Thursday, March 27, 2014

Study Shows Benefits of Collaborative Care in Pediatric Practices

A collaborative care model based in pediatric practices showed significant advantages over enhanced usual care in a randomized trial, reported David Kolko, Ph.D., a professor of psychiatry, psychology, and pediatrics at the University of Pittsburgh School of Medicine, and colleagues online in Pediatrics.

Most (64 percent) of the 321 children in the study (average age, 8 years) were diagnosed with attention–deficit/hyperactivity disorder (ADHD) or disruptive behavior disorder. The Doctor Office Collaborative Care (DOCC) program used treatment based on family-oriented cognitive-behavioral therapy for children with behavioral problems being treated in pediatricians' offices. A care manager in those offices coordinated a variety of interventions for children and their caregivers. Enhanced usual care included psychoeducation and a referral to a local mental health provider.

Children in both cohorts improved over time. However, 99 percent of the children in the DOCC arm of the study used services, compared with 54 percent of those in the enhanced usual care arm, the researchers noted. The former also engaged in more hours and weeks of services, were more likely to complete the course of treatment, and were less likely to need outside referrals or drop out of treatment. The clinicians in the DOCC arm also reported that there was increased involvement with treatment and better ADHD medication management skills.

“Implementing a collaborative care intervention for behavior problems in community pediatric practices is feasible and broadly effective, supporting the utility of integrated behavioral health care services,” the researchers concluded.

For more in Psychiatric News about collaboration with pediatricians on mental health issues, see the article, “Pediatricians Get Help Managing Psychotropic Drugs in Children.”

(Image: Levent Konuk/


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