A collaborative care team to integrate behavioral health care and treatment of poorly-controlled type 2 diabetes in an urban safety net primary care clinic

Chwastiak, Lydia; Jackson, Sara L.; Russo, Joan; DeKeyser, Pamela; Kiefer, Meghan M.; Belyeu, Brittaney M.; Mertens, Kathleen; Chew, Lisa D.; Lin, Elizabeth

doi:10.1016/j.genhosppsych.2016.10.005

Cited by 48 publications

(46 citation statements)

References 22 publications

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“…Fundamental facilitators included quality communication between health professionals, and appropriate education and support for community‐based clinicians, in line with the wider literature . Effective interprofessional collaboration requires information sharing and ongoing communication between providers and across health care settings and upskilling of health practitioners.…”

Section: Discussionmentioning

confidence: 94%

“…Shared, or collaborative, care entails integration of primary‐ and tertiary‐level care, where specialist and the primary care providers share clinical responsibilities for patient management . This model has successfully been applied in depression, mental health care more broadly, and chronic disease managements, with significant improvements in physical and mental well‐being . The effectiveness of depression shared care models in cancer has been demonstrated .…”

Section: Introductionmentioning

confidence: 99%

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Barriers and facilitators to community‐based psycho‐oncology services: A qualitative study of health professionals’ attitudes to the feasibility and acceptability of a shared care model

et al. 2019

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Objective: Psychological therapies combined with medication are effective treatments for depression and anxiety in patients with cancer. However, the psychooncology workforce is insufficient to meet patient need and is hard to access outside of the major cities. To bridge this gap, innovative models of care are required. Implementation of a new model of care requires attention to the facilitators and barriers.The aim of this study was to explore stakeholders' attitudes to the feasibility and acceptability of a community-based, shared care model for the treatment of depression and anxiety.Methods: Semi-structured interviews were conducted with community-based clinical psychologists (n = 10), general practitioners (n = 6), and hospital-based psychologists working in psycho-oncology (n = 9). Framework analysis was conducted to identify key themes. Results: All stakeholders perceived the model as feasible and acceptable. Potential barriers/facilitators to implementation were summarised under six key themes: (a) initiative, ownership, and autonomy; (b) resources; (c) pathway establishment; (d) support; (e) skill acquisition; and (f) patient engagement. Facilitators included quality communication between health professionals across primary and tertiary care and appropriate education and support for community-based clinicians. Conclusions: This in-depth exploration of Australian health professionals' perceptions of the feasibility and acceptability of a community-based model of psychooncology care revealed that most clinicians were willing to adopt the proposed changes into practice. An RCT of a shared care intervention for depressed patients with cancer is needed.

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Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Barriers and facilitators to community‐based psycho‐oncology services: A qualitative study of health professionals’ attitudes to the feasibility and acceptability of a shared care model

et al. 2019

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“…Primary interview questions were informed by collaborative care core principles (ie, patient-centred care, team-based care, measurement guided and population-based care) and focused on patients’ experiences accessing and interacting with care team members in IC settings. 12 35 36 Initial interview questions were open-ended and developed iteratively with the research team ( online supplementary appendix 1 ). Subsequent revisions of the interview guide were informed by emerging themes and sensitising concepts generated through data collection and analysis.…”

Section: Methodsmentioning

confidence: 99%

“Caring About Me": a pilot framework to understand patient-centered care experience in integrated care - a qualitative study

et al. 2020

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ObjectiveThe aim of this study is to examine patients’ experiences in integrated care (IC) settings.DesignQualitative study using semistructured interviews.SettingsTwo IC sites in Toronto, Canada: (1) a community-based primary healthcare centre, supporting patients with hepatitis C and comorbid mental health and substance use issues; and (2) an integrated bariatric surgery programme, an academic tertiary care centre.ParticipantsThe study included patients (n=12) with co-occurring mental and physical health conditions. Seven participants (58%) were female and five (42%) were male.MethodsTwelve indepth semistructured interviews were conducted with a purposeful sample of patients (n=12) with comorbid mental and physical conditions at two IC sites in Toronto between 2017 and 2018. Data were collected and analysed using grounded theory approach.ResultsFour themes emerged in our analysis reflecting patients’ perspectives on patient-centred care experience in IC: (1) caring about me; (2) collaborating with me; (3) helping me understand and self-manage my care; and (4) personalising care to address my needs. Patients’ experiences of care were primarily shaped by quality of relational interactions with IC team members. Positive interactions with IC team members led to enhanced patient access to care and fostered personalising care plans to address unique needs.ConclusionThis study adds to the literature on creating patient-centredness in IC settings by highlighting the importance of recognising patients’ unique needs and the context of care for the specific patient population.

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“…The protocol for this systematic review and meta-analysis has been registered at the Besides primary care settings, CC is now also provided in other settings, such as in general hospitals and occupational health care [3][4][5][6][7]. It involves a care manager (CM) with training in the treatment of depression and anxiety disorders, a medical doctor (a general practitioner (GP), medical specialist or a pharmacist) and a psychiatrist [8][9][10].…”

Section: Protocol Registration Numbermentioning

confidence: 99%

Illness burden and physical outcomes associated with collaborative care in patients with comorbid depressive disorder in chronic medical conditions: A systematic review and meta-analysis

Sluijs

Castelijns

Eijsbroek

et al. 2018

General Hospital Psychiatry

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Objective Collaborative care (CC) improves depressive symptoms in people with comorbid depressive disorder in chronic medical conditions, but its effect on physical symptoms has not yet systematically been reviewed. This study aims to do so. Methods Systematic review and meta-analysis was conducted using Pubmed, the Cochrane Library, and the European and US Clinical Trial Registers. Eligible studies included randomized controlled trials (RCTs) of CC compared to care as usual (CAU), in primary care and general hospital setting, reporting on physical and depressive symptoms as outcomes. Overall treatment effects were estimated for illness burden, physical outcomes and depression, respectively. Results Twenty RCTs were included, with N = 4774 patients. The overall effect size of CC versus CAU for illness burden was OR 1.64 (95%CI 1.47;1.83), d = 0.27 (95%CI 0.21;0.33). Overall, depression outcomes were better for CC than for CAU. Moderator analyses did not yield statistically significant differences. Conclusions CC is more effective than CAU in terms of illness burden, physical outcomes and depression, in patients with comorbid depression in chronic medical conditions. More research covering multiple physical disorders is needed. Corresponding AuthorChristina Van der Feltz-Cornelis Corresponding Author's InstitutionClinical Centre of excellence for Body, Mind and Health, GGz Breburg, Tilburg, The Netherlands Appendix A_searchterm.docx [Figure] Appendix B_PRISMA 2009 checklist.docx [Figure] Appendix C_risk of bias assessment.docx [Figure] Forest plot 1.docx [Figure] Forest plot 2.docx [Figure] Forest plot 3.docx [Figure] Forest plot 4.docx [Figure] Forest plot 5.docx [Figure] Funnel plot 1.docx [Figure] PRISMA flow diagram.docx [Figure] Table] To view all the submission files, including those not included in the PDF, click on the manuscript title on your EVISE Homepage, then click 'Download zip file'. Order of AuthorsDear Dr. Huffman,We have received your comments with regard to our manuscript 'Physical outcomes of collaborative care and illness burden in patients with comorbid depressive disorder in chronic medical conditions: a systematic review and meta-analysis' (GHP_2017_110_R1).We would like to thank you for the fast and careful review of our manuscript, and are pleased that your Journal is interested in considering a revised version. We have carefully attended to the remarks, which were most helpful for improving the manuscript. Enclosed you will also find the revised version of the manuscript, in which we have marked the revisions in yellow.During the revision process we have also changed the title to: 'Illness burden and physical outcomes associated with collaborative care in patients with comorbid depressive disorder in chronic medical conditions: A systematic review and meta-analysis'. We hope that our revised manuscript is suitable for publication in General Hospital Psychiatry. Editor comments and our response:Thank you very much for your comprehensive re...

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A collaborative care team to integrate behavioral health care and treatment of poorly-controlled type 2 diabetes in an urban safety net primary care clinic

Cited by 48 publications

References 22 publications

Barriers and facilitators to community‐based psycho‐oncology services: A qualitative study of health professionals’ attitudes to the feasibility and acceptability of a shared care model

Barriers and facilitators to community‐based psycho‐oncology services: A qualitative study of health professionals’ attitudes to the feasibility and acceptability of a shared care model

“Caring About Me": a pilot framework to understand patient-centered care experience in integrated care - a qualitative study

Illness burden and physical outcomes associated with collaborative care in patients with comorbid depressive disorder in chronic medical conditions: A systematic review and meta-analysis

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