OBJECTIVE: Collaborative chronic care models (CCMs) improve outcome in chronic medical illnesses and depression treated in primary care settings. The effect of such models across other treatment settings and mental health conditions has not been comprehensively assessed. The authors performed a systematic review and meta-analysis to assess the comparative effectiveness of CCMs for mental health conditions across disorders and treatment settings. METHOD: Randomized controlled trials comparing CCMs with other care conditions, published or in press by August 15, 2011, were identified in a literature search and through contact with investigators. CCMs were defined a priori as interventions with at least three of the six components of the Improving Chronic Illness Care initiative (patient self-management support, clinical information systems, delivery system redesign, decision support, organizational support, and community resource linkages). Articles were included if the CCM effect on mental health symptoms or mental quality of life was reported. Data extraction included analyses of these outcomes plus social role function, physical and overall quality of life, and costs. Meta-analyses included comparisons using unadjusted continuous measures. RESULTS: Seventy-eight articles yielded 161 analyses from 57 trials (depression, N=40; bipolar disorder, N=4; anxiety disorders, N=3; multiple/other disorders, N=10). The meta-analysis indicated significant effects across disorders and care settings for depression as well as for mental and physical quality of life and social role function (Cohen's d values, 0.20-0.33). Total health care costs did not differ between CCMs and comparison models. A systematic review largely confirmed and extended these findings across conditions and outcome domains. CONCLUSIONS: CCMs can improve mental and physical outcomes for individuals with mental disorders across a wide variety of care settings, and they provide a robust clinical and policy framework for care integration.
OBJECTIVE: Collaborative chronic care models (CCMs) improve outcome in chronic medical illnesses and depression treated in primary care settings. The effect of such models across other treatment settings and mental health conditions has not been comprehensively assessed. The authors performed a systematic review and meta-analysis to assess the comparative effectiveness of CCMs for mental health conditions across disorders and treatment settings. METHOD: Randomized controlled trials comparing CCMs with other care conditions, published or in press by August 15, 2011, were identified in a literature search and through contact with investigators. CCMs were defined a priori as interventions with at least three of the six components of the Improving Chronic Illness Care initiative (patient self-management support, clinical information systems, delivery system redesign, decision support, organizational support, and community resource linkages). Articles were included if the CCM effect on mental health symptoms or mental quality of life was reported. Data extraction included analyses of these outcomes plus social role function, physical and overall quality of life, and costs. Meta-analyses included comparisons using unadjusted continuous measures. RESULTS: Seventy-eight articles yielded 161 analyses from 57 trials (depression, N=40; bipolar disorder, N=4; anxiety disorders, N=3; multiple/other disorders, N=10). The meta-analysis indicated significant effects across disorders and care settings for depression as well as for mental and physical quality of life and social role function (Cohen's d values, 0.20-0.33). Total health care costs did not differ between CCMs and comparison models. A systematic review largely confirmed and extended these findings across conditions and outcome domains. CONCLUSIONS: CCMs can improve mental and physical outcomes for individuals with mental disorders across a wide variety of care settings, and they provide a robust clinical and policy framework for care integration.
Authors: Robin R Whitebird; Leif I Solberg; Nancy A Jaeckels; Pamela B Pietruszewski; Senka Hadzic; Jürgen Unützer; Kris A Ohnsorg; Rebecca C Rossom; Arne Beck; Kenneth E Joslyn; Lisa V Rubenstein Journal: Am J Manag Care Date: 2014-09 Impact factor: 2.229
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Authors: Emma E McGinty; Alene Kennedy-Hendricks; Sarah Linden; Seema Choksy; Elizabeth Stone; Gail L Daumit Journal: Gen Hosp Psychiatry Date: 2017-12-16 Impact factor: 3.238
Authors: Christopher J Miller; Kevin N Griffith; Kelly Stolzmann; Bo Kim; Samantha L Connolly; Mark S Bauer Journal: Med Care Date: 2020-10 Impact factor: 2.983
Authors: Martha Sajatovic; Sergio A Strejilevich; Ariel G Gildengers; Annemiek Dols; Rayan K Al Jurdi; Brent P Forester; Lars Vedel Kessing; John Beyer; Facundo Manes; Soham Rej; Adriane R Rosa; Sigfried Ntm Schouws; Shang-Ying Tsai; Robert C Young; Kenneth I Shulman Journal: Bipolar Disord Date: 2015-09-19 Impact factor: 6.744
Authors: Sanjay Basu; Bruce E Landon; John W Williams; Asaf Bitton; Zirui Song; Russell S Phillips Journal: J Gen Intern Med Date: 2017-12 Impact factor: 5.128
Authors: Agustín Ciapponi; Simon Lewin; Cristian A Herrera; Newton Opiyo; Tomas Pantoja; Elizabeth Paulsen; Gabriel Rada; Charles S Wiysonge; Gabriel Bastías; Lilian Dudley; Signe Flottorp; Marie-Pierre Gagnon; Sebastian Garcia Marti; Claire Glenton; Charles I Okwundu; Blanca Peñaloza; Fatima Suleman; Andrew D Oxman Journal: Cochrane Database Syst Rev Date: 2017-09-13