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Psychosocial Services (psychosocial + services)
Selected AbstractsNeed for Medical and Psychosocial Services Among Injection Drug Users: A Comparative Study of Needle Exchange and Methadone MaintenanceTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 4 2002Michael D. Stein M.D. This study compares the prevalence of perceived and unmet needs of HIV-negative injection drug users (IDUs) not receiving drug treatment (n = 251) and those recruited from a methadone maintenance program (n = 312) in 1998. We studied self-reported needs for six community services: medical, mental health, housing, income assistance, alcohol treatment, and drug treatment. Respondents reported the highest levels of need for mental health and housing services. Ninety-four percent of out-of-treatment IDUs reported having at least one need compared to 62% of methadone clients (p < .001). Across all reported service needs, at least 69% of respondents in both cohorts reported their needs were unmet. While HIV-infected drug users receive assistance through the Ryan White CARE Act, these findings suggest that seronegative drug users may benefit from similar community service programs. [source] Cost and cost-effectiveness of standard methadone maintenance treatment compared to enriched 180-day methadone detoxificationADDICTION, Issue 6 2004Carmen L. Masson ABSTRACT Aims To compare the cost and cost-effectiveness of methadone maintenance treatment and 180-day methadone detoxification enriched with psychosocial services. Design Randomized controlled study conducted from May 1995 to April 1999. Setting Research clinic in an established drug treatment program. Participants One hundred and seventy-nine adults with diagnosed opioid dependence. Intervention Patients were randomized to methadone maintenance (n = 91), which required monthly 1 hour/week of psychosocial therapy during the first 6 months or 180-day detoxification (n = 88), which required 3 hours/week of psychosocial therapy and 14 education sessions during the first 6 months. Measurements Total health-care costs and self-reported injection drug use. A two-state Markov model was used to estimate quality-adjusted years of survival. Findings Methadone maintenance produced significantly greater reductions in illicit opioid use than 180-day detoxification during the last 6 months of treatment. Total health-care costs were greater for maintenance than detoxification treatment ($7564 versus $6687; P < 0.001). Although study costs were significantly higher for methadone maintenance than detoxification patients ($4739 versus $2855, P < 0.001), detoxification patients incurred significantly higher costs for substance abuse and mental health care received outside the study. Methadone maintenance may provide a modest survival advantage compared with detoxification. The cost per life-year gained is $16 967. Sensitivity analysis revealed a cost-effectiveness ratio of less than $20 000 per quality-adjusted life-year over a wide range of modeling assumptions. Conclusions Compared with enriched detoxification services, methadone maintenance is more effective than enriched detoxification services with a cost-effectiveness ratio within the range of many accepted medical interventions and may provide a survival advantage. Results provide additional support for the use of sustained methadone therapy as opposed to detoxification for treating opioid addiction. [source] Relationship of stress management skill to psychological distress and quality of life in adults with cancer,PSYCHO-ONCOLOGY, Issue 1 2010Leigh Anne Faul Abstract Background: Distress is common among cancer patients, especially those undergoing chemotherapy. Although skill in stress management is often the target of intervention efforts, its relationship to distress and quality of life in patients about to begin cancer treatment has not been examined. Objective: To examine the relationship of pre-treatment skill in stress management to patient distress and quality of life. Methods: One hundred and ten adults diagnosed with stage I,IV cancer and ECOG,2 provided data on perceived stress management skill, anxiety, depression, and health-related quality of life prior to their initial chemotherapy infusion. Results: As predicted, greater skill in stress management was associated with lower levels of anxiety and depression and better overall mental quality of life. These relationships were generally independent of demographic and clinical variables also found to be associated with distress and quality of life. Conclusions: Findings confirm that skill in stress management is related to pre-chemotherapy distress and quality of life and suggest the importance of assessing this variable as part of efforts to link distressed patients to appropriate psychosocial services. Findings also raise the possibility that assessing extant stress management skills could be used to match patients to the type of intervention most likely to benefit them. Copyright © 2009 John Wiley & Sons, Ltd. [source] Interest in services among prostate cancer patients receiving androgen deprivation therapyPSYCHO-ONCOLOGY, Issue 8 2004Pamela J. Shapiro Treatment side effects and decreased quality of life associated with androgen deprivation therapy (ADT) suggest the need for supportive services for prostate cancer (PC) patients receiving ADT. Nonetheless, uptake of services is low, suggesting that PC patients' preferences are not being addressed. We examined interest in supportive services and predictors of interest among 118 PC patients receiving ADT. Overall interest in services was associated with lower quality of life (p=0.01). The majority of participants expressed interest in informational services (70%), with a minority (22%) expressing interest in psychosocial services. Interest in psychosocial services was associated with younger age (p=0.02), and shorter duration of ADT (p<0.04), but was unrelated to psychological distress or social support. Although most men (68%) reported that they would prefer not to take medication for depression, 75% would do so if advised by their physician. Overall, results suggest that PC patients on ADT prefer individualized informational support. Substantial interest (61%) in Oncolink, an internet-based informational resource, suggests the Internet may provide an acceptable mode of service delivery. Health care providers should consider integrating increased informational support into routine care and, more generally, consider patient preferences in prioritizing and designing support services. Copyright © 2003 John Wiley & Sons, Ltd. [source] | ||||||||||