Screening and brief intervention for unhealthy substance use in patients with chronic medical conditions: a systematic review

Timko, Christine; Kong, Calvin; Vittorio, Lisa; Cucciare, Michael A.

doi:10.1111/jocn.13244

Cited by 31 publications

(22 citation statements)

References 42 publications

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“…Furthermore, patients and families need to learn approaches to reduce the risk of transmission and how to change behaviours that can accelerate disease such alcohol use. Brief alcohol interventions can be effectively administered by nurses (Timko, Kong, Vittorio, & Cucciare, ). In the USA, the healthcare system is uniquely challenging for low‐income, minority residents because of access, continuity and coverage issues that must be overcome to achieve a cure for this chronic infection.…”

Section: Resultsmentioning

confidence: 99%

Improving support and education of low‐income baby boomers diagnosed with chronic hepatitis C virus infection through universal screening

Turner

Craig

Makanji

et al. 2017

Journal of Clinical Nursing

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Aims and objectives The objective of this study was to identify support needs of low income baby boomers recently diagnosed with chronic hepatitis C virus infection. Background The United States Preventive Services Task Force has endorsed one-time screening of all baby boomers (born 1945 to 1965) for hepatitis C because 75% of the estimated 2 to 3 million persons with chronic infection are in this age range. We hypothesized that persons diagnosed by routine screening would have significant psycho-emotional, cognitive, and health care challenges that need to be met by collaborative care and services from nurses and other health care personnel. Design Qualitative descriptive study of data from three focus groups with predominantly minority participants (N=16). Data were analyzed using qualitative content analysis, transcribed data were categorized by 3 domains in a previously developed model and a new domain identified in this study. Frequencies of unique participants’ comments about each theme were calculated. Results Elucidated domains were: 1) psycho-emotional effects due to social stigma, shame, fear, dealing with risky behaviors; 2) social effects due to concerns about infecting others; and 3) cognitive deficits because of poor understanding about HCV infection and its care. A new domain related to health care emerged reflecting the following themes: poor access to care, barriers to costly treatment, and navigating complex care for comorbidities. Despite these challenges, participants strongly endorsed universal baby boomer hepatitis C virus screening. Conclusion This study describes psycho-emotional and social challenges of people dealing with a hepatitis C diagnosis that are compounded by poor knowledge and barriers to supportive care. Relevance to clinical practice Nursing and other allied health personnel require structured support programs to assist older persons diagnosed with hepatitis C with addressing these common challenges with the ultimate goal of achieving a cure.

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Section: Resultsmentioning

confidence: 99%

Improving support and education of low‐income baby boomers diagnosed with chronic hepatitis C virus infection through universal screening

Turner

Craig

Makanji

et al. 2017

Journal of Clinical Nursing

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“…La literatura científica nacional e internacional seña-la que la consejería breve, es decir una sola sesión de 30 minutos, puede motivar el cambio en etapas iniciales del consumo (Martínez et al, 2010;Tavera & Martínez, 2008;Timko, Kong, Vittorio, & Cucciare, 2016;Winters, Fahnhorst, Botzet, Lee, & Lalone, 2012). Sin embargo, valdría la pena profundizar en esta hipótesis y determinar qué tanto una sola sesión bien estructurada puede lograr una transformación en los jóvenes que se inician en el uso de sustancias.…”

Section: Conclusionesunclassified

Intervención breve para adolescentes que inician el consumo abusivo de alcohol y otras drogas: su eficacia en un escenario clínico

Durán¹,

Echeverría²,

Martínez³

et al. 2017

RIIAD

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RESUMENIntroducción: en las últimas décadas, se ha observado en los adolescentes mexicanos un incremento en la cantidad y frecuencia del consumo de alcohol y drogas ilícitas; los programas de intervención breve han demostrado ser eficaces para reducir el consumo y abuso de sustancias en diversas poblaciones. Objetivo: determinar la eficacia del Programa de Intervención Breve para Adolescentes que Inician el Consumo Abusivo de Alcohol y otras Drogas (PIBA), así como el mantenimiento del cambio en los jóvenes que asistieron. Método: se utilizó un diseño de medidas repetidas, no probabilístico y sin grupo control. En el seguimiento participaron 60 usuarios consumidores de sustancias de entre 16 y 20 años de edad, de ambos sexos, habitantes de la Ciudad de México. Resultados: al comparar la preintervención vs. el seguimiento, se encontró que los adolescentes que participaron en el PIBA mantuvieron una reducción en su patrón de consumo (cantidad, frecuencia y tiempo de abstinencia) de alcohol, mariguana e inhalables; disminuyeron los problemas asociados con el consumo; e incrementaron su nivel de autoeficacia percibida. La mejoría fue mayor en quienes concluyeron la intervención breve que en quienes no terminaron todas las sesiones. Conclusiones: el PIBA fue coadyuvante en la consecución de las metas propuestas por la mayoría de los adolescentes que asistieron a este tratamiento psicológico.Palabras clave: adolescentes, consumo de sustancias, intervenciones breves. SUMMARYIntroduction: in recent decades, it has been observed an increase in the amount and frequency of alcohol intake and consume of illicit drugs in Mexican adolescents. Brief intervention programs have been effective reducing consumption and substance abuse, in diverse teens populations. Objective: to determine the effectiveness of the Brief Intervention Program for Adolescents Initiating Abusive Consumption of Alcohol and Other Drugs (PIBA), as well as, the maintenance of the change in the youngsters who were attended. Method: a repeated measures design, pre and post test, no probabilistic and without control group, was used. In the follow-up, 60 substance users participated, between 16 and 20 years of age, of both sexes, inhabitants of the Mexico City. Results: by comparing the pre-intervention versus follow-up, teens who participated in the PIBA maintained a reduction in their consumption pattern (amount, frequency and time of abstinence substances alcohol, marijuana and inhalants), decreased the problems associated with consumption, and they increased their level of perceived self-efficacy. The improvement was greater in the group that concluded the brief intervention than in the group that left it unfinished.

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“…However, studies have shown that management of hypertension, cardiovascular disease, and diabetes at primary care level is suboptimal [4–7], and only half of the patients achieve their target blood pressure and blood sugar level, which increases their risk for CVD events [4,5]. Some of the challenges in treating and managing chronic conditions are suboptimal adherence to management guidelines by the physicians [5,8], lack of regular patient monitoring and undiagnosed comorbidities such as anxiety, depression, and alcohol use disorders which can contribute to failure to follow treatment plans [9–11]. Mobile health (mHealth) technologies are being advocated to strengthen the health system, and systematic reviews have shown that an mHealth-based Clinical Decision Support System (CDSS) improves preventive care and the physician’s clinical decision quality in hypertension and diabetes management [8] although the evidence on their effects on cardiovascular outcomes is limited [12].…”

Section: Introductionmentioning

confidence: 99%

Development of mWellcare: an mHealth intervention for integrated management of hypertension and diabetes in low-resource settings

Jindal

Gupta

Jha

et al. 2018

Global Health Action

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Background: Cardiovascular diseases and diabetes are among the leading causes of premature adult deaths in India. Innovative approaches such as clinical decision support (CDS) software could play a major role in improving the quality of hypertension/diabetes care in primary care settings. Objective: To describe the steps and processes in the development of mWellcare, a complex intervention based on mobile health (mHealth) technology. Methods: The Medical Research Council framework was used to develop mWellcare in four steps: (1) identify gaps in usual care through literature review and health facility assessments; (2) identify the components of the intervention through discussions and consultations with experts; (3) develop intervention (clinical algorithms and mHealth system); and (4) evaluate acceptability and feasibility through pilot testing in five community health centers. Results: Lack of evidence-based, integrated, and systematic management of chronic conditions were major gaps identified. Experts in information technology, clinical fields, and public health professionals identified intervention components to address these gaps. Thereafter, clinical algorithm contextualized to primary care settings were prepared and the mWellcare intervention was developed. During the 2-month pilot, 631 patients diagnosed with hypertension and/or diabetes were registered, with a follow-up rate of 36.2%. The major barrier was resistance to follow mWellcare recommended patient workflow, and to overcome it, we emphasized onsite training and orientation program to cover all health care team member in each CHC. Conclusion: A pilot-tested mWellcare intervention is an mHealth system with important components, i.e. integrated management of chronic conditions, evidence-based CDS, longitudinal health data and automated short-messaging service to reinforce compliance to drug intake and follow-up visit, which will be used by nurses at primary health care settings in India. The effectiveness and cost-effectiveness of the intervention will be tested through a cluster randomized trial (trial registration number NCT02480062).

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Screening and brief intervention for unhealthy substance use in patients with chronic medical conditions: a systematic review

Cited by 31 publications

References 42 publications

Improving support and education of low‐income baby boomers diagnosed with chronic hepatitis C virus infection through universal screening

Improving support and education of low‐income baby boomers diagnosed with chronic hepatitis C virus infection through universal screening

Intervención breve para adolescentes que inician el consumo abusivo de alcohol y otras drogas: su eficacia en un escenario clínico

Development of mWellcare: an mHealth intervention for integrated management of hypertension and diabetes in low-resource settings

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