Screening for opioid use disorder and co-occurring depression and post-traumatic stress disorder in primary care in New Mexico.
Screening for opioid use disorder and co-occurring depression and post-traumatic stress disorder in primary care in New Mexico.
复制标题
在新墨西哥州的初级保健中筛查阿片类药物使用障碍和同时发生的抑郁症和创伤后应激障碍。
DOI：
10.1186/s13722-023-00362-5
复制
发表时间：
2023-01-27
影响因子：
3.7
通讯作者：
Page, Kimberly
中科院分区：
文献类型：
--
作者：
Murray-Krezan, Cristina;Dopp, Alex;Tarhuni, Lina;Carmody, Mary D. D.;Becker, Kirsten;Anderson, Jessica;Komaromy, Miriam;Meredith, Lisa S. S.;Watkins, Katherine E. E.;Wagner, Katherine;Page, Kimberly
确定初级保健服务中有阿片类药物使用障碍和共生精神健康障碍的患者对于提供治疗至关重要。本研究的目的是(1)评估招募人员在初级保健诊所候诊室亲自筛查阿片类药物使用障碍和共生精神健康障碍(抑郁症和/或创伤后应激障碍)的可行性，为随机对照试验做准备，以及(2)比较通过普遍的面对面筛查与电子健康记录(EHR)诊断检测这些障碍的结果。这项横断面可行性和试点研究招募了来自新墨西哥州三个卫生保健组织的四个初级保健诊所的参与者，其中两个是农村的，两个是城市的。纳入标准为成年人(≥ 18岁)，以患者身份到四家诊所之一就诊，会说英语或西班牙语。排除标准是因非初级保健就诊而到诊所就诊的人(例如，牙科、取药、社会支持)。主要结果和衡量标准是：(1)招募可行性，这是通过接近和同意亲自筛查的人的频率和比例来评估的；(2)根据患病率和患病率衡量，等候室检测到的阿片类药物使用障碍和共生精神健康障碍相对于每个诊所的总体EHR数据的相对差异。在两周的时间里，1478名潜在参与者接受了接触，1145名患者同意并进行了筛查(77.5%的患者接受了接触)。在筛查的人中，2.4%的人确定了可能的阿片类药物使用障碍和共同发生的精神健康障碍，而在EHR中，这一比例为0.8%。同样，与EHR相关的普遍筛查发现，可能存在阿片类药物使用障碍(4.5%比3.4%)、抑郁症(17.5%比12.7%)和创伤后应激障碍(19.0%比3.6%)的比例更高。对阿片类药物使用障碍、抑郁和创伤后应激障碍进行普遍筛查是可行的，并发现患有这些共生障碍的患者是EHR的三倍。每种情况的比例也更高，特别是创伤后应激障碍。结果表明，在初级保健服务中对这些疾病的识别可能存在差距，并表明需要更好地解决这些共生疾病持续存在的公共卫生问题。网上版载有补充材料，可在10.1186/s13722-023-00362-5查阅。
Identifying patients in primary care services with opioid use disorder and co-occurring mental health disorders is critical to providing treatment. Objectives of this study were to (1) assess the feasibility of recruiting people to screen in-person for opioid use disorder and co-occurring mental health disorders (depression and/or post-traumatic stress disorder) in primary care clinic waiting rooms in preparation for a randomized controlled trial, and (2) compare results of detecting these disorders by universal in-person screening compared to electronic health record (EHR) diagnoses. This cross-sectional feasibility and pilot study recruited participants from four primary care clinics, two rural and two urban, from three health care organizations in New Mexico. Inclusion criteria were adults (≥ 18 years), attending one of the four clinics as a patient, and who spoke English or Spanish. Exclusion criteria were people attending the clinic for a non-primary care visit (e.g., dental, prescription pick up, social support). The main outcomes and measures were (1) recruitment feasibility which was assessed by frequencies and proportions of people approached and consented for in-person screening, and (2) relative differences of detecting opioid use disorder and co-occurring mental health disorders in waiting rooms relative to aggregate EHR data from each clinic, measured by prevalence and prevalence ratios. Over two-weeks, 1478 potential participants were approached and 1145 were consented and screened (77.5% of patients approached). Probable opioid use disorder and co-occurring mental health disorders were identified in 2.4% of those screened compared to 0.8% in EHR. Similarly, universal screening relative to EHR identified higher proportions of probable opioid use disorder (4.5% vs. 3.4%), depression (17.5% vs. 12.7%) and post-traumatic stress disorder (19.0% vs. 3.6%). Universal screening for opioid use disorder, depression, and post-traumatic stress disorder was feasible, and identified three times as many patients with these co-occurring disorders compared to EHR. Higher proportions of each condition were also identified, especially post-traumatic stress disorder. Results support that there are likely gaps in identification of these disorders in primary care services and demonstrate the need to better address the persistent public health problem of these co-occurring disorders. The online version contains supplementary material available at 10.1186/s13722-023-00362-5.
登录
查看更多内容
影响因子：
3.7
作者：
Adam, Angeline;Schwartz, Robert P.;McNeely, Jennifer
通讯作者：
McNeely, Jennifer
影响因子：
2.3
作者：
Fareed, Ayman;Eilender, Pamela;Drexler, Karen
通讯作者：
Drexler, Karen
影响因子：
3.9
作者：
Hallgren, Kevin A.;Witwer, Elizabeth;Stephens, Kari A.
通讯作者：
Stephens, Kari A.
影响因子：
4.2
作者：
Jones, Christopher M.
通讯作者：
Jones, Christopher M.
DOI：
10.1136/ebmed-2016-110522
发表时间：
2016-12-01
期刊：
Evidence-based medicine
影响因子：
--
作者：
Farah, Wigdan H;Alsawas, Mouaz;LeBlanc, Annie
通讯作者：
LeBlanc, Annie