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Integrated behavioral health primary care

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https://www.readbyqxmd.com/read/28634906/delivery-of-brief-cognitive-behavioral-therapy-for-medically-ill-patients-in-primary-care-a-pragmatic-randomized-clinical-trial
#1
Jeffrey A Cully, Melinda A Stanley, Nancy J Petersen, Natalie E Hundt, Michael R Kauth, Aanand D Naik, Kristen Sorocco, Shubhada Sansgiry, Darrell Zeno, Mark E Kunik
BACKGROUND: Few studies have examined the practical effectiveness and implementation potential of brief psychotherapies that integrate mental and physical health. OBJECTIVE: To determine whether an integrated brief cognitive behavioral therapy (bCBT), delivered by mental health providers in primary care, would improve depression, anxiety and quality of life for medically ill veterans. DESIGN: Pragmatic patient-randomized trial comparing bCBT to enhanced usual care (EUC)...
June 20, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28622823/does-behavioral-health-integration-improve-primary-care-providers-perceptions-of-health-care-system-functioning-and-their-own-knowledge
#2
Leah Zallman, Robert Joseph, Colleen O'Brien, Emily Benedetto, Ellie Grossman, Lisa Arsenault, Assaad Sayah
OBJECTIVE: To examine the impact of behavioral health integration (BHI) on primary care providers' (PCPs') (1) perceptions of behavioral health (BH)-primary care (PC) system functioning and (2) perceptions of their own knowledge regarding how to manage, triage, and access help in caring for patients with mental health conditions and substance use disorders. METHODS: We implemented BHI based on evidence-based models consisting of seven elements: (1)Screening for mental health and substance use disorders, (2)Training of PC teams, (3)Integration of BH providers into PC teams, (4)Roll-out of unlicensed mental health care managers and establishment of a BH registry, (5)Psychiatry consult service, (6)Site-based BHI meetings, and (7)Site self assessments...
May 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28619114/reducing-the-rate-and-duration-of-re-admissions-among-patients-with-unipolar-disorder-and-bipolar-disorder-using-smartphone-based-monitoring-and-treatment-the-radmis-trials-study-protocol-for-two-randomized-controlled-trials
#3
Maria Faurholt-Jepsen, Mads Frost, Klaus Martiny, Nanna Tuxen, Nicole Rosenberg, Jonas Busk, Ole Winther, Jakob Eyvind Bardram, Lars Vedel Kessing
BACKGROUND: Unipolar and bipolar disorder combined account for nearly half of all morbidity and mortality due to mental and substance use disorders, and burden society with the highest health care costs of all psychiatric and neurological disorders. Among these, costs due to psychiatric hospitalization are a major burden. Smartphones comprise an innovative and unique platform for the monitoring and treatment of depression and mania. No prior trial has investigated whether the use of a smartphone-based system can prevent re-admission among patients discharged from hospital...
June 15, 2017: Trials
https://www.readbyqxmd.com/read/28617023/integrated-behavioral-health-practice-facilitation-in-patient-centered-medical-homes-a-promising-application
#4
Sarah S Roderick, Nelly Burdette, Debra Hurwitz, Pano Yeracaris
INTRODUCTION: The purpose of this study was to assess the degree of behavioral health (BH) integration change in patient-centered medical homes (PCMHs) when using a practice facilitator (PF) specially trained in implementing integrated care and how a quasi-experimental design assists in this process. METHOD: Twelve PCMHs, 8 Federally Qualified Health Centers and 4 private practices, with varying degrees of BH services participated in this study. The degree of BH integration was assessed with a quasi-experimental design using the Maine Health Access Foundation's Site Self Assessment (MeHAF SSA) at baseline and after implementing site-specific BH services...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28617022/reducing-hospital-readmission-through-team-based-primary-care-a-7-week-pilot-study-integrating-behavioral-health-and-pharmacy
#5
Lauren N DeCaporale-Ryan, Nabila Ahmed-Sarwar, Robbyn Upham, Karen Mahler, Katie Lashway
INTRODUCTION: A team-based service delivery model was applied to provide patients with biopsychosocial care following hospital discharge to reduce hospital readmission. Most previous interventions focused on transitions of care occurred in the inpatient setting with attention to predischarge strategies. These interventions have not considered psychosocial stressors, and few have explored management in primary care settings. METHOD: A 7-week team-based service delivery model was implemented in a family medicine practice emphasizing a biopsychosocial approach...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28617021/development-and-implementation-of-a-psychotherapy-tracking-database-in-primary-care
#6
Julia R Craner, Craig N Sawchuk, John D Mack, Michelle A LeRoy
INTRODUCTION: Although there is a rapid increase in the integration of behavioral health services in primary care, few studies have evaluated the effectiveness of these services in real-world clinical settings, in part due to the difficulty of translating traditional mental health research designs to this setting. Accordingly, innovative approaches are needed to fit the unique challenges of conducting research in primary care. The development and implementation of one such approach is described in this article...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28617020/need-access-and-the-reach-of-integrated-care-a-typology-of-patients
#7
Ana J Bridges, Bianca T Villalobos, Elizabeth A Anastasia, Aubrey R Dueweke, Samantha J Gregus, Timothy A Cavell
INTRODUCTION: This paper is a report on a study exploring a potential typology of primary care patients referred for integrated behavioral health care (IBHC) services. We considered whether primary care patients could be grouped into meaningful clusters based on perceived need for behavioral health services, barriers to accessing care, and past-year service utilization. We also described the development of a working partnership between our university-based research team and a federally qualified health center (FQHC)...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28617019/initial-examination-of-characteristics-of-patients-who-are-high-utilizers-of-an-established-primary-care-behavioral-health-consultation-service
#8
Meghan Fondow, Elizabeth Zeidler Schreiter, Chantelle Thomas, Ashley Grosshans, Neftali Serrano, Kenneth Kushner
Obective: Although much has been studied regarding high-utilizing patients of medical services, no studies have been published regarding high-utilizing patients of integrated primary care behavioral health (PCBH) services. The primary purpose of the current study was to examine characteristics of high-utilizing patients of PCBH services and model adherence. The secondary purpose was to describe the process of conducting this research by clinicians in integrated care. METHOD: Data were obtained from electronic health records retrospectively for the study's time period, 2007-2013, for the sample of all patients who met with the behavioral health consultation team during that time...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28617018/integrated-care-in-rural-health-seeking-sustainability
#9
Mary Peterson, Jeri Turgesen, Laura Fisk, Seamus McCarthy
INTRODUCTION: The increased awareness of the financial impact associated with social determinants of health coincides with expectations of the Affordable Care Act (HR 3590) to improve care while reducing costs. The integration of behavioral health providers (BHPs) into primary care has demonstrated improved clinical outcomes. This study was designed with 2 aims, including the evaluation of the financial viability of an integrated care model in a rural setting and the demonstration of incorporating practice-based research into clinical work...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28617016/a-systematic-review-of-evaluation-research-in-integrated-behavioral-health-care-operational-and-financial-characteristics
#10
Amelia R Muse, Angela L Lamson, Katharine W Didericksen, Jennifer L Hodgson
INTRODUCTION: Integrated behavioral health care (IBHC) is an emerging solution for the delivery of behavioral health in primary care contexts. Although IBHC has been implemented and studied for more than 2 decades, little seems to be known about how it is best evaluated. This article illustrates a framework for IBHC evaluation based on the Three World view (with a focus on the operational and financial worlds) and delivers results from a systematic review on the operational and financial characteristics of existing IBHC research...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28617015/using-implementation-science-to-guide-the-integration-of-evidence-based-family-interventions-into-primary-care
#11
Justin D Smith, Jodi Polaha
This article is a demonstration of how an implementation-science (IS) framework can be coupled with the measurement of implementation outcomes to effectively integrate evidence-based family interventions in primary care. The primary care environment presents a number of challenges for successfully integrating such interventions. However, IS methods can improve the prospect of successfully implementing a new intervention while simultaneously and rigorously evaluating the impact on salient outcomes. We used our experiences across 2 pilot trials in which the family check-up (Smith, Montaño, Mauricio, Berkel, & Dishion, 2016), an evidence-based family intervention, was integrated into primary care...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28610561/blended-care-vs-usual-care-in-the-treatment-of-depressive-symptoms-and-disorders-in-general-practice-blending-study-protocol-of-a-non-inferiority-randomized-trial
#12
Btissame Massoudi, Marco H Blanker, Evelien van Valen, Hans Wouters, Claudi L H Bockting, Huibert Burger
BACKGROUND: The majority of patients with depressive disorders are treated by general practitioners (GPs) and are prescribed antidepressant medication. Patients prefer psychological treatments but they are under-used, mainly due to time constraints and limited accessibility. A promising approach to deliver psychological treatment is blended care, i.e. guided online treatment. However, the cost-effectiveness of blended care formatted as an online psychological treatment supported by the patients' own GP or general practice mental health worker (MHW) in routine primary care is unknown...
June 13, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28607831/primary-care-integration-of-psychiatric-and-behavioral-health-services-a-primer-for-providers-and-case-report-of-local-implementation
#13
Anthony Ps Guerrero, Cori L Takesue, Jared Hn Medeiros, Aileen A Duran, Joseph W Humphry, Ryan M Lunsford, Diana V Shaw, Michael H Fukuda, Earl S Hishinuma
Mental health conditions are common, disabling, potentially life-threatening, and costly; however, they are mostly treatable with early detection and intervention. Unfortunately, mental healthcare is in significantly short supply both nationally and locally, and particularly in small, rural, and relatively isolated communities. This article provides physicians and other health practitioners with a primer on the basic rationale and principles of integrating behavioral healthcare - particularly psychiatric specialty care - in primary care settings, including effective use of teleconferencing...
June 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28606419/the-evolving-practice-of-psychiatry-in-the-era-of-integrated-care
#14
REVIEW
Robert Joseph, Rachel Kester, Colleen O'Brien, Hsiang Huang
BACKGROUND: Integrating behavioral health care into the primary care setting is increasingly recognized as an effective way to manage mental illness and substance use disorders on a population level in the United States. The term "integrated care," however, is used in many ways and encompasses several different models. OBJECTIVES: The aim of this article is to provide a conceptual framework to understand the landscape of models of integrated care and to use this framework to contrast the roles of behavioral health providers in integrated settings with those in traditional behavioral health delivery models...
April 13, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28599868/a-latent-profile-analysis-on-patient-empowerment-programme-in-a-hong-kong-primary-care-setting
#15
Mike K T Cheung, Sam C C Chan, Anchor T F Hung, Angela Y M Leung, Albert Lee, Frank W K Chan, K L Chung, Peter K K Poon, Chetwyn C H Chan
OBJECTIVE: This study identified the profiles of subgroups of type 2 diabetic (T2DM) patients of the Patient Empowerment Programme (PEP) by different levels of benefits gained in diabetic self-management behaviors, self-efficacy, and health literacy. METHODS: This study adopted a non-experimental repeated-measures design on T2DM patients who joined PEP, using structured questionnaires. Latent profile analysis (LPA) was used to identify patterns of participants' change on the outcome measures...
May 24, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28596103/training-general-practitioners-to-detect-probable-mental-disorders-in-young-people-during-health-risk-screening
#16
Anne-Emmanuelle Ambresin, Christiaan P Otjes, George C Patton, Susan M Sawyer, Sharmala Thuraisingam, Dallas R English, Dagmar M Haller, Lena A Sanci
PURPOSE: The purpose of the study is to investigate whether a training intervention increases general practitioners' (GPs) detection sensitivity for probable mental disorders in young people. METHODS: Forty general practices were randomized to an intervention (29 GPs) or comparison arm (49 GPs). Intervention GPs participated in 9 hours of interactive training on youth-friendly care, psychosocial health risk screening, and responding to risk-taking behavior with motivational interviewing approaches, followed by practice visits assisting with integration of screening processes and tools...
June 5, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/28574235/how-arizona-medicaid-accelerated-the-integration-of-physical-and-behavioral-health-services
#17
Deborah Bachrach, Patricia M Boozang, Hailey E Davis
ISSUE: In most states, one agency has responsibility for Medicaid enrollees' physical health services and at least one other agency has responsibility for their behavioral health services. Apportioning responsibility for the physical and behavioral health of Medicaid beneficiaries into different agencies inevitably leads to different--and sometimes misaligned--policy goals, program priorities, and purchasing strategies, thereby impeding the delivery of integrated care. GOAL: To describe the rationale, process, and impact of Arizona's 2015 consolidation of its physical and behavioral health services agencies into its Medicaid agency...
May 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28571997/rationale-and-design-of-the-enhancing-outcomes-through-goal-assessment-and-generating-engagement-in-diabetes-mellitus-engage-dm-pragmatic-trial
#18
Julie C Lauffenburger, Jennifer Lewey, Saira Jan, Gina Nanchanatt, Sagar Makanji, Christina A Ferro, John Sheehan, Eric Wittbrodt, Kyle Morawski, Jessica Lee, Roya Ghazinouri, Niteesh K Choudhry
BACKGROUND: Poor glycemic control among patients with diabetes may stem from poor medication and lifestyle adherence or a failure to appropriately intensify therapy. A patient-centered approach could discern the most likely possibility and would then, as appropriate, address patient barriers to non-adherence (using behavioral interviewing methods such as motivational interviewing) or help facilitate choices among treatment augmentation options (using methods such as shared decision-making)...
May 29, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28566268/high-level-of-integration-in-integrated-disease-management-leads-to-higher-usage-in-the-e-vita-study-self-management-of-chronic-obstructive-pulmonary-disease-with-web-based-platforms-in-a-parallel-cohort-design
#19
Esther Pwa Talboom-Kamp, Noortje A Verdijk, Marise J Kasteleyn, Lara M Harmans, Irvin Jsh Talboom, Mattijs E Numans, Niels H Chavannes
BACKGROUND: Worldwide, nearly 3 million people die of chronic obstructive pulmonary disease (COPD) every year. Integrated disease management (IDM) improves disease-specific quality of life and exercise capacity for people with COPD, but can also reduce hospital admissions and hospital days. Self-management of COPD through eHealth interventions has shown to be an effective method to improve the quality and efficiency of IDM in several settings, but it remains unknown which factors influence usage of eHealth and change in behavior of patients...
May 31, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28535316/residents-confidence-providing-primary-care-with-behavioral-health-integration
#20
Patrick Hemming, Amber Hewitt, Joseph J Gallo, Rodger Kessler, R B Levine
BACKGROUND AND OBJECTIVES: Behavioral health integration (BHI) entails integrated behavioral health clinicians (IBHCs) providing care-generally for mental health and substance abuse disorders and behavioral comorbidity- within the operational functioning of primary care. Because limited data exist regarding BHI in residency, we studied its impact on resident education by examining whether increased behavioral health (BH) co-management improved residents' perceived ability to treat BH conditions...
May 2017: Family Medicine
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