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Integrated care: treatment initiation following positive depression screens.
J Gen Intern Med. 2013 Mar; 28(3):346-52.JG

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.

Authors+Show Affiliations

Department of Chronic Disease Epidemiology, Yale School of Public Heath, New Haven, CT 06520-8034, USA. benjamin.szymanski@yale.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

23150068

Citation

Szymanski, Benjamin R., et al. "Integrated Care: Treatment Initiation Following Positive Depression Screens." Journal of General Internal Medicine, vol. 28, no. 3, 2013, pp. 346-52.
Szymanski BR, Bohnert KM, Zivin K, et al. Integrated care: treatment initiation following positive depression screens. J Gen Intern Med. 2013;28(3):346-52.
Szymanski, B. R., Bohnert, K. M., Zivin, K., & McCarthy, J. F. (2013). Integrated care: treatment initiation following positive depression screens. Journal of General Internal Medicine, 28(3), 346-52. https://doi.org/10.1007/s11606-012-2218-y
Szymanski BR, et al. Integrated Care: Treatment Initiation Following Positive Depression Screens. J Gen Intern Med. 2013;28(3):346-52. PubMed PMID: 23150068.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Integrated care: treatment initiation following positive depression screens. AU - Szymanski,Benjamin R, AU - Bohnert,Kipling M, AU - Zivin,Kara, AU - McCarthy,John F, Y1 - 2012/11/13/ PY - 2012/02/02/received PY - 2012/08/08/accepted PY - 2012/07/11/revised PY - 2012/11/15/entrez PY - 2012/11/15/pubmed PY - 2013/8/24/medline SP - 346 EP - 52 JF - Journal of general internal medicine JO - J Gen Intern Med VL - 28 IS - 3 N2 - 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. SN - 1525-1497 UR - https://www.unboundmedicine.com/medline/citation/23150068/Integrated_care:_treatment_initiation_following_positive_depression_screens_ L2 - https://dx.doi.org/10.1007/s11606-012-2218-y DB - PRIME DP - Unbound Medicine ER -