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

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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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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: Perron, Brian
Kilbourne, Amy M.
Bauer, Mark S.
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
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Health Sciences › Medicine › Family Practice › 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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Comparative Effectiveness of Collaborative Chronic Care Models for Mental Health Conditions Across Primary, Specialty, and Behavioral Health Care Settings: Systematic Review and Meta-Analysis

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