the behavioral and psychosocial elements of managing disease. The collaborative care model for the treatment of depression and anxiety in primary care includes the integration of a behavioral health specialist, in collaboration with the primary care provider, and psychiatric consultation to effectively screen and treat common mental health problems. Dissemination and sustainability of the model have encountered numerous barriers across systems of care...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28109247/effectiveness-and-cost-effectiveness-of-a-guided-internet-and-mobile-based-intervention-for-the-indicated-prevention-of-major-depression-in-patients-with-chronic-back-pain-study-protocol-of-the-prod-bp-multicenter-pragmatic-rct
#19
L Sander, S Paganini, J Lin, S Schlicker, D D Ebert, C Buntrock, H Baumeister
BACKGROUND: Reducing the disease burden of major depressive disorder (MDD) is of major public health relevance. The prevention of depression is regarded as one possible approach to reach this goal. People with multiple risk factors for MDD such as chronic back pain and subthreshold depressive symptoms may benefit most from preventive measures. The Internet as intervention setting allows for scaling up preventive interventions on a public mental health level. METHODS: This study is a multicenter pragmatic randomized controlled trial (RCT) of parallel design aiming to investigate the (cost-) effectiveness of an Internet- and mobile-based intervention (IMI) for the prevention of depression in chronic back pain patients (PROD-BP) with subthreshold depressive symptoms...
January 21, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28088871/herbal-medicine-practices-of-patients-with-liver-cancer-in-peru
#20
Teresa Rojas Rojas, Geneviève Bourdy, Eloy Ruiz, Juan-Pablo Cerapio, Pascal Pineau, Jacques Gardon, Franco Doimi, Xavier Deparis, Eric Deharo, Stéphane Bertani
RATIONALE: The highest burden of liver cancer occurs in developing countries, where the use of herbal medicine (HM) is still widespread. Despite this trend, few studies have been conducted to report HM practices of patients with a hepatic tumor in the developing world. Hence, this study aimed to document the use of HM among patients with liver cancer in Peru. STUDY DESIGN AND METHODS: A comparative behavioral epidemiological survey was conducted among liver cancer patients attending the National Cancer Institute of Peru...
December 1, 2016: Integrative Cancer Therapies
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