Multicondition collaborative care intervention cost effective

Background An integrated collaborative care intervention was used to treat primary care patients with comorbid obesity and depression in a randomized clinical trial. To increase wider uptake and dissemination, information is needed on translational potential. Methods The trial collected longitudinal, qualitative data at baseline, 6 months (end of intensive treatment), 12 months (end of maintenance treatment), and 24 months (end of follow-up). Semi-structured interviews (n = 142) were conducted with 54 out of 409 randomly selected trial participants and 37 other stakeholders, such as recruitment staff, intervention staff, and clinicians. Using a Framework Analysis approach, we examined themes across time and stakeholder groups according to the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. Results At baseline, participants and other stakeholders reported being skeptical of the collaborative care approach related to some RE-AIM dimensions. However, over time they indicated greater confidence regarding the potential for future public health impact. They also provided information on barriers and actionable information to enhance program reach, effectiveness, adoption, implementation, and maintenance. Conclusions RE-AIM provided a useful framework for understanding how to increase the impact of a collaborative and integrative approach for treating comorbid obesity and depression. It also demonstrates the utility of using the framework as a planning tool early in the evidence-generation pipeline.

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Rationale and design of technology assisted stepped collaborative care intervention to improve patient-centered outcomes in hemodialysis patients (TĀCcare trial)

Contemporary Clinical Trials ◽

10.1016/j.cct.2018.09.002 ◽

2018 ◽

Vol 73 ◽

pp. 81-91 ◽

Cited By ~ 6

Author(s):

Maria-Eleni Roumelioti ◽

Jennifer L. Steel ◽

Jonathan Yabes ◽

Kevin E. Vowles ◽

Yoram Vodovotz ◽

...

Keyword(s):

Collaborative Care ◽

Hemodialysis Patients ◽

Patient Centered ◽

Care Intervention ◽

Improve Patient

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Delivering Integrated Psychosocial Oncology Care

Psycho-Oncology ◽

10.1093/med/9780190097653.003.0049 ◽

2021 ◽

pp. 385-392

Author(s):

Jesse R. Fann ◽

Julia Ruark ◽

Michael Sharpe

Keyword(s):

Collaborative Care ◽

Psychosocial Care ◽

Cost Effective ◽

Psychosocial Oncology ◽

Cancer Services ◽

Care Approach ◽

Integrated Delivery ◽

Oncology Care ◽

Institutional Challenges ◽

Systematic Identification

This chapter describes how the collaborative care model can be used to integrate psychosocial care into cancer care. It also describes the evolution of, and evidence for, the collaborative care approach in cancer services. Collaborative care consists of systematic identification of need, integrated delivery of psychosocial care by care managers with specialist supervision, and the stepping up of care based on the systematic measurement of outcomes. Trials of this approach for the management of depression and pain in patients with cancer have found it to be feasible to deliver, effective in improving outcomes, and cost-effective. The chapter describes how to overcome patient, provider, and institutional challenges in providing psychosocial care in diverse oncology settings. It concludes by proposing practical steps for implementing and sustaining an integrated psychosocial oncology service based on the principles of collaborative care.

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A worked example of initial theory-building: PARTNERS2 collaborative care for people who have experienced psychosis in England

Evaluation ◽

10.1177/1356389019850199 ◽

2019 ◽

Vol 26 (1) ◽

pp. 6-26

Author(s):

Ruth Gwernan-Jones ◽

Nicky Britten ◽

Jon Allard ◽

Elina Baker ◽

Laura Gill ◽

...

Keyword(s):

Focus Groups ◽

Complex Intervention ◽

Collaborative Care ◽

Iterative Process ◽

Complex Interventions ◽

Theory Building ◽

Service Users ◽

Programme Theory ◽

Worked Example ◽

Care Intervention

In this article, we present an exemplar of the initial theory-building phase of theory-driven evaluation for the PARTNERS2 project, a collaborative care intervention for people with experience of psychosis in England. Initial theory-building involved analysis of the literature, interviews with key leaders and focus groups with service users. The initial programme theory was developed from these sources in an iterative process between researchers and stakeholders (service users, practitioners, commissioners) involving four activities: articulation of 442 explanatory statements systematically developed using realist methods; debate and consensus; communication; and interrogation. We refute two criticisms of theory-driven evaluation of complex interventions. We demonstrate how the process of initial theory-building made a meaningful contribution to our complex intervention in five ways. Although time-consuming, it allowed us to develop an internally coherent and well-documented intervention. This study and the lessons learnt provide a detailed resource for other researchers wishing to build theory for theory-driven evaluation.

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Early Effects of the Trauma Collaborative Care Intervention

Journal of Orthopaedic Trauma ◽

10.1097/bot.0000000000001740 ◽

2020 ◽

Vol 34 (4) ◽

pp. e153

Keyword(s):

Collaborative Care ◽

Care Intervention ◽

Early Effects

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Blended collaborative care in the secondary prevention of coronary heart disease improves risk factor control: Results of a randomised feasibility study

European Journal of Cardiovascular Nursing ◽

10.1177/1474515119880062 ◽

2019 ◽

Vol 19 (2) ◽

pp. 134-141 ◽

Cited By ~ 1

Author(s):

Lena Bosselmann ◽

Stella V Fangauf ◽

Birgit Herbeck Belnap ◽

Mira-Lynn Chavanon ◽

Jonas Nagel ◽

...

Keyword(s):

Risk Factors ◽

Coronary Heart Disease ◽

Risk Factor ◽

Heart Disease ◽

Collaborative Care ◽

Intervention Group ◽

Psychosocial Risk ◽

Control Group ◽

Risk Factor Control ◽

Care Intervention

Background: Risk factor control is essential in limiting the progression of coronary heart disease, but the necessary active patient involvement is often difficult to realise, especially in patients suffering psychosocial risk factors (e.g. distress). Blended collaborative care has been shown as an effective treatment addition, in which a (non-physician) care manager supports patients in implementing and sustaining lifestyle changes, follows-up on patients, and integrates care across providers, targeting both, somatic and psychosocial risk factors. Aims: The aim of this study was to test the feasibility, acceptance and effect of a six-month blended collaborative care intervention in Germany. Methods: For our randomised controlled pilot study with a crossover design we recruited coronary heart disease patients with ⩾1 insufficiently controlled cardiac risk factors and randomised them to either immediate blended collaborative care intervention (immediate intervention group, n=20) or waiting control (waiting control group, n=20). Results: Participation rate in the intervention phase was 67% ( n=40), and participants reported high satisfaction ( M=1.63, standard deviation=0.69; scale 1 (very high) to 5 (very low)). The number of risk factors decreased significantly from baseline to six months in the immediate intervention group ( t(60)=3.07, p=0.003), but not in the waiting control group t(60)=−0.29, p=0.77). Similarly, at the end of their intervention following the six-month waiting period, the waiting control group also showed a significant reduction of risk factors ( t(60)=3.88, p<0.001). Conclusion: This study shows that blended collaborative care can be a feasible, accepted and effective addition to standard medical care in the secondary prevention of coronary heart disease in the German healthcare system.

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