Skip to main content
Duke University Libraries
DukeSpace Scholarship by Duke Authors
  • Login
  • Ask
  • Menu
  • Login
  • Ask a Librarian
  • Search & Find
  • Using the Library
  • Research Support
  • Course Support
  • Libraries
  • About
View Item 
  •   DukeSpace
  • Duke Scholarly Works
  • Scholarly Articles
  • View Item
  •   DukeSpace
  • Duke Scholarly Works
  • Scholarly Articles
  • View Item
JavaScript is disabled for your browser. Some features of this site may not work without it.

Substance use disorders and medical comorbidities among high-need, high-risk patients with diabetes.

Thumbnail
View / Download
345.8 Kb
Date
2018-05
Authors
Wu, Li-Tzy
Ghitza, Udi E
Zhu, He
Spratt, Susan
Swartz, Marvin
Mannelli, Paolo
Repository Usage Stats
64
views
23
downloads
Abstract
The majority of the U.S. healthcare resources are utilized by a small population characterized as high-risk, high-need persons with complex care needs (e.g., adults with multiple chronic conditions). Substance use disorders (SUDs) and mental health disorders (MHDs) are a driver of poor health and additional healthcare costs, but they are understudied among high-need patients.We examine the prevalence and correlates of SUDs and MHDs among adults with high-risk diabetes, who are patients at the top 10% risk score for developing poor outcomes (hospital admission or death).A risk algorithm developed from Duke University Health System electronic health records (EHRs) data was used to identify patients with high-risk diabetes for targeting home-based primary care. The EHR data of the 263 patients with high-risk diabetes were analyzed to understand patterns of SUDs and MHDs to inform care-coordinating efforts.Both SUDs (any SUD 48.3%, alcohol 12.5%, tobacco 38.8%, drug 23.2%) and MHDs (any MHD 74.9%, mood 53.2%, sleep 37.3%, anxiety 32.7%, schizophrenia/psychotics/delusional 14.8%, dementia/delirium/amnestic/cognitive 14.4%, adjustment 9.1%) were prevalent. Overall, 81.7% of the sample had SUD or MHD. Elevated odds of SUD were noted among men (tobacco, alcohol) and those who were never-married (alcohol, cannabis). African-American race (vs. other race/ethnicity) was associated with lower odds of anxiety disorders.While data are limited to one large academic health system, they provide clinical evidence revealing that 82% of patients with high-risk diabetes had SUD and/or MHD recorded in their EHRs, highlighting a need for developing service models to optimize high-risk care.
Type
Journal article
Subject
Humans
Diabetes Complications
Substance-Related Disorders
Treatment Outcome
Prevalence
Hospital Mortality
Risk
Mental Disorders
Comorbidity
Algorithms
Socioeconomic Factors
Adult
Aged
Middle Aged
Delivery of Health Care
Female
Male
Permalink
https://hdl.handle.net/10161/19930
Published Version (Please cite this version)
10.1016/j.drugalcdep.2018.01.008
Publication Info
Wu, Li-Tzy; Ghitza, Udi E; Zhu, He; Spratt, Susan; Swartz, Marvin; & Mannelli, Paolo (2018). Substance use disorders and medical comorbidities among high-need, high-risk patients with diabetes. Drug and alcohol dependence, 186. pp. 86-93. 10.1016/j.drugalcdep.2018.01.008. Retrieved from https://hdl.handle.net/10161/19930.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
Collections
  • Scholarly Articles
More Info
Show full item record

Scholars@Duke

Mannelli

Paolo Mannelli

Associate Professor of Psychiatry and Behavioral Sciences
Spratt

Susan Elizabeth Spratt

Associate Professor of Medicine
Swartz

Marvin Stanley Swartz

Professor of Psychiatry and Behavioral Sciences
My major research interest is in examining the effectiveness of services for severely mentally ill individuals, including factors that improve or impede good outcomes. Current research includes: the effectiveness of involuntary outpatient commitment, psychiatric advance directives, criminal justice outcomes for persons with mental illnesses, violence and mental illness and antipsychotic medications. I also served as member of the MacArthur Foundation Research Network on Mandate
Wu

Li-Tzy Wu

Professor in Psychiatry and Behavioral Sciences
Education/Training: Pre- and post-doctoral training in mental health service research, psychiatric epidemiology (NIMH T32), and addiction epidemiology (NIDA T32) from Johns Hopkins University School of Public Health (Maryland); Fellow of the NIH Summer Institute on the Design and Conduct of Randomized Clinical Trials.Director: Duke Community Based Substance Use Disorder Research Program.Research interests: COVID-19, Opioid misuse, Opioid overdose, Opioid use disorder, Opio
Alphabetical list of authors with Scholars@Duke profiles.
Open Access

Articles written by Duke faculty are made available through the campus open access policy. For more information see: Duke Open Access Policy

Rights for Collection: Scholarly Articles


Works are deposited here by their authors, and represent their research and opinions, not that of Duke University. Some materials and descriptions may include offensive content. More info

Make Your Work Available Here

How to Deposit

Browse

All of DukeSpaceCommunities & CollectionsAuthorsTitlesTypesBy Issue DateDepartmentsAffiliations of Duke Author(s)SubjectsBy Submit DateThis CollectionAuthorsTitlesTypesBy Issue DateDepartmentsAffiliations of Duke Author(s)SubjectsBy Submit Date

My Account

LoginRegister

Statistics

View Usage Statistics
Duke University Libraries

Contact Us

411 Chapel Drive
Durham, NC 27708
(919) 660-5870
Perkins Library Service Desk

Digital Repositories at Duke

  • Report a problem with the repositories
  • About digital repositories at Duke
  • Accessibility Policy
  • Deaccession and DMCA Takedown Policy

TwitterFacebookYouTubeFlickrInstagramBlogs

Sign Up for Our Newsletter
  • Re-use & Attribution / Privacy
  • Harmful Language Statement
  • Support the Libraries
Duke University