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Study Rationale: We implemented a feasibility/pilot study to assess identification of opioid use disorder (OUD) and co-occurring mental health disorders (depression and post-traumatic stress disorder; co-MHD) in 4 primary care (PC) clinics. The main goals were to: 1) assess the feasibility of implementing universal screening for probable OUD, depression, and PTSD in PC clinics to inform recruitment for a planned clinical trial (2) assess pilot measures for detecting probable OUD and co-MHD (“observed”) by comparing to electronic health record diagnoses (EHR, “expected”).

Methods: Two sources of data were accessed, and prevalence estimates were calculated and compared on: aggregate data from each clinic’s EHR on diagnoses of OUD, depression and PTSD and the survey data obtained from a Universal Screening sample of patients in clinic waiting rooms.

Results: Over two weeks, a mean of 115 patients were screened/day for 1145 overall. Clinic EHR data indicated that 3.4% of patients were diagnosed with OUD, 12.7% with depression, and 3.6% with PTSD. Universal Screening identified that 4.5% of patients surveyed had probable OUD, 18.7% had probable depression, 19.0% had probable PTSD. OUD and co-MHD were identified through Universal Screening in 2.4% of the sample compared to 0.8% in the EHR.

Conclusions: Universal Screening for OUD, depression, and PTSD was feasible and will optimize research recruitment. There were 3.0 times as many patients identified with probable OUD + co-MHD in the waiting room sample compared to EHR. Results support quantification of and conclusion that there is a large gap in identification of these disorders in the PC setting.


Poster presented at the Brain & Behavioral Health Research Day 2022

This research was supported by the National Institute of Mental Health/NIMH (U01MH121954).



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