Future research needs for the integration of mental health/substance abuse and primary care identification of future research needs from Evidence report/technology assessment no. 173

The majority of the studies involved older patients. Some studies that found improved outcomes with integrated care have been largely composed of minority populations. The main barriers to a broader use of integrated care include programmatic costs, insurance coverage, and relationships with multipl...

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Bibliographic Details
Main Author: Carey, Tim
Corporate Authors: Effective Health Care Program (U.S.), United States Agency for Healthcare Research and Quality, Research Triangle Institute-University of North Carolina Evidence-based Practice Center
Format: eBook
Language:English
Published: Rockville, MD Agency for Healthcare Research and Quality 2010, [2010]
Series:Future research needs papers
Subjects:
Online Access:
Collection: National Center for Biotechnology Information - Collection details see MPG.ReNa
Description
Summary:The majority of the studies involved older patients. Some studies that found improved outcomes with integrated care have been largely composed of minority populations. The main barriers to a broader use of integrated care include programmatic costs, insurance coverage, and relationships with multiple payers. The U.S. Department of Veterans Affairs (VA) was shown to offer a good model of a sustained program. Key elements of successful models included active support at all levels of the organization and through specific funding. The authors of the 2008 AHRQ review (Evidence Report/Technology Assessment No. 173) identified multiple research gaps and limitations (summarized in Table ES-1), including conditions other than depression or care integration in younger populations. Other gaps included research in rural areas, examination of the use of information technology (IT), and development of financial models.
In 2008, the Agency for Healthcare Research and Quality (AHRQ), commissioned the University of Minnesota Evidence-based Practice Center (EPC) to conduct a systematic review of the literature evaluating the integration of mental health and substance abuse treatment with primary care. The review addressed six key questions (KQ); Table A lists a summary of findings, limitations, and future recommendations. The report found substantial evidence for improved outcomes through integrated care, although most of the evidence was for treatment of depression in primary care settings. Studies reported positive results for symptom severity, treatment response, and achievement of remission when compared with usual care. The level of integration did not seem to be related to treatment outcomes. Most of the studies addressed the integration of mental health professionals into primary care; few examined the integration of primary care into mental health.
One of the largest gaps was on integrating medical care into mental health care for patients with serious and persistent mental illness. In February 2010, AHRQ commissioned the RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center (RTI-UNC EPC) to work with stakeholders to develop a prioritized list of future research needs in this area that would inform researchers, funders, practitioners, advocacy groups, patients, and family members. A structured approach, including the AHRQ population, intervention, comparator, outcome, timeframe, setting (PICOTS) framework, to future research needs prioritization is new: this project, therefore, also served as a pilot for development and testing of methods to conduct such an evaluation. In the future, it is anticipated that all AHRQ-sponsored comparative effectiveness research systematic reviews will contain a documentation of future research needs
Item Description:Title from PDF t.p. - "September 2010.". - Mode of access: Internet
Physical Description:1 PDF file (various pagings)