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Zhang BR, Yang X. Motivational interviewing in postoperative rehabilitation and chronic disease management: Current findings and future research directions. World J Psychiatry 2025; 15:102737. [DOI: 10.5498/wjp.v15.i1.102737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2024] [Revised: 11/20/2024] [Accepted: 11/26/2024] [Indexed: 12/18/2024] Open
Abstract
This editorial highlights a recently published study examining the effectiveness of music therapy combined with motivational interviewing (MI) in addressing anxiety and depression among young and middle-aged patients following percutaneous coronary intervention. It further explores existing evidence and potential future research directions for MI in postoperative rehabilitation and chronic disease management. MI aims to facilitate behavioral change and promote healthier lifestyles by fostering a trusting relationship with patients and enhancing intrinsic motivation. Research has demonstrated its effectiveness in postoperative recovery for oncological surgery, stroke, organ transplants, and gastrointestinal procedures, as well as in managing chronic conditions such as diabetes, obesity, and periodontal disease. The approach is patient-centered, adaptable, cost-effective, and easily replicable, though its limitations include reliance on the therapist’s expertise, variability in individual responses, and insufficient long-term follow-up studies. Future research could focus on developing individualized and precise intervention models, exploring applications in digital health management, and confirming long-term outcomes to provide more comprehensive support for patient rehabilitation.
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Affiliation(s)
- Bing-Ren Zhang
- Affiliated Hospital (School of Clinical Medicine), Hangzhou Normal University, Hangzhou 311121, Zhejiang Province, China
| | - Xiao Yang
- Mental Health Education and Counseling Center, Hangzhou Normal University, Hangzhou 311121, Zhejiang Province, China
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Kenya S, Young B, Escarfuller S, Jones-Weiss D, Carrasquillo O, Riccio A, Yue P. Improving HIV Outcomes in Miami's Black populations with clinic-based community health workers protocol: The integrated navigation and support for treatment adherence, counseling, and research (INSTACARE) randomized controlled trial. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.12.11.24318859. [PMID: 39711703 PMCID: PMC11661356 DOI: 10.1101/2024.12.11.24318859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2024]
Abstract
Miami-Dade is an HIV epicenter where Black populations experience excess AIDS-related deaths due to poor medication adherence, which prevents achieving an undetectable HIV viral load (VL). A promising approach to improving HIV outcomes in Black populations has been the use of community health workers (CHWs). Evidence shows CHWs trained in motivational interviewing (MI) may further improve outcomes, however little data exists about Black CHWs trained in MI who support Black patients with HIV. While CHWs traditionally help address social determinants of health in nonclinical locations, there is less information on CHWs who provide support in clinical settings, which may result in even greater improvements in HIV outcomes. To examine effects of CHWs trained in MI who provide HIV care in both clinic and community settings, a randomized controlled trial (RCT) is being conducted in Miami-Dade's largest public hospital. The Integrated Navigation and Support for Treatment, Adherence, Counseling, and Research intervention is a RCT of 300 Black adults with an unmanaged HIV VL (> 200 copies/mL). CHWs trained in MI are embedded into HIV clinical care teams and participate in hospital rounds with clinicians treating inpatients. Participants randomized into the CHW intervention arm receive 12 months of CHW-led health education and assistance with health care navigation and social services. The primary outcome is change in HIV viral load suppression at 12 months. Secondary outcomes include changes in medication adherence and social determinants of health. Study enrollment began in 2023 and will be completed by 2027. The first results are expected to be submitted for publication in 2025. INSTACARE is one of the first RCTs to examine effects of clinic-based support provided by CHWs trained in MI on Black populations with an unmanaged VL and will provide evidence on the impact of such strategies on medication adherence and social determinants of health.
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Affiliation(s)
- Sonjia Kenya
- Department of General Internal Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - BreAnne Young
- Department of General Internal Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sebastian Escarfuller
- Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Deborah Jones-Weiss
- Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Olveen Carrasquillo
- Department of General Internal Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ana Riccio
- Department of General Internal Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Pan Yue
- Department of Public Health Sciences Biostatistics, University of Miami Miller School of Medicine, Miami, FL, USA
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Dion KM, Ferland F, Farand L, Gauvin L, Fleury MJ. Reasons for High Emergency Department Use Among Patients With Common Mental Disorders or Substance-Related Disorders. Healthc Policy 2024; 19:55-69. [PMID: 39229663 PMCID: PMC11411648 DOI: 10.12927/hcpol.2024.27333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2024] Open
Abstract
Aims This study examined the reasons for high emergency department (ED) use among patients with common mental disorders (MDs), substance-related disorders (SRDs) or co-occurring MDs-SRDs. Method Following content analysis, 42 high ED users (three-plus visits/year) recruited in two Quebec EDs were interviewed. Results The reasons included barriers to outpatient care, patient disabilities and professional practices. Patients with SRDs trust outpatient services less, those with MDs had important unmet needs and those with MDs-SRDs faced care coordination issues. Conclusion Improvements such as ED use monitoring, consolidating MD-SRD practices and continuous training are needed in EDs and outpatient services to enhance access and continuity of care.
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Affiliation(s)
- Karine-MichÈle Dion
- Researcher, Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Research Assistant, Douglas Mental Health University Institute Research Centre, Montreal, QC
| | - Francine Ferland
- Researcher, School of Social Work, Laval University, Addiction Rehabilitation Centre, National Capital University Integrated Health and Social Services Centre, Quebec City, QC
| | - Lambert Farand
- Honorary Professor, Department of Health Administration, Policy and Evaluation, School of Public Health, University of Montreal, Montreal, QC
| | - Lise Gauvin
- Professor, Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Theme Leader, Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre, Montreal, QC
| | - Marie-JosÉe Fleury
- Professor, Department of Psychiatry, Douglas Research Centre, McGill University, Montreal, QC
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Celik M, Gold MS, Fuehrlein B. A Narrative Review of Current and Emerging Trends in the Treatment of Alcohol Use Disorder. Brain Sci 2024; 14:294. [PMID: 38539681 PMCID: PMC10969323 DOI: 10.3390/brainsci14030294] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/14/2024] [Accepted: 03/19/2024] [Indexed: 11/11/2024] Open
Abstract
Alcohol use disorder (AUD) is a significant contributor to morbidity and mortality in the United States. It contributes to over 140,000 annual deaths, to over 200 related diseases and health conditions globally, and accounts for 5.1% of the global disease burden. Despite its substantial impact, AUD remains undertreated, marked by a scarcity of approved medications. This paper explores the current treatment landscape and novel strategies for both alcohol withdrawal syndrome and AUD. Promising results, including the use of psychedelics alongside psychotherapy, noninvasive neural-circuit-based interventions, phosphodiesterase-4 inhibitors, and GLP-1 receptor agonists, have emerged from recent studies. While these advancements show potential, further research is crucial for a comprehensive understanding of their effectiveness. The clear shortage of approved medications and other treatment modalities underscores the pressing need for ongoing research.
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Affiliation(s)
- Muhammet Celik
- New York Medical College at Saint Joseph’s Medical Center, Yonkers, NY 10705, USA;
| | - Mark S. Gold
- Department of Psychiatry, School of Medicine, Washington University, St. Louis, MO 63130, USA
| | - Brian Fuehrlein
- Mental Health Service Line, VA Connecticut Healthcare System, West Haven, CT 06516, USA;
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, USA
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Nordeck CD, Sharma A, Terplan M, Dusek K, Gilliams E, Gryczynski J. Opioid Use Disorder Treatment Linkage at Strategic Touchpoints Using Buprenorphine (OUTLAST-B): Rationale, Design, and Evolution of a Randomized Controlled Trial. JOURNAL OF PSYCHIATRY AND BRAIN SCIENCE 2023; 8:e230010. [PMID: 38456042 PMCID: PMC10919199 DOI: 10.20900/jpbs.20230010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Background Despite the effectiveness and growing availability of treatment for opioid use disorder (OUD) with buprenorphine, many people with OUD do not access treatment services. This article describes the rationale, methodological design, evolution, and progress of an ongoing clinical trial of treatment linkage strategies for people with untreated OUD. Methods The study, titled Opioid Use Disorder Treatment Linkage at Strategic Touchpoints using Buprenorphine (OUTLAST-B), uses "strategic touchpoints", initially sexual health clinics and subsequently broadened to other service venues and participant social networks, for recruitment and screening. Adults with untreated OUD (target N = 360) are randomized to one of the three arms: Usual Care (UC, enhanced with overdose education and naloxone distribution), Patient Navigation (PN), or Patient Navigation with an immediate short-term bridge prescription for buprenorphine (PN + BUP). In the PN and PN + BUP arms, the Patient Navigator works with participants for 2 months to facilitate treatment entry and early retention, resolve barriers (e.g., ID cards, transportation), and provide motivational support. Results The primary outcome is OUD treatment entry within 30 days of enrollment. Participants are assessed at baseline and followed at 3- and 6-months post-enrollment on measures of healthcare utilization, substance use, and general functioning. Challenges and recruitment adaptations pursuant to the COVID-19 pandemic are discussed. Conclusions This study could provide insights on how to reach people with untreated OUD and link them to care through non-traditional routes. Trial Registration The study is registered at ClinicalTrials.gov (NCT04991974).
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Affiliation(s)
| | - Anjalee Sharma
- Friends Research Institute, Baltimore, MD 21201, USA
- Behavioral Pharmacology Research Unit, Johns Hopkins School of Medicine, Baltimore, MD 21224, USA
| | | | - Kristi Dusek
- Friends Research Institute, Baltimore, MD 21201, USA
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