Book file PDF easily for everyone and every device.
You can download and read online Addressing Unhealthy Alcohol Use in Primary Care file PDF Book only if you are registered here.
And also you can download or read online all Book PDF file that related with Addressing Unhealthy Alcohol Use in Primary Care book.
Happy reading Addressing Unhealthy Alcohol Use in Primary Care Bookeveryone.
Download file Free Book PDF Addressing Unhealthy Alcohol Use in Primary Care at Complete PDF Library.
This Book have some digital formats such us :paperbook, ebook, kindle, epub, fb2 and another formats.
Here is The CompletePDF Book Library.
It's free to register here to get Book file PDF Addressing Unhealthy Alcohol Use in Primary Care Pocket Guide.
Addressing Unhealthy Substance Use in Primary Care. Primary care-based treatment of opioid and alcohol use disorders can be effective; more data are.
Table of contents
- About This Item
- One question may gauge the severity of unhealthy drug and alcohol use
- Addressing Unhealthy Alcohol Use in Older Populations in Primary Care
- Publisher Description
St-Georges de Beauce. Centre Rockland.
Carrefour l'Estrie. Les Galeries de Terrebonne. Galeries d Anjou. Prix :. Auteur :. Titre :. Date de parution :. Collection :. Sujet :. ISBN :. No de produit :. Suivi de commande. The design of the integrated stepped care model i. Social Worker and Psychologist-delivered manualized counseling focused on enhancing patient motivation to change their alcohol consumption and structured, personalized feedback for patients facilitated its implementation. While the providers found these techniques to be familiar, they found that the integrated stepped care model provided them with new techniques and materials for enhancing patient motivation, which they perceived to be a barrier to promoting treatment.
Indeed, these tools may serve to reinforce motivations to decrease alcohol consumption that have been previously identified as reasons that HIV-infected patients limit their drinking i. Importantly, treating unhealthy alcohol use through clinic-based settings was perceived by providers to be consistent with VA priorities.
About This Item
Specifically, there have been extensive efforts to promote evidence-based AUDIT-C screening followed by appropriate intervention i. In contrast, uptake of evidence-based pharmacotherapy for alcohol use disorders has been slow  despite VA guidelines supporting the use of pharmacotherapy . Addiction Psychiatrists generally recognized accessible pharma-cotherapy as an important treatment option for alcohol use disorders, yet reported variable success in initiating treatment.
This suggests that patient and HIV provider-targeted education and marketing may be important for improving uptake among non-treatment seeking individuals in the setting of shared-decision making after consideration of all available treatment options . Furthermore, providers found that the integrated stepped care model was consistent with VA priorities given recent initiatives to develop and evaluate new models for delivering screening and treatment for unhealthy alcohol use.
Such models. While providers were consistent in their reported beliefs that the integrated stepped care model offered a high quality intervention, there were differences based on provider experience and type regarding the ideal way in which to integrate treatment of unhealthy alcohol use into HIV clinics. For example, while some Social Workers believed it was ideal for social workers to deliver the BNI, other suggested that either Infectious Disease Physicians or nurses might provide these services.
Additionally, they felt they had the requisite skills and experience to provide the MET intervention. Similarly, it was suggested by Addiction Psychiatrists that Infectious Disease Physicians might be best positioned to engage patients in treatment for unhealthy alcohol use.
That a tension exists regarding how to best integrate services is not surprising. On one hand, Infectious Disease and HIV-specialty trained physicians, who increasingly serve as the primary care physician for HIV-infected patients, have an existing relationship with the patient and are managing other treatments. However, prior multi-site studies indicate that HIV providers are often unaware of their patient's alcohol use and often do not discuss it, even with patients with higher levels of drinking [29, 30, 78].
Thus, it is likely that team-based approaches as structured in the integrated stepped care model, which do not rely on HIV providers to deliver treatment for unhealthy alcohol use, are likely to be an important strategy for effectively addressing unhealthy alcohol use. This model is consistent with others developed to treat other substance use disorders i. If effectiveness of integrated stepped care for unhealthy alcohol use in HIV clinics is demonstrated, future studies should focus on determining the optimal role of HIV providers, based on their knowledge and self-efficacy, for delivering such treatments.
In addition, the extent to which such an intervention should target other health behaviors, such as drug use or sexual risk behaviors, warrants investigation. The results of this study should be interpreted in the context of its limitations. First, the providers represented a convenience sample of individuals involved with an ongoing randomized controlled trial. Our results may not reflect the opinions of other providers involved with the randomized controlled trial or apply to other VA-based providers more generally. Second, our interview guides were not piloted in advance of our study.
In retrospect,. Third, these findings may not transfer universally to other HIV clinical settings, particularly settings where Psychologists and Addiction Psychiatrists are less available. If effectiveness is demonstrated, issues of generalizability of this and the main study's findings to other HIV clinical settings will be carefully considered.
Fourth, this qualitative study was conducted during the 1st year of implementation of integrated stepped care in the context of a randomized controlled trial. Whether these findings will apply at later stages is unclear; though this study does provide important insights to inform planning phases and initial implementation of integrated stepped care models.
Fifth, given our small sample size, we are unable to determine whether we had reached thematic saturation. Regardless, this study provides meaningful data given its focus on implementation of a novel model of care for unhealthy alcohol use in HIV clinics based on a robust deductive approach to data analysis, which revealed consistency in findings within and across different groups of providers. Sixth, our study may have been subject to social desirability bias given the proportion of interviewers relative to interventionists; however, we felt that the diverse perspectives of the interviewers served to enhance the richness of the conversation and data collection.
In conclusion, our study represents an important step in identifying key considerations based upon the CFIR constructs when implementing an integrated stepped care model for unhealthy alcohol use in HIV clinics. We found that implementation of this model may be facilitated by tools to help providers enhance patient motivation, close alignment with organizational values and existing models of care, and optimization of provider self-efficacy and roles. Future efforts aimed at obtaining the perspectives of additional providers, as well as patients and HIV providers will be important for developing a comprehensive understanding of factors impacting implementation of integrated stepped care for unhealthy alcohol use in HIV clinics.
In addition, consideration of alternative models involving various providers completing the primary components of the intervention, will be important for informing the development of successful interventions. EJE participated in all aspects of this study, including writing the HIC protocol, leading the data analysis and writing the first draft of the manuscript. CD contributed to the design of the data collection tools and data analysis.
LEF participated in data collection. DAF participated in all aspects of this study, 7. All authors made substantial contributions to the revising of the manuscript. All authors read and approved the final manuscript. Neither NIH nor the VA had a role in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.
Kendall Bryant, a NIAAA employee and scientific collaborator on the project, participated in the analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. Saitz R. Clinical practice. Unhealthy alcohol use. N Engl J Med. J Acquir Immune Defic Syndr. Problem drinking and medication adherence among persons with HIV infection. J Gen Intern Med.
Longitudinal assessment of the effects of drug and alcohol abuse on HIV-1 treatment outcomes in an urban clinic. Alcohol consumption and HIV disease progression: are they related? Alcohol Clin Exp Res. Impact of active drug use on antiretroviral therapy adherence and viral suppression in HIV-infected drug users.
J Gen Int Med. Alcohol and associated characteristics among older persons living with human immunodeficiency virus on antiretroviral therapy. Subst Abus. Health-related quality of life in HIV-infected patients: the role of substance use. Unhealthy alcohol and illicit drug use are associated with decreased quality of HIV care. The association between alcohol consumption and prevalent cardiovascular diseases among HIV-infected and HIV-uninfected men.
Relationship between alcohol use categories and noninvasive markers of advanced hepatic fibrosis in HIV-infected, chronic hepatitis C virus-infected, and uninfected patients. Clin Infect Dis. Hepatocellular carcinoma and non-Hodgkin's lymphoma: the roles of HIV, hepatitis C infection, and alcohol abuse. J Clin Oncol. Factors associated with amplified hiv transmission behavior among american men who have sex with men engaged in care: implications for clinical providers. Ann Behav Med.
Intoxication before intercourse and risky sexual behavior in male veterans with and without human immunodeficiency virus infection. Med Care. Alcohol consumption among HIV-infected patients. Petry NM. Alcohol use in HIV patients: what we don't know may hurt us. Alcohol consumption and HIV disease progression. Behavioral counseling after screening for alcohol misuse in primary care: a systematic review and meta-analysis for the US preventive services task force. Ann Intern Med. Pharmacotherapy for adults with alcohol use disorders in outpatient settings: a systematic review and meta-analysis.
Interventions to reduce alcohol use among HIV-infected individuals: a review and critique of the literature. Reducing heavy drinking in HIV primary care: a randomized trial of brief intervention, with and without technological enhancement. Drinking motives as prospective predictors of outcome in an intervention trial with heavily drinking HIV patients. Drug Alcohol Depend. Drinking motives among HIV primary care patients. AIDS Behav. How harmful is hazardous alcohol use and abuse in HIV infection: do health care providers know who is at risk? Role of alcohol in determining human immunodeficiency virus HIV -relevant outcomes: a conceptual model to guide the implementation of evidence-based interventions into practice.
Substance use and the quality of patient-provider communication in HIV clinics. Attitudes and training needs of new england hiv care and addiction treatment providers: opportunities for better integration of hiv and alcohol treatment services. Addict Disord Their Treat.
Stepped care treatment delivery for depression: a systematic review and meta-analysis. Psychol Med. National Institute on Alcohol Abuse and Alcoholism. What's "at-risk" or "heavy" drinking? Accessed 18 July American Psychiatric Association. Washington: American Psychiatric Press; Development and implementation of an emergency practitioner-performed brief intervention for hazardous and harmful drinkers in the emergency department. Acad Emerg Med. Development of a scale to measure practitioner adherence to a brief. J Subst Abuse Treat. A brief intervention reduces hazardous and harmful drinking in emergency department patients.
Ann Emerg Med. Accessed 1 Jan HIV Med. Predictive accuracy of the veterans aging cohort study index for mortality with HIV infection: a North American cross cohort analysis.
One question may gauge the severity of unhealthy drug and alcohol use
An internationally generalizable risk index for mortality after 1 year of antiretroviral therapy. The patient-centered medical home in the Veterans Health Administration. Am J Manag Care. The role of mental and behavioral health in the application of the patient-centered medical home in the department of veterans affairs.
Transl Behav Med. Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact. Substance abuse treatment implementation research.
- How To Play Tennis: Learn The Tennis Rules. Tennis For Beginners - Discover The Rules Of Tennis In This Great Short Tennis Guide.?
- Dont Fix Me; Im Not Broken: Changing Our Minds About Ourselves and Our Children?
- One question may gauge severity of unhealthy drug, alcohol use -- ScienceDaily!
- Globalization, Meaning and Scope: A collection of essays on Globalization and its Impact.
- Video examples:.
- Kei(th) and the Genic Seed.
- Addressing Unhealthy Substance Use in Primary Care. - Abstract - Europe PMC?
A qualitative study of the adoption of buprenorphine for opioid addiction treatment. Contingency management in substance abuse treatment: a structured review of the evidence for its transportability. A guiding framework and approach for implementation research in substance use disorders treatment. Psychol Addict Behav. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science.
Implement Sci. Qualitative and mixed methods provide unique contributions to outcomes research. Three approaches to qualitative content analysis.
Addressing Unhealthy Alcohol Use in Older Populations in Primary Care
Qual Health Res. Elo S, Kyngas H. The qualitative content analysis process. J Adv Nurs. Local politico-administrative perspectives on quality improvement based on national registry data in Sweden: a qualitative study using the consolidated framework for implementation research. Evaluation of a large-scale weight management program using the consolidated framework for implementation research CFIR.
Understanding diagnosis and management of dementia and guideline implementation in general practice: a qualitative study. Knowledge translation in Uganda: a qualitative study of Ugandan midwives' and managers' perceived relevance of the sub-elements of the context cornerstone in the PARIHS framework. Opioids, chronic pain, and addiction in primary care. J Pain. Integrating buprenorphine treatment into office-based practice: a qualitative study. A qualitative study to inform the development of a video game for adolescent HIV prevention.
Games Health J. Opportunities for improving partner notification for HIV: results from a community-based participatory research study. Methods of changing patterns of substance use among individuals with co-occurring schizophrenia and substance use disorder. What Do Women Want? A qualitative study of dating. Violence Against Women. In their own voices: a qualitative study of women's risk for intimate partner violence and HIV in South Africa. Doing Qualitative Research.
Thousand Oaks: Sage Publications; Reasons for limiting drinking in an HIV primary care sample. Implementation of evidence-based alcohol screening in the Veterans Health Administration. An early evaluation of implementation of brief intervention for unhealthy alcohol use in the US veterans health administration. Use of naltrexone for alcohol use disorders in the Veterans' Health Administration: a national study.
Long-acting injectable depot naltrexone use in the Veterans' Health Administration: a national study.
Addict Behav. Prescription of topiramate to treat alcohol use disorders in the veterans health administration. Addict Sci Clin Pract. In: Department of veterans affairs DoD. Bringing patient-centered care to patients with alcohol use disorders. Substance abuse treatment in human immunodeficiency virus: the role of patient-provider discussions. Improving adherence to HIV quality of care indicators in persons with opioid dependence: the role of buprenorphine. Patient perspectives of an integrated program of medical care and substance use treatment.
Implementation of integrated stepped care for unhealthy alcohol use in HIV clinics Academic research paper on " Clinical medicine ". Similar topics of scientific paper in Clinical medicine , author of scholarly article — E. Jennifer Edelman, Nathan B. Hansen, Christopher J.
Cutter, Cheryl Danton, Lynn E. Fiellin, et al. Physician versus non-physician delivery of alcohol screening, brief intervention and referral to treatment in adult primary care: the ADVISe cluster randomized controlled implementation trial. Closing the treatment gap for mental, neurological and substance use disorders by strengthening existing health care platforms: strategies for delivery and integration of evidence-based interventions. Contributor s : Saitz, Richard [editor. Tags from this library: No tags from this library for this title.
Total holds: 0. Log in to your account to post a comment. Export Cancel. Share Facebook.