Screening for opioid use disorder and co-occurring depression and post-traumatic stress disorder in primary care in New Mexico
Abstract 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-...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-01-01
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| Series: | Addiction Science & Clinical Practice |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13722-023-00362-5 |
| _version_ | 1811175734768566272 |
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| author | Cristina Murray-Krezan Alex Dopp Lina Tarhuni Mary D. Carmody Kirsten Becker Jessica Anderson Miriam Komaromy Lisa S. Meredith Katherine E. Watkins Katherine Wagner Kimberly Page the CLARO Study Group |
| author_facet | Cristina Murray-Krezan Alex Dopp Lina Tarhuni Mary D. Carmody Kirsten Becker Jessica Anderson Miriam Komaromy Lisa S. Meredith Katherine E. Watkins Katherine Wagner Kimberly Page the CLARO Study Group |
| author_sort | Cristina Murray-Krezan |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-10T19:40:39Z |
| format | Article |
| id | doaj.art-2e63394294b548b5b224a550ee7be160 |
| institution | Directory Open Access Journal |
| issn | 1940-0640 |
| language | English |
| last_indexed | 2024-04-10T19:40:39Z |
| publishDate | 2023-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Addiction Science & Clinical Practice |
| spelling | doaj.art-2e63394294b548b5b224a550ee7be1602023-01-29T12:18:34ZengBMCAddiction Science & Clinical Practice1940-06402023-01-011811910.1186/s13722-023-00362-5Screening for opioid use disorder and co-occurring depression and post-traumatic stress disorder in primary care in New MexicoCristina Murray-Krezan0Alex Dopp1Lina Tarhuni2Mary D. Carmody3Kirsten Becker4Jessica Anderson5Miriam Komaromy6Lisa S. Meredith7Katherine E. Watkins8Katherine Wagner9Kimberly Page10the CLARO Study GroupDepartment of Internal Medicine, Division of Epidemiology, Biostatistics and Preventive Medicine, University of New Mexico Health Sciences CenterHealth Care Division, RAND CorporationDepartment of Internal Medicine, Division of Epidemiology, Biostatistics and Preventive Medicine, University of New Mexico Health Sciences CenterDepartment of Internal Medicine, Division of Epidemiology, Biostatistics and Preventive Medicine, University of New Mexico Health Sciences CenterHealth Care Division, RAND CorporationDepartment of Internal Medicine, Division of Epidemiology, Biostatistics and Preventive Medicine, University of New Mexico Health Sciences CenterGrayken Center for Addiction, Boston Medical Center, Boston UniversityHealth Care Division, RAND CorporationHealth Care Division, RAND CorporationDepartment of Internal Medicine, Division of Epidemiology, Biostatistics and Preventive Medicine, University of New Mexico Health Sciences CenterDepartment of Internal Medicine, Division of Epidemiology, Biostatistics and Preventive Medicine, University of New Mexico Health Sciences CenterAbstract 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.https://doi.org/10.1186/s13722-023-00362-5Primary careOpioid use disorderMental healthDepressionPost-traumatic stress disorder |
| spellingShingle | Cristina Murray-Krezan Alex Dopp Lina Tarhuni Mary D. Carmody Kirsten Becker Jessica Anderson Miriam Komaromy Lisa S. Meredith Katherine E. Watkins Katherine Wagner Kimberly Page the CLARO Study Group Screening for opioid use disorder and co-occurring depression and post-traumatic stress disorder in primary care in New Mexico Addiction Science & Clinical Practice Primary care Opioid use disorder Mental health Depression Post-traumatic stress disorder |
| 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 | Primary care Opioid use disorder Mental health Depression Post-traumatic stress disorder |
| url | https://doi.org/10.1186/s13722-023-00362-5 |
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