Kyle Possemato1, Emily M Johnson2, Gregory P Beehler3, Robyn L Shepardson4, Paul King5, Christina L Vair6, Jennifer S Funderburk7, Stephen A Maisto4, Laura O Wray8. 1. VA Center for Integrated Healthcare, New York/New Jersey VA Healthcare System, United States; Department of Psychology, Syracuse University, Syracuse, NY, United States. Electronic address: kyle.possemato@va.gov. 2. VA Center for Integrated Healthcare, New York/New Jersey VA Healthcare System, United States. 3. VA Center for Integrated Healthcare, New York/New Jersey VA Healthcare System, United States; Community Health and Health Behavior, University at Buffalo, Buffalo, NY, United States. 4. VA Center for Integrated Healthcare, New York/New Jersey VA Healthcare System, United States; Department of Psychology, Syracuse University, Syracuse, NY, United States. 5. VA Center for Integrated Healthcare, New York/New Jersey VA Healthcare System, United States; Department of Counseling, School, and Educational Psychology, University at Buffalo, Buffalo, NY, United States. 6. Salisbury VA Health Care System, Salisbury, NC, United States. 7. VA Center for Integrated Healthcare, New York/New Jersey VA Healthcare System, United States; Department of Psychology, Syracuse University, Syracuse, NY, United States; Department of Psychiatry, University of Rochester, Rochester, NY, United States. 8. VA Center for Integrated Healthcare, New York/New Jersey VA Healthcare System, United States; Division of Geriatrics/Palliative Care, Jacobs School of Medicine, University at Buffalo, Buffalo, NY, United States.
Abstract
OBJECTIVE: This systematic review focused on Primary Care Behavioral Health (PCBH) services delivered under normal clinic conditions that included the patient outcomes of: 1) access/utilization of behavioral health services, 2) health status, and 3) satisfaction. METHOD: Following PRISMA guidelines, comprehensive database searches and rigorous coding procedures rendered 36 articles meeting inclusion criteria. The principle summary measures of odd ratios or Cohen's d effect sizes were reported. RESULTS: Due to significant limitations in the methodological rigor of reviewed studies, robust findings only emerged for healthcare utilization: PCBH is associated with shorter wait-times for treatment, higher likelihood of engaging in care, and attending a greater number of visits. Several small, uncontrolled studies report emerging evidence that functioning, depression, and anxiety improve overtime. There was no evidence of greater improvement in patient health status when PCBH was compared to other active treatments. The limited available evidence supports that patient satisfaction with PCBH services is high. CONCLUSIONS: The implementation of PCBH services is ahead of the science supporting the usefulness of these services. Patient outcomes for PCBH are weaker than outcomes for Collaborative Care. More rigorous investigations of patient outcomes associated with PCBH are needed to allow for optimization of services. Published by Elsevier Inc.
OBJECTIVE: This systematic review focused on Primary Care Behavioral Health (PCBH) services delivered under normal clinic conditions that included the patient outcomes of: 1) access/utilization of behavioral health services, 2) health status, and 3) satisfaction. METHOD: Following PRISMA guidelines, comprehensive database searches and rigorous coding procedures rendered 36 articles meeting inclusion criteria. The principle summary measures of odd ratios or Cohen's d effect sizes were reported. RESULTS: Due to significant limitations in the methodological rigor of reviewed studies, robust findings only emerged for healthcare utilization: PCBH is associated with shorter wait-times for treatment, higher likelihood of engaging in care, and attending a greater number of visits. Several small, uncontrolled studies report emerging evidence that functioning, depression, and anxiety improve overtime. There was no evidence of greater improvement in patient health status when PCBH was compared to other active treatments. The limited available evidence supports that patient satisfaction with PCBH services is high. CONCLUSIONS: The implementation of PCBH services is ahead of the science supporting the usefulness of these services. Patient outcomes for PCBH are weaker than outcomes for Collaborative Care. More rigorous investigations of patient outcomes associated with PCBH are needed to allow for optimization of services. Published by Elsevier Inc.
Entities:
Keywords:
Access; Functioning; Primary care behavioral health; Satisfaction; Utilization
Authors: Gregory P Beehler; Jennifer S Funderburk; Paul R King; Kyle Possemato; John A Maddoux; Wade R Goldstein; Michael Wade Journal: J Clin Psychol Med Settings Date: 2020-03
Authors: Allison J Carroll; Anna E Jaffe; Kimberley Stanton; Constance Guille; Gweneth B Lazenby; David E Soper; Amanda K Gilmore; Lauren Holland-Carter Journal: J Clin Psychol Med Settings Date: 2020-06
Authors: Paul R King; Gregory P Beehler; Laura J Buchholz; Emily M Johnson; Laura O Wray Journal: Fam Syst Health Date: 2019-01-07 Impact factor: 1.950