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Integrated behavioral health primary care

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https://www.readbyqxmd.com/read/28448775/exploring-electronic-medical-record-and-self-administered-medication-risk-screening-tools-in-a-primary-care-clinic
#1
Mark J Makowsky, Ken Cor, Tat Wong
BACKGROUND: Electronic medical record (EMR) screening for indicators of medication risk could improve efficiency in identifying primary care clinic patients in need of clinical pharmacist care compared with patient self-reporting. OBJECTIVES: To (a) compare the performance of an EMR medication risk assessment questionnaire (MRAQ) with a self-administered (SA) MRAQ and (b) explore each tool's ability to predict indicators of health behavior, health status, and health care utilization...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28440861/findings-from-the-families-on-track-intervention-pilot-trial-for-children-with-fetal-alcohol-spectrum-disorders-and-their-families
#2
Christie L M Petrenko, Mary E Pandolfino, Luther K Robinson
BACKGROUND: Individuals with fetal alcohol spectrum disorders (FASD) are at high risk for costly, debilitating mental health problems and secondary conditions, such as school disruption, trouble with the law, and substance use. The study objective was to pilot a multi-component intervention designed to prevent secondary conditions in children with FASD and improve family adaptation. METHODS: Thirty children with FASD or prenatal alcohol exposure (PAE) (ages 4 to 8) and their primary caregivers were enrolled...
April 25, 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/28435321/a-behavioral-medicine-intervention-for-community-dwelling-older-adults-with-chronic-musculoskeletal-pain-protocol-for-a-randomized-controlled-trial
#3
Sara Cederbom, Eva Denison, Astrid Bergland
BACKGROUND: Chronic musculoskeletal pain is a major health problem among older adults, particularly those who live alone and/or those who are dependent on formal care. Chronic pain is associated with mobility problems, falls, fear of falling, catastrophizing thoughts, and a lower quality of life. Research shows that physical therapy interventions based on behavioral medicine approaches are beneficial for middle-aged adults with chronic pain. However, there appears to be no previous randomized controlled trials (RCTs) based on this theoretical framework that have examined the effect on older adults with chronic musculoskeletal pain who live alone at home and are dependent on formal care to manage their everyday lives...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28434457/system-changes-to-implement-the-joint-commission-tobacco-treatment-tob-performance-measures-for-improving-the-treatment-of-tobacco-use-among-hospitalized-patients
#4
Donna Shelley, Keith S Goldfeld, Hannah Park, Ana Mola, Ryan Sullivan, Jonathan Austrian
BACKGROUND: In 2012 The Joint Commission implemented new Tobacco Treatment (TOB) performance measures for hospitals. A study evaluated the impact of a hospital-based electronic health record (EHR) intervention on adherence to the revised TOB measures. METHODS: The study was conducted in two acute care hospitals in New York City. Data abstracted from the EHR were analyzed retrospectively from 4,871 smokers discharged between December 2012 and March 2015 to evaluate the impact of two interventions: an order set to prompt clinicians to prescribe pharmacotherapy and a nurse-delivered counseling module that automatically populated the nursing care plan for all smokers...
May 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28423744/design-and-validation-of-a-platform-to-evaluate-mhealth-apps
#5
Daniel Philpott, Aziz Guergachi, Karim Keshavjee
Emerging technologies show great potential in the field of patient care. One such technology is mobile heath applications (mhealth apps), which have exploded in number and variety in recent years, and offer great promise in the ability to collect and monitor patient health data. Despite their apparent success in proliferation and user adoption, these applications struggle to integrate into the primary care system and there is scant information regarding their efficacy to effect patient behavior and consequently health outcomes...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28418987/the-roles-of-behavioral-and-social-science-research-in-the-fight-against-hiv-aids-a-functional-framework
#6
Paul Gaist, Michael J Stirratt
Landmark advances have been made in HIV/AIDS prevention and treatment. These include proof-of-concept and public health implementation of pre-exposure prophylaxis (PrEP) and "treatment as prevention" (TasP) to reduce HIV transmission as well as definitive evidence of the clinical gain from early antiretroviral treatment (ART) initiation. Significant progress has been made in understanding and addressing the social contexts and behavioral factors that impact HIV prevention, care, and treatment interventions...
April 7, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28410002/comparing-behavioral-health-models-for-reducing-risky-drinking-among-older-male-veterans
#7
Nikki R Wooten, Abbas S Tavakoli, Marlene B Al-Barwani, Naomi A Thomas, Hrishikesh Chakraborty, Anna M Scheyett, Kelly M Kaminski, Alyssia C Woods, Sue E Levkoff
BACKGROUND: Screening older veterans in Veterans Affairs Medical Center (VAMC) primary care clinics for risky drinking facilitates early identification and referral to treatment. OBJECTIVE: This study compared two behavioral health models, integrated care (a standardized brief alcohol intervention co-located in primary care clinics) and enhanced referral care (referral to specialty mental health or substance abuse clinics), for reducing risky drinking among older male VAMC primary care patients...
April 14, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28408361/design-of-a-mobile-app-for-nutrition-education-trec-lifestyle-and-formative-evaluation-with-families-of-overweight-children
#8
Silvia Gabrielli, Marco Dianti, Rosa Maimone, Marta Betta, Lorena Filippi, Monica Ghezzi, Stefano Forti
BACKGROUND: Nutrition and diet apps represent today a popular area of mobile health (mHealth), offering the possibility of delivering behavior change (BC) interventions for healthy eating and weight management in a scalable and cost-effective way. However, if commercial apps for pediatric weight management fail to retain users because of a lack of theoretical background and evidence-based content, mHealth apps that are more evidence-based are found less engaging and popular among consumers...
April 13, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28394156/the-readiness-for-integrated-care-questionnaire-ricq-an-instrument-to-assess-readiness-to-integrate-behavioral-health-and-primary-care
#9
Victoria C Scott, Tara Kenworthy, Erin Godly-Reynolds, Gilberte Bastien, Jonathan Scaccia, Courtney McMickens, Sharon Rachel, Sayon Cooper, Glenda Wrenn, Abraham Wandersman
Integration of behavioral health and primary care services is a promising approach for reducing health disparities. The growing national emphasis on care coordination has mobilized efforts to integrate behavioral health and primary care services across the United States. These efforts align with broader health care system goals of improving health care quality, health equity, utilization efficiency, and patient outcomes. Drawing from our work on a multiyear integrated care initiative (Integrated Care Leadership Program; ICLP) and an implementation science heuristic for organizational readiness (Readiness = Motivation x General Capacity and Innovation-Specific Capacity; R = MC2), this article describes the development and implementation of a tool to assess organizational readiness for integrated care, referred to as the Readiness for Integrated Care Questionnaire (RICQ)...
April 10, 2017: American Journal of Orthopsychiatry
https://www.readbyqxmd.com/read/28383618/oral-health-status-and-oral-health-related-quality-of-life-in-italian-deinstitutionalized-psychiatric-patients
#10
D Corridore, F Guerra, C La Marra, D Di Thiene, L Ottolenghi
INTRODUCTION: The aim of this study is to investigate the oral health status and Oral Health-Related Quality of Life (OHRQoL, measured with OHIP- 14) in psychiatric patients assisted by the unique Italian mental health care system, in accordance to regulatory Law 180/78. MATERIALS AND METHODS: Demographic and medical variables were retrieved from institutional medical records. General health and oral health variables, oral health-related behavior and last dental contact were recorded...
March 2017: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28379819/outcomes-of-integrated-behavioral-health-with-primary-care
#11
Bijal A Balasubramanian, Deborah J Cohen, Katelyn K Jetelina, L Miriam Dickinson, Melinda Davis, Rose Gunn, Kris Gowen, Frank V deGruy, Benjamin F Miller, Larry A Green
BACKGROUND: Integrating behavioral health and primary care is beneficial to patients and health systems. However, for integration to be widely adopted, studies demonstrating its benefits in community practices are needed. The objective of this study was to evaluate effect of integrated care, adapted to local contexts, on depression severity and patients' experience of care. METHODS: This study used a convergent mixed-methods design, merging findings from a quasi-experimental study with patient interviews conducted as part of Advancing Care Together, a community demonstration project that created an innovation incubator for practices implementing evidence-based integration strategies...
March 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28379816/improving-family-medicine-with-thoughtful-research
#12
EDITORIAL
Anne Victoria Neale, Marjorie A Bowman, Dean A Seehusen
This issue is about improving primary health care outcomes, from behavioral health to opioid issues to diagnosing hypertension to providing hope for childhood obesity. It includes hints for integrating behavioral health and care managers into family medicine practices. Opiate prescribing practices vary considerably between Japan and the United States, with helpful insights for our opiate abuse epidemic. Suicidality is high among patients taking opiates. Diagnosing hypertension the recommended way is not easily accomplished...
March 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28370758/market-environment-and-medicaid-acceptance-what-influences-the-access-gap
#13
Amelia Bond, William Pajerowski, Daniel Polsky, Michael R Richards
The U.S. health care system is undergoing significant changes. Two prominent shifts include millions added to Medicaid and greater integration and consolidation among firms. We empirically assess if these two industry trends may have implications for each other. Using experimentally derived ("secret shopper") data on primary care physicians' real-world behavior, we observe their willingness to accept new privately insured and Medicaid patients across 10 states. We combine this measure of patient acceptance with detailed information on physician and commercial insurer market structure and show that insurer and provider concentration are each positively associated with relative improvements in appointment availability for Medicaid patients...
March 28, 2017: Health Economics
https://www.readbyqxmd.com/read/28369904/curriculum-influence-on-interdisciplinary-oral-health-education-and-practice
#14
Melinda Clark, Rocio Quinonez, Jonathan Bowser, Hugh Silk
OBJECTIVES: Oral diseases are very prevalent across the lifespan and impact overall health, yet are largely preventable. The Smiles for Life (SFL) curriculum was created to educate healthcare providers about oral disease and support integration of oral health and primary care. This study examines SFL's influence on clinical practice and education. METHODS: Surveys were sent to registered users of SFL. Users who self-identified as direct care providers (DCPs), or educators, were included in the analysis...
March 28, 2017: Journal of Public Health Dentistry
https://www.readbyqxmd.com/read/28369443/integrated-primary-medical-behavioral-health-care-for-adolescent-and-young-adult-depression-predictors-of-service-use-in-the-youth-partners-in-care-trial
#15
Amy M Rapp, Denise A Chavira, Catherine A Sugar, Joan R Asarnow
Depression, a chronic and disabling condition, frequently has its first onset during adolescence, underscoring the value of early effective treatment and prevention. Integrated medical-behavioral health care provides one strategy for improving treatment access for adolescents and young adults (AYA). This study examined predictors of accessing treatment in a multisite randomized controlled trial evaluating an integrated collaborative care intervention aimed at improving access to evidence-based depression treatment through primary health care, compared with usual care...
March 25, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/28356722/from-therapeutic-patient-education-principles-to-educative-attitude-the-perceptions-of-health-care-professionals-a-pragmatic-approach-for-defining-competencies-and-resources
#16
Benoit Pétré, Remi Gagnayre, Vincent De Andrade, Olivier Ziegler, Michèle Guillaume
Educative attitude is an essential, if implicit, aspect of training to acquire competency in therapeutic patient education (TPE). With multiple (or nonexistent) definitions in the literature, however, the concept needs clarification. The primary aim of this study was to analyze the representations and transformations experienced by health care professionals in the course of TPE training in order to characterize educative attitude. We conducted an exploratory qualitative study using several narrative research-based tools with participants of two TPE continuing education courses...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28337689/managing-chronic-pain-in-primary-care-it-really-does-take-a-village
#17
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
#18
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
#19
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
#20
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
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