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Cited by 603Psychiatric care and mental health servicesMental Health Treatment and AccessPrimary Care and Health Outcomes

Comparative Effectiveness of Collaborative Chronic Care Models for Mental Health Conditions Across Primary, Specialty, and Behavioral Health Care Settings: Systematic Review and Meta-Analysis

Woltmann, Emily, Grogan-Kaylor, Andrew, Perron, Brian, Georges, Hebert, Kilbourne, Amy M., Bauer, Mark S.·2012·American Journal of Psychiatry
DOI 10.1176/appi.ajp.2012.11111616
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Abstract

OBJECTIVE: Collaborative chronic care models (CCMs) improve outcome in chronic medical illnesses and depression treated in primary care settings. The effect of such models across other treatment settings and mental health conditions has not been comprehensively assessed. The authors performed a systematic review and meta-analysis to assess the comparative effectiveness of CCMs for mental health conditions across disorders and treatment settings. METHOD: Randomized controlled trials comparing CCMs with other care conditions, published or in press by August 15, 2011, were identified in a literature search and through contact with investigators. CCMs were defined a priori as interventions with at least three of the six components of the Improving Chronic Illness Care initiative (patient self-management support, clinical information systems, delivery system redesign, decision support, organizational support, and community resource linkages). Articles were included if the CCM effect on mental health symptoms or mental quality of life was reported. Data extraction included analyses of these outcomes plus social role function, physical and overall quality of life, and costs. Meta-analyses included comparisons using unadjusted continuous measures. RESULTS: Seventy-eight articles yielded 161 analyses from 57 trials (depression, N=40; bipolar disorder, N=4; anxiety disorders, N=3; multiple/other disorders, N=10). The meta-analysis indicated significant effects across disorders and care settings for depression as well as for mental and physical quality of life and social role function (Cohen's d values, 0.20-0.33). Total health care costs did not differ between CCMs and comparison models. A systematic review largely confirmed and extended these findings across conditions and outcome domains. CONCLUSIONS: CCMs can improve mental and physical outcomes for individuals with mental disorders across a wide variety of care settings, and they provide a robust clinical and policy framework for care integration.

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  • Screening and behavioral health programs integrated into routine practice can mitigate the deleterious effects of alcohol use disorder, substance abuse, and depression in patients with chronic liver disease.

    “Screening and behavioral health programs integrated into routine practice can mitigate the deleterious effects of such illnesses but have not been adopted in hepatology practices.”

    From A Behavioral Health Program for Alcohol Use Disorder, Substance Abuse, and Depression in Chronic Liver Disease (2019) · cites this paper as [1]

  • Behavioral health interventions integrated into routine clinical practice for chronic diseases have been shown to achieve the triple aim of improved health outcome, better quality of care, and reduced health care costs.

    “Behavioral health interventions integrated into routine clinical practice for chronic diseases have been shown to achieve the triple aim of improved health outcome, better quality of care, and reduced health care costs.1, 2”

    From A Behavioral Health Program for Alcohol Use Disorder, Substance Abuse, and Depression in Chronic Liver Disease (2019) · cites this paper as [1]

  • The chronic care model has been shown in multiple randomized trials to improve physical and mental health outcomes across different mental disorders with little to no added cost.

    “The chronic care model has been shown in multiple randomized trials to improve physical and mental health outcomes across different mental disorders, with little to no added cost 42 .”

    From Measuring and improving the quality of mental health care: a global perspective (2018) · cites this paper as [42]

  • Collaborative care models have demonstrated to be effective and cost-effective in the treatment of depression.

    “Collaborative care models, which involve primary care teams working in coordination with case managers and mental health specialists [12], have demonstrated to be effective and cost-effective in the treatment of depression [13]”

    From A remote collaborative care program for patients with depression living in rural areas: open-label trial (2018) · cites this paper as [13]

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Authors
Woltmann, E., Grogan-Kaylor, A., Perron, B., Georges, H., Kilbourne, A. M., & Bauer, M. S.
Affiliations
  • Harvard University (US)
  • From the Brown School, Washington University, St. Louis; School of Social Work, University of Michigan, Ann Arbor, Mich.; Harvard South Shore Psychiatry Residency Training Program, Harvard Medical School, Brockton, Mass.; Ann Arbor VA Medical Center, Ann Arbor; Department of Psychiatry, University of Michigan Health System, Ann Arbor; Center for Organization, Leadership, and Management Research, VA Boston Healthcare System, Boston.
ORCID
Venue
American Journal of Psychiatry
Publisher
American Psychiatric Association Publishing
Published
2012-08
Volume
169
Issue
8
Pages
790-804
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
DOI
10.1176/appi.ajp.2012.11111616
OpenAlex
W2168474679
Cited by
603
References
130
Citations by year
2026: 30 · 2025: 22 · 2024: 38 · 2023: 43 · 2022: 36 · 2021: 45 · 2020: 44 · 2019: 52 · 2018: 53 · 2017: 54 · 2016: 57 · 2015: 51 · 2014: 39 · 2013: 32 · 2012: 7
FWCI
6.00
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Mental Health (R01MH079994)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
Keywords
mental illness, depression, bipolar disorder, anxiety disorders, quality of life, health care costs, integrated care, primary care, behavioral health services, specialist care
MeSH terms
Mental Disorders, Cooperative Behavior, Delivery of Health Care, Humans, Long-Term Care, Medicine, Mental Health Services, Primary Health Care, Models, Organizational, Comparative Effectiveness Research

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