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Screening for opioid use disorder and co-occurring depression and post-traumatic stress disorder in primary care in New Mexico

BACKGROUND: 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-occurrin...

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Autores principales: Murray-Krezan, Cristina, Dopp, Alex, Tarhuni, Lina, Carmody, Mary D., Becker, Kirsten, Anderson, Jessica, Komaromy, Miriam, Meredith, Lisa S., Watkins, Katherine E., Wagner, Katherine, Page, Kimberly
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9881516/
https://www.ncbi.nlm.nih.gov/pubmed/36707910
http://dx.doi.org/10.1186/s13722-023-00362-5
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author Murray-Krezan, Cristina
Dopp, Alex
Tarhuni, Lina
Carmody, Mary D.
Becker, Kirsten
Anderson, Jessica
Komaromy, Miriam
Meredith, Lisa S.
Watkins, Katherine E.
Wagner, Katherine
Page, Kimberly
author_facet Murray-Krezan, Cristina
Dopp, Alex
Tarhuni, Lina
Carmody, Mary D.
Becker, Kirsten
Anderson, Jessica
Komaromy, Miriam
Meredith, Lisa S.
Watkins, Katherine E.
Wagner, Katherine
Page, Kimberly
author_sort Murray-Krezan, Cristina
collection PubMed
description BACKGROUND: 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. METHODS: 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. RESULTS: 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%). CONCLUSIONS: 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13722-023-00362-5.
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spelling pubmed-98815162023-01-27 Screening for opioid use disorder and co-occurring depression and post-traumatic stress disorder in primary care in New Mexico Murray-Krezan, Cristina Dopp, Alex Tarhuni, Lina Carmody, Mary D. Becker, Kirsten Anderson, Jessica Komaromy, Miriam Meredith, Lisa S. Watkins, Katherine E. Wagner, Katherine Page, Kimberly Addict Sci Clin Pract Research BACKGROUND: 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. METHODS: 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. RESULTS: 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%). CONCLUSIONS: 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13722-023-00362-5. BioMed Central 2023-01-27 2023 /pmc/articles/PMC9881516/ /pubmed/36707910 http://dx.doi.org/10.1186/s13722-023-00362-5 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Murray-Krezan, Cristina
Dopp, Alex
Tarhuni, Lina
Carmody, Mary D.
Becker, Kirsten
Anderson, Jessica
Komaromy, Miriam
Meredith, Lisa S.
Watkins, Katherine E.
Wagner, Katherine
Page, Kimberly
Screening for opioid use disorder and co-occurring depression and post-traumatic stress disorder in primary care in New Mexico
title Screening for opioid use disorder and co-occurring depression and post-traumatic stress disorder in primary care in New Mexico
title_full Screening for opioid use disorder and co-occurring depression and post-traumatic stress disorder in primary care in New Mexico
title_fullStr Screening for opioid use disorder and co-occurring depression and post-traumatic stress disorder in primary care in New Mexico
title_full_unstemmed Screening for opioid use disorder and co-occurring depression and post-traumatic stress disorder in primary care in New Mexico
title_short Screening for opioid use disorder and co-occurring depression and post-traumatic stress disorder in primary care in New Mexico
title_sort screening for opioid use disorder and co-occurring depression and post-traumatic stress disorder in primary care in new mexico
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9881516/
https://www.ncbi.nlm.nih.gov/pubmed/36707910
http://dx.doi.org/10.1186/s13722-023-00362-5
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