21.2 MICHIGAN CHILD COLLABORATIVE CARE PROGRAM (MC3): TEN YEARS OF GROWTH, ADAPTATION, AND LEARNING

Problem Children with cleft-related articulation disorders receive ineffectual or inappropriate speech therapy locally due to lack of training and a disconnect between the team and local speech-language pathologists. Solution A collaborative care program that is billable for the team allows the local speech-language pathologist to earn continuing education units and facilitates effective local speech therapy. This program is the first of its kind, according to the American Speech-Language-Hearing Association Continuing Education Board for Speech Pathology.

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Lamotrigine and lithium in primary care psychiatric consultation: adoption and adverse effects

Family Practice ◽

10.1093/fampra/cmaa131 ◽

2020 ◽

Author(s):

James R Phelps ◽

Olivia R Pipitone ◽

Kenneth Squires ◽

Jonathan D Bale

Keyword(s):

Primary Care ◽

Weight Gain ◽

Adverse Effects ◽

Collaborative Care ◽

Bipolar Depression ◽

Care Program ◽

Primary Care Providers ◽

Thyroid Stimulating Hormone ◽

Care Providers ◽

Psychiatric Consultation

Abstract Background The Collaborative Care Model of psychiatric consultation in primary care has improved outcomes for unipolar depression, but bipolar depressions are challenging for providers and consultants. Although lamotrigine and lithium are both first line medications for bipolar depression, their use in primary care has been declining over the last decade. Objective Our project aimed to quantify the frequency of and adoption of recommendations for lamotrigine and lithium, and their adverse effects, in a Collaborative Care program. Methods Chart review. Results For 620 depressed adult patients (Public Health Questionnaire, 9-item ≥10), lamotrigine and lithium were recommended by psychiatric consultant for 35% and 26% of patients, respectively; and when recommended, were prescribed by primary care providers 50% and 32% of the time, respectively. Eighty-four percent of lithium dosages were 600 mg or less; average serum level 0.32 mEq/l. In follow-up up to 6 months, lithium was associated with no more weight gain than lamotrigine; but 12% of patients receiving lithium had thyroid stimulating hormone increases exceeding the upper limit of normal, occurring in an average of 32 days after the initial prescription. Conclusions (i) In a Collaborative Care program of psychiatric consultation, recommendations for lamotrigine and lithium were very frequent. (ii) Adoption of these recommendations is variable, warranting further investigation. (iii) Like higher doses, low doses of lithium induced hypothyroidism (rapidly)—but not weight gain.

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The Michigan Child Collaborative Care Program: Building a Telepsychiatry Consultation Service

Psychiatric Services ◽

10.1176/appi.ps.201800151 ◽

2019 ◽

Vol 70 (9) ◽

pp. 849-852 ◽

Cited By ~ 1

Author(s):

Sheila Marcus ◽

Nasuh Malas ◽

Richard Dopp ◽

Joanna Quigley ◽

Anne C. Kramer ◽

...

Keyword(s):

Collaborative Care ◽

Care Program ◽

Consultation Service

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A collaborative care program for management of common mental disorders among diabetic patients in a primary healthcare setting

Journal of Public Health ◽

10.1007/s10389-016-0722-y ◽

2016 ◽

Vol 24 (4) ◽

pp. 273-279 ◽

Cited By ~ 2

Author(s):

Zeinab Moinfar ◽

Mojtaba Sedaghat ◽

Farid Abolhassani ◽

Vandad Sharifi ◽

Zahra Moinfar ◽

...

Keyword(s):

Mental Disorders ◽

Primary Healthcare ◽

Collaborative Care ◽

Common Mental Disorders ◽

Care Program ◽

Healthcare Setting ◽

Diabetic Patients

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71.4 Building Bridges With Primary Care Providers Across the State: The Michigan Child Collaborative Care Program (MC3)

Journal of the American Academy of Child & Adolescent Psychiatry ◽

10.1016/j.jaac.2017.07.413 ◽

2017 ◽

Vol 56 (10) ◽

pp. S106

Author(s):

Nasuh Malas

Keyword(s):

Primary Care ◽

Collaborative Care ◽

Care Program ◽

Primary Care Providers ◽

The State ◽

Care Providers

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Italian study on a Collaborative Care program for primary care attenders with depressive disorders

Journal of Psychosomatic Research ◽

10.1016/j.jpsychores.2013.03.063 ◽

2013 ◽

Vol 74 (6) ◽

pp. 553-554

Author(s):

M. Menchetti ◽

C. Sighinolfi ◽

C. Nespeca ◽

V. Di Michele ◽

P. Peloso ◽

...

Keyword(s):

Primary Care ◽

Collaborative Care ◽

Depressive Disorders ◽

Care Program ◽

Italian Study

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A Remote Collaborative Care Program for Patients with Depression Living in Rural Areas: Open-Label Trial (Preprint)

10.2196/preprints.8803 ◽

2017 ◽

Author(s):

Graciela Rojas ◽

Viviana Guajardo ◽

Pablo Martínez ◽

Ariel Castro ◽

Rosemarie Fritsch ◽

...

Keyword(s):

Mental Health ◽

Primary Care ◽

Usual Care ◽

Collaborative Care ◽

Rural Areas ◽

Care Program ◽

Open Label ◽

Rural Primary Care ◽

Primary Care Teams ◽

Clinical Records

BACKGROUND In the treatment of depression, primary care teams have an essential role, but they are most effective when inserted into a collaborative care model for disease management. In rural areas, the shortage of specialized mental health resources may hamper management of depressed patients. OBJECTIVE The aim was to test the feasibility, acceptability, and effectiveness of a remote collaborative care program for patients with depression living in rural areas. METHODS In a nonrandomized, open-label (blinded outcome assessor), two-arm clinical trial, physicians from 15 rural community hospitals recruited 250 patients aged 18 to 70 years with a major depressive episode (DSM-IV criteria). Patients were assigned to the remote collaborative care program (n=111) or to usual care (n=139). The remote collaborative care program used Web-based shared clinical records between rural primary care teams and a specialized/centralized mental health team, telephone monitoring of patients, and remote supervision by psychiatrists through the Web-based shared clinical records and/or telephone. Depressive symptoms, health-related quality of life, service use, and patient satisfaction were measured 3 and 6 months after baseline assessment. RESULTS Six-month follow-up assessments were completed by 84.4% (221/250) of patients. The remote collaborative care program achieved higher user satisfaction (odds ratio [OR] 1.94, 95% CI 1.25-3.00) and better treatment adherence rates (OR 1.81, 95% CI 1.02-3.19) at 6 months compared to usual care. There were no statically significant differences in depressive symptoms between the remote collaborative care program and usual care. Significant differences between groups in favor of remote collaborative care program were observed at 3 months for mental health-related quality of life (beta 3.11, 95% CI 0.19-6.02). CONCLUSIONS Higher rates of treatment adherence in the remote collaborative care program suggest that technology-assisted interventions may help rural primary care teams in the management of depressive patients. Future cost-effectiveness studies are needed. CLINICALTRIAL Clinicaltrials.gov NCT02200367; https://clinicaltrials.gov/ct2/show/NCT02200367 (Archived by WebCite at http://www.webcitation.org/6xtZ7OijZ)

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