Tuesday, June 25, 2013

Integrated Care Driven by Health Reform Law, Mounting Evidence of Effectiveness

Integrated care, also known as collaborative care, is poised to transform the U.S. health system, and with it the care of people with mental illness. That’s what psychiatrist Wayne Katon, M.D., says in an interview published online June 19 in the “Medical News and Perspectives Column” of JAMA. Katon, a leader in integrated care, says the movement toward collaborative care models is driven by the Affordable Care Act and a growing body of evidence showing the effectiveness of integrated care models for complex conditions, including psychiatric illness. (Integrated care refers to a model of patient-centered, multidisciplinary care emphasizing population-based care, measurement-based care, and integration of psychiatric expertise into primary care.)

“Extensive evidence from clinical trials shows that the collaborative care model can almost double the rates of exposure to evidence-based depression/anxiety treatments as well as markedly improve clinical outcomes for patients with depression and anxiety,” Katon said. “More recent evidence also suggests that many people with depression have comorbid medical illnesses. In a 2010 trial, we aimed to improve care for depression and poorly controlled diabetes and/or heart disease with a multicondition collaborative care model. It improved not only the patients’ depression-related outcomes, but also improved blood glucose, systolic blood pressure,  and LDL cholesterol and reduced overall medical costs.”

Look for a special series of articles on integrated care to begin in Psychiatric News in July. For other news about collaborative care, see Psychiatric News here. Also see an Open Forum in Psychiatric Services on this topic here.

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