Economic Grand Rounds: Incentives for Primary Care Providers to Participate in a Collaborative Care Program for Depression

2005 ◽  
Vol 56 (11) ◽  
pp. 1344-1346 ◽  
Author(s):  
Mitchell D. Feldman ◽  
Patricia A. Areán ◽  
Michael K. Ong ◽  
Deborah L. Lee ◽  
Saul Feldman
Keyword(s):  
Primary Care ◽  
Collaborative Care ◽  
Care Program ◽  
Primary Care Providers ◽  
Care Providers ◽  
Grand Rounds

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

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.

The Experience of Primary Care Providers With an Integrated Mental Health Care Program in Safety-Net Clinics

2015 ◽  
Vol 38 (2) ◽  
pp. 158-168 ◽  
Author(s):  
Wayne D. Bentham ◽  
Anna Ratzliff ◽  
David Harrison ◽  
Ya-Fen Chan ◽  
Steven Vannoy ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Care Program ◽  
Primary Care Providers ◽  
Safety Net ◽  
Care Providers ◽  
Health Care Program ◽  
Safety Net Clinics ◽  
Integrated Mental Health

scholarly journals Do Telemedicine Wound Care Specialist Consults Meet the Needs of the Referring Physician? A Survey of Primary Care Providers

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Marek K. Dobke ◽  
Dhaval Bhavsar ◽  
Fernando Herrera
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Wound Care ◽  
Care Program ◽  
Primary Care Providers ◽  
Care Providers ◽  
Face To Face ◽  
Telemedicine Consultation ◽  
Number Of Patients ◽  
One Year

The purpose of our study was to determine the factors that influence the use of telemedicine consultation by primary care physicians (PCPs) in the management of patients with problem wounds. A short questionnaire was administered to thirty-six PCPs who referred to our Wound Care Program within one year. Participants were asked to rate the importance of specific concerns and benefits regarding the role of wound care surgical specialist (WCSS) and the use of telemedicine consults prior to possible face-to-face consultation. Sixty percent of respondents felt comfortable with telemedicine consultation based on recommendations alone. The total number of patients referred for telemedicine consult was 230, and face-to-face consultation with a WCSS was offered and arranged for 30% of patients. The perception of shared decision making, streamlining patient care, and an opportunity for followup were all highly ranked benefits. The majority of PCPs (93%) agreed that telemedicine wound care consult is a useful tool in their practice and would continue to use the telemedicine consult service.

scholarly journals Erratum to: Collaborative Care: a Pilot Study of a Child Psychiatry Outpatient Consultation Model for Primary Care Providers

2016 ◽  
Vol 44 (3) ◽  
pp. 515-515 ◽  
Author(s):  
Elise M. Fallucco ◽  
Emma Robertson Blackmore ◽  
Carolina M. Bejarano ◽  
Chelsea B. Kozikowski ◽  
Steven Cuffe ◽  
...  
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Child Psychiatry ◽  
Collaborative Care ◽  
Primary Care Providers ◽  
Care Providers ◽  
Outpatient Consultation ◽  
Consultation Model

Collaborative Care: a Pilot Study of a Child Psychiatry Outpatient Consultation Model for Primary Care Providers

2016 ◽  
Vol 44 (3) ◽  
pp. 386-398 ◽  
Author(s):  
Elise M. Fallucco ◽  
Emma Robertson Blackmore ◽  
Carolina M. Bejarano ◽  
Chelsea B. Kozikowksi ◽  
Steven Cuffe ◽  
...  
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Child Psychiatry ◽  
Collaborative Care ◽  
Primary Care Providers ◽  
Care Providers ◽  
Outpatient Consultation ◽  
Consultation Model

scholarly journals Evaluation of a Pilot Asthma Care Program for Electronic Communication between School Health and a Healthcare System’s Electronic Medical Record

2016 ◽  
Vol 07 (04) ◽  
pp. 969-982 ◽  
Author(s):  
Yhenneko Taylor ◽  
Hazel Tapp ◽  
Thomas Ludden ◽  
Lindsay Shade ◽  
Beth Burton ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Record ◽  
Electronic Medical Record ◽  
School Health ◽  
Electronic Communication ◽  
Care Program ◽  
Primary Care Providers ◽  
School Nurse ◽  
School Nurses ◽  
Care Providers

SummaryObjective Asthma is a common childhood chronic lung disease affecting greater than 10% of children in the United States. School nurses are in a unique position to close gaps in care. Indeed, effective asthma management is more likely to result when providers, family, and schools work together to optimize the patient’s treatment plan. Currently, effective communication between schools and healthcare systems through electronic medical record (EMR) systems remains a challenge. The goal of this feasibility pilot was to link the school-based care team with primary care providers in the healthcare system network via electronic communication through the EMR, on behalf of pediatric asthma patients who had been hospitalized for an asthma exacerbation. The implementation process and the potential impact of the communication with providers on the reoccurrence of asthma exacerbations with the linked patients were evaluated.Methods By engaging stakeholders from the school system and the healthcare system, we were able to collaboratively design a communication process and implement a pilot which demonstrated the feasibility of electronic communication between school nurses and primary care providers. Outcomes data was collected from the electronic medical record to examine the frequency of asthma exacerbations among patients with a message from their school nurse. The percent of exacerbations in the 12 months before and after electronic communication was compared using McNemar’s test.ResultsThe pilot system successfully established communication between the school nurse and primary care provider for 33 students who had been hospitalized for asthma and a decrease in hospital admissions was observed with students whose school nurse communicated through the EMR with the primary care provider.Conclusions Findings suggest a collaborative model of care that is enhanced through electronic communication via the EMR could positively impact the health of children with asthma or other chronic illnesses.Citation: Reeves KW, Taylor Y, Tapp H, Ludden T, Shade LE, Burton B, Courtlandt C, Dulin M. Evaluation of a pilotasthma care program for electronic communication between school health and a healthcare system’s electronic medicalrecord.

Collaborative Care: Integrating Behavioral Health Into the Primary Care Setting

2021 ◽  
pp. 107839032110416
Author(s):  
Virginia Reising ◽  
Lauren Diegel-Vacek ◽  
Lisa Dadabo MSW ◽  
Susan Corbridge
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Behavioral Health ◽  
Nurse Practitioners ◽  
Collaborative Care ◽  
Primary Care Providers ◽  
Care Team ◽  
Screening Tools ◽  
Care Providers ◽  
Family Nurse Practitioners

INTRODUCTION Integrated behavioral health is a model of health care that aims to meet the complex health care needs of patients in primary care settings. Collaborative Care (CC) is an evidence-based model incorporating an interdisciplinary team to improve outcomes for behavioral health disorders commonly seen by primary care providers. OBJECTIVE CC was implemented in a nurse-managed health center in a medically underserved community of Chicago with a team of family nurse practitioners, psychiatric mental health nurse practitioners, and a licensed clinical social worker. METHOD Integration of the CC model required restructuring of the patient visit, the care team, and financial operations. Weekly team meetings were held for interdisciplinary case consultation and training for the primary care team by the psychiatric nurse practitioner. The model includes suggested goals of reducing patient scores of validated depression (Patient Health Questionnaire–9) and anxiety (Generalized Anxiety Disorder–7) screening tools to a score less than 5 points or to less than 50% of original score. RESULTS During the initial year of implementation, 166 patients received care under the CC model, with 64 patients currently receiving active care. In this cohort, 22% reached suggested goals for depression and 47% for anxiety. CONCLUSIONS CC has benefits for both patients and providers. Patients receive holistic treatment of both mental and physical health needs and access to psychiatric services for medication initiation and behavioral health modalities when necessary. We observed that the CC model improved collaboration with behavioral health specialists and the competence and confidence of family nurse practitioners.

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