Psychology's Role in Collaborative-Care Treatment of Anxiety in Primary Care Patients Postdisaster

2014 ◽  
Author(s):  
Anne E. Ciccone ◽  
Erin T. Reuther ◽  
Howard J. Osofsky ◽  
Joy D. Osofsky
Keyword(s):  
Primary Care ◽  
Collaborative Care ◽  
Care Treatment ◽  
Primary Care Patients

scholarly journals Collaborative care needs and preferences of primary care patients with multimorbidity

2005 ◽  
Vol 8 (1) ◽  
pp. 54-63 ◽  
Author(s):  
Polly Hitchcock Noel ◽  
B. Chris Frueh ◽  
Anne C. Larme ◽  
Jacqueline A. Pugh
Keyword(s):  
Primary Care ◽  
Collaborative Care ◽  
Care Needs ◽  
Primary Care Patients

scholarly journals Collaborative care clinician perceptions of computerized cognitive behavioral therapy for depression in primary care

2020 ◽  
Vol 10 (3) ◽  
pp. 565-572
Author(s):  
Lucinda B Leung ◽  
Karen E Dyer ◽  
Elizabeth M Yano ◽  
Alexander S Young ◽  
Lisa V Rubenstein ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Cognitive Behavioral Therapy ◽  
Collaborative Care ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Mental Health Clinicians ◽  
Depression Care ◽  
Care Managers ◽  
Primary Care Patients

Abstract In Veterans Health Administration’s (VA) Primary Care–Mental Health Integration (PC-MHI) models, primary care providers, care managers, and mental health clinicians collaboratively provide depression care. Primary care patients, however, still lack timely, sufficient access to psychotherapy treatment. Adapting PC-MHI collaborative care to improve uptake of evidence-based computerized cognitive behavioral therapy (cCBT) may be a potential solution. Understanding primary care-based mental health clinician perspectives is crucial for facilitating adoption of cCBT as part of collaborative depression care. We examined PC-MHI mental health clinicians’ perspectives on adapting collaborative care models to support cCBT for VA primary care patients. We conducted 16 semi-structured interviews with PC-MHI nurse care managers, licensed social workers, psychologists, and psychiatrists in one VA health-care system. Interviews were audio-recorded, transcribed, coded using the constant comparative method, and analyzed for overarching themes. Although cCBT awareness and knowledge were not widespread, participants were highly accepting of enhancing PC-MHI models with cCBT for depression treatment. Participants supported cCBT delivery by a PC-MHI care manager or clinician and saw it as an additional tool to engage patients, particularly younger Veterans, in mental health treatment. They commented that current VA PC-MHI models did not facilitate, and had barriers to, use of online and mobile treatments. If effectively implemented, however, respondents thought it had potential to increase the number of patients they could treat. There is widespread interest in modernizing health systems. VA PC-MHI mental health clinicians appear open to adapting collaborative care to increase uptake of cCBT to improve psychotherapy access.

Collaborative care for primary care treatment of late‐life depression in Singapore: Randomized controlled trial

2020 ◽  
Vol 35 (10) ◽  
pp. 1171-1180
Author(s):  
Tze Pin Ng ◽  
Ma S. Z. Nyunt ◽  
Liang Feng ◽  
Rajeev Kumar ◽  
Calvin S. L. Fones ◽  
...  
Keyword(s):  
Primary Care ◽  
Randomized Controlled Trial ◽  
Collaborative Care ◽  
Controlled Trial ◽  
Late Life ◽  
Late Life Depression ◽  
Randomized Controlled ◽  
Care Treatment

scholarly journals Depression Outcomes in Smokers and Nonsmokers: Comparison of Collaborative Care Management Versus Usual Care

2019 ◽  
Vol 10 ◽  
pp. 215013271986126 ◽  
Author(s):  
Joseph A. Akambase ◽  
Nathaniel E. Miller ◽  
Gregory M. Garrison ◽  
Paul Stadem ◽  
Heather Talley ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Outcomes ◽  
Collaborative Care ◽  
Clinical Remission ◽  
Care Management ◽  
Negative Impact ◽  
Reference Group ◽  
Care Practice ◽  
Treatment Type ◽  
Primary Care Patients

Background: Depression is common in the primary care setting and tobacco use is more prevalent among individuals with depression. Recent research has linked smoking to poorer outcomes of depression treatment. We hypothesized that in adult primary care patients with the diagnosis of depression, current smoking would have a negative impact on clinical outcomes, regardless of treatment type (usual primary care [UC] vs collaborative care management [CCM]). Methods: A retrospective chart review study of 5155 adult primary care patients with depression in a primary care practice in southeast Minnesota was completed. Variables obtained included age, gender, marital status, race, smoking status, initial Patient Health Questionnaire–9 (PHQ-9), and 6-month PHQ-9. Clinical remission (CR) was defined as 6-month PHQ-9 <5. Persistent depressive symptoms (PDS) were defined as PHQ-9 ≥10 at 6 months. Treatment in both CCM and UC were compared. Results: Using intention to treat analysis, depressed smokers treated with CCM were 4.60 times as likely (95% CI 3.24-6.52, P < .001) to reach CR and were significantly less likely to have PDS at 6 months (adjusted odds ratio [AOR] 0.19, 95% CI 0.14-0.25, P < .001) compared with smokers in UC. After a 6-month follow-up, depressed smokers treated with CCM were 1.75 times as likely (95% CI 1.18-2.59, P = .006) to reach CR and were significantly less likely to have PDS (AOR 0.45, 95% CI 0.31-0.64, P < .001) compared with smokers in UC. Conclusions: CCM significantly improved depression outcomes for smokers at 6 months compared with UC. However, in the UC group, smoking outcomes were not statistically different at 6 months for either remission or PDS. Also, nonsmokers in CCM had the best clinical outcomes at 6 months in both achieving clinical remission and reduction of PDS when compared with smokers in UC as the reference group.

scholarly journals Stepped Collaborative Care for Primary Care Patients With Persistent Symptoms of Depression

1999 ◽  
Vol 56 (12) ◽  
pp. 1109 ◽  
Author(s):  
Wayne Katon ◽  
Michael Von Korff ◽  
Elizabeth Lin ◽  
Greg Simon ◽  
Ed Walker ◽  
...  
Keyword(s):  
Primary Care ◽  
Collaborative Care ◽  
Persistent Symptoms ◽  
Symptoms Of Depression ◽  
Primary Care Patients

Cost-Effectiveness of a Collaborative Care Program for Primary Care Patients With Persistent Depression

2001 ◽  
Vol 158 (10) ◽  
pp. 1638-1644 ◽  
Author(s):  
Gregory E. Simon ◽  
Wayne J. Katon ◽  
Michael VonKorff ◽  
Jürgen Unützer ◽  
Elizabeth H.B. Lin ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Collaborative Care ◽  
Care Program ◽  
Primary Care Patients ◽  
Persistent Depression

Trauma-informed Collaborative Care for African American Primary Care Patients in Federally Qualified Health Centers

Medical Care ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Lisa S. Meredith ◽  
Eunice Wong ◽  
Karen Chan Osilla ◽  
Margaret Sanders ◽  
Mahlet G. Tebeka ◽  
...  
Keyword(s):  
Primary Care ◽  
African American ◽  
Collaborative Care ◽  
Health Centers ◽  
Federally Qualified Health Centers ◽  
Trauma Informed ◽  
Primary Care Patients

Introduction

CNS Spectrums ◽  
2007 ◽  
Vol 12 (S13) ◽  
pp. 3-3
Author(s):  
Madhukar Trivedi
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Usual Care ◽  
Health Care System ◽  
Collaborative Care ◽  
Depressive Disorders ◽  
Care Setting ◽  
Primary Care Setting ◽  
Care Treatment ◽  
Care Models

AbstractMajor depressive disorder (MDD) is often a chronic, recurrent, and debilitating disorder with a lifetime prevalence of 16.2% and a 12-month prevalence of 6.6% in the United States. The disorder is associated with high rates of comorbidity with other psychiatric disorders and general medical illnesses, lower rates of adherence to medication regimens, and poorer outcomes for chronic physical illness. While 51.6% of cases reporting MDD received health care treatment for the illness, only 21.7% of all MDD cases received minimal guideline-level treatment. Because the overwhelming majority of patients with depressive disorders are seen annually by their primary care physicians, the opportunity to diagnose and treat patients early in the course of their illness in the primary care setting is substantial, though largely unfulfilled by our current health care system. The goal of treatment is 2-fold: early and complete remission of symptoms of depression and eventual recovery to premorbid levels of functioning in response to acute-phase treatment, and prevention of relapse during the continuation phase or recurrence during the maintenance phase. However, only 25% to 50% of patients with MDD adhere to their antidepressant regimen for the length of time recommended by depression guidelines, and nearly 50% of depressed patients referred from primary care to specialty care treatment fail to complete the referral. Patients with chronic or treatment-resistant depression often require multiple trials using an algorithm-based approach involving more than one treatment strategy. Under conditions of usual care, 40% to 44% of patients with MDD treated with antidepressants in the primary care setting show a >50% improvement in depression scores at 4-month follow-up, compared with 70% to 75% of those treated using collaborative care models. This demonstrates the importance of factors other than antidepressant medication per se for achieving treatment effectiveness. Additional research is needed to evaluate longer-term outcomes of algorithm-based, stepped, collaborative care models that incorporate patient self-management in conjunction with usual care. Furthermore, the health care system must undergo major transformation to effectively treat depression, along with other chronic illnesses. The use of evidence-based treatment algorithms are discussed and recommendations are provided for patients and physicians based on collaborative care interventions that may be useful for improving the current management of depressive disorders.

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