Substance Use Disorder-Related Disparities in Patient Experiences of Primary Care

Hoggatt, Katherine J.; Frayne, Susan M.; Saechao, Fay; Yano, Elizabeth M.; Washington, Donna L.

doi:10.1089/heq.2018.0069

Cited by 18 publications

(7 citation statements)

References 17 publications

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“…The criminalization of drug use has serious public health consequences that adversely impact on the global community [3][4][5]. Previous studies have highlighted the negative health consequences of some drugs for people who use them [6][7][8]. In relation to oral health specifically, there is evidence that people who use drugs (PWUD) have a high sugar intake [9,10].…”

Section: Introductionmentioning

confidence: 99%

Dental caries and periodontal disease among people who use drugs: a systematic review and meta-analysis

et al. 2020

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Background: The aim of our study was to perform a systematic review of the literature and meta-analysis in order to investigate relationship between drug use and oral health. Methods: We searched for studies in English published before July 1, 2019 on PsycINFO, PubMed, SciELO, Scopus, and Web of Science. We assessed the relationship between drug use (methamphetamines, heroin; opiates; crack, cocaine and cannabis as dependent variables) and reported tooth loss, periodontal disease, or decayed, missing, and filled teeth index as an independent variable. The data were analyzed using Stata 12.0 software. Results:We initially identified 1836 potential articles (with 1100 duplicates) and screened the remaining 736 titles and abstracts, comprising 54 studies. In the next step, we evaluated the full-texts; 44 studies were excluded, accordingly. In total, we included 10 publications in the meta-analysis. Drug type was associated with periodontal disease (OR 1.44; 95% CI 0.8-2.6) and pooled estimates showed that type of drug used increased the odds of the number of decayed, missed and filled teeth (DMFT) (OR 4.11; 95% CI 2.07-8.15) respectively. Conclusions: The analytical challenges of segregating the impact of individual drug types on oral health diseases mean that investigations on the direct relationship between oral health status and drug use are limited. Developing programs to improve potential confounding with various substances and addressing the dental health needs of people who use drugs is vital if we are to improve their overall quality of life.

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Section: Introductionmentioning

confidence: 99%

Dental caries and periodontal disease among people who use drugs: a systematic review and meta-analysis

et al. 2020

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“…38,39 DAA treatment among patients with HCV who have psychiatric disorders has also been shown to significantly reduce the frequency of both of nonpsychiatric and psychiatric hospitalisations in the year after initiation. 42 Given that patients with psychiatric or substance use disorders in particular are known to experience substantial health disparities in the United States, [43][44][45] the presence of barriers to HCV treatment may exacerbate existing health inequities for these vulnerable populations. 32 Interventions designed to increase HCV treatment uptake are therefore a critical element of the global effort to eliminate HCV as a public health threat.…”

Section: Discussionmentioning

confidence: 99%

Characteristics associated with receipt of treatment among patients diagnosed with chronic hepatitis C virus

Gordon

Kaushik

Chastek

et al. 2023

Journal of Viral Hepatitis

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Although current guidelines recommend that nearly all patients with chronic hepatitis C virus (HCV) infection receive treatment, a substantial proportion remain untreated. We conducted an administrative claims analysis to provide real‐world data on treatment patterns and characteristics of treated versus untreated patients among individuals with HCV in the United States. Adults with an HCV diagnosis from 01 July 2016 through 30 September 2020 and continuous health plan enrolment for 12 months before and ≥1 month after the diagnosis date were identified in the Optum Research Database. Descriptive and multivariable analyses were conducted to evaluate the association between patient characteristics and the rate of treatment. Of 24,374 patients identified with HCV, only 30% initiated treatment during follow‐up. Factors associated with increased rate of treatment included younger age versus age 75+ (hazard ratio [HR] 1.50–1.83 depending on age group), commercial versus Medicare insurance (HR 1.32), and diagnosis by a specialist versus a primary care physician (HR 2.56 and 2.62 for gastroenterology and infectious disease or hepatology, respectively) (p < .01 for all). Several baseline comorbidities were associated with decreased rate of treatment, including psychiatric disorders (HR 0.87), drug use disorders (HR 0.85) and cirrhosis (HR 0.42) (p < .01 for all). These findings highlight existing HCV treatment inequities, particularly among older patients and those with psychiatric disorders, substance use disorders or chronic comorbidities. Targeted efforts to increase treatment uptake in these populations could mitigate a considerable future burden of HCV‐related morbidity, mortality and healthcare costs.

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“…However, inequities and areas of improvement for inclusiveness continue to be documented. For example, Veterans with a substance use disorder receiving primary care services reported poorer perceptions of care including access, provider communication, and information received (Hoggatt, et al, 2019 ). More broadly, health outcome disparities for chronic conditions, in particular diabetes and hypertension, were found to vary but persist during the first 5 years of implementation of the PCMH (Washington et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Broad and Adaptive Integrated Health Psychology Services: Engaging BIPOC Veterans in VA Healthcare

Bloor

Jendrusina

Rexer

2022

J Clin Psychol Med Settings

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Clinical health psychologists provide adaptive, evidenced-based interventions that incorporate behavioral medicine and behavioral health strategies, with the potential to integrate broadly across the medical system. Veterans Affairs (VA) healthcare strives to meet the needs of an increasingly diverse patient population with complex behavioral health needs. This conceptual paper describes an example of health psychology at one VA healthcare system, with a focus on adaptive and culturally responsive services reaching Black, Indigenous and People of Color/Veterans of Color (BIPOC). The clinical health psychology services and cases described aim to reach Veterans who may not participate in, or benefit as fully from, traditional disease self-management or mental health services. The authors offer recommendations, to secure the value and sustainability of these integrated health psychology services, and hopefully contribute to addressing healthcare inequities.

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Substance Use Disorder-Related Disparities in Patient Experiences of Primary Care

Cited by 18 publications

References 17 publications

Dental caries and periodontal disease among people who use drugs: a systematic review and meta-analysis

Dental caries and periodontal disease among people who use drugs: a systematic review and meta-analysis

Characteristics associated with receipt of treatment among patients diagnosed with chronic hepatitis C virus

Broad and Adaptive Integrated Health Psychology Services: Engaging BIPOC Veterans in VA Healthcare

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