Literature DB >> 23150068

Integrated care: treatment initiation following positive depression screens.

Benjamin R Szymanski1, Kipling M Bohnert, Kara Zivin, John F McCarthy.   

Abstract

BACKGROUND: Primary Care-Mental Health Integration (PC-MHI) may improve mental health services access and continuity of care.
OBJECTIVE: To assess whether receipt of integrated PC-MHI services on the date of an initial positive depression screen influences receipt of depression treatment among primary care (PC) patients in the Veterans Health Administration.
DESIGN: Retrospective cohort study.
SUBJECTS: Thirty-six thousand, two hundred and sixty-three PC patients with positive depression screens between October 1, 2009 and September 30, 2010. MAIN MEASURES: Subjects were assessed for depression diagnosis and initiation of antidepressants or psychotherapy on the screening day, within 12 weeks, and within 6 months. Among individuals with PC encounters on the screening day, setting of services received that day was categorized as PC only, PC-MHI, or Specialty Mental Health (SMH). Using multivariable generalized estimating equations (GEE) logistic regression, we assessed likelihood of treatment initiation, adjusting for demographic and clinical measures, including depression screening score. KEY
RESULTS: Patients who received same-day PC-MHI services were more likely to initiate psychotherapy (OR: 8.16; 95 % CI: 6.54-10.17) and antidepressant medications (OR: 2.33, 95 % CI: 2.10-2.58) within 12 weeks than were those who received only PC services on the screening day.
CONCLUSIONS: Receipt of same-day PC-MHI may facilitate timely receipt of depression treatment.

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Year:  2012        PMID: 23150068      PMCID: PMC3579958          DOI: 10.1007/s11606-012-2218-y

Source DB:  PubMed          Journal:  J Gen Intern Med        ISSN: 0884-8734            Impact factor:   5.128


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