Evidence map›Paper›PMID 38370852›Full record

ArticlemedRxiv : the preprint server for health sciences2024

Effects of intervention stage completion in an integrated behavioral health and primary care randomized pragmatic intervention trial.

Kari A Stephens, Constance van Eeghen, Zihan Zheng, Tracy Anastas, Kris Pui Kwan Ma, Maria G Prado, Jessica Clifton, Gail Rose, Daniel Mullin, Kwun C G Chan and 1 more

Abstract readPreprint
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Kari A StephensDepartment of Family Medicine, University of Washington, Seattle, WA 98195, USA.ORCID 0000-0002-2520-5526
Constance van EeghenDepartment of Medicine, University of Vermont, Burlington, VT 05405, USA.ORCID 0000-0001-8591-5004
Zihan ZhengDepartment of Family Medicine, University of Washington, Seattle, WA 98195, USA.
Tracy AnastasDepartment of Family Medicine, University of Washington, Seattle, WA 98195, USA.ORCID 0000-0001-8706-5760
Kris Pui Kwan MaDepartment of Family Medicine, University of Washington, Seattle, WA 98195, USA.ORCID 0000-0003-4198-0052
Maria G PradoDepartment of Family Medicine, University of Washington, Seattle, WA 98195, USA.
Jessica CliftonDepartment of Medicine, University of Vermont, Burlington, VT 05405, USA.ORCID 0000-0002-3254-9386
Gail RoseDepartment of Psychiatry, University of Vermont, Burlington, VT 05405, USA.ORCID 0000-0003-4997-401X
Daniel MullinDepartment of Family Medicine and Community Health, UMass Chan Medical School, Worcester, MA 01655, USA.ORCID 0000-0001-7121-9403
Kwun C G ChanDepartment of Biostatistics, University of Washington, Seattle, WA 98195, USA.
Rodger KesslerDepartment of Family Medicine, University of Colorado, Denver, CO 80217, USA.

Funding

Transform Dissemination and Implementation Science in CTSA ProgramsUL1TR002319 · NCATS · UNIVERSITY OF WASHINGTON · PI John K. Amory · 2017 to 2026
$100.0M
Psychiatry Primary Care NRSA T-32 AwardT32MH020021 · NIMH · UNIVERSITY OF WASHINGTON · PI JOHN C. FORTNEY, JURGEN UNUTZER · 1998 to 2026
$5.6M
NCATS NIH HHS UL1 TR002319NIMH NIH HHS T32 MH020021
6 · The paper itself

Abstract

Purpose: A pragmatic, cluster-randomized controlled trial of a comprehensive practice-level, multi-staged practice transformation intervention aimed to increase behavioral health integration in primary care practices and improve patient outcomes. We examined association between the completion of intervention stages and patient outcomes across a heterogenous national sample of primary care practices. Methods: Forty-two primary care practices across the U.S. with co-located behavioral health and 2,426 patients with multiple chronic medical and behavioral health conditions completed surveys at baseline, midpoint and two year follow-up. Effects of the intervention on patient health and primary care integration outcomes were examined using multilevel mixed-effects models, while controlling for baseline outcome measurements. Results: No differences were found associated with the number of intervention stages completed in patient health outcomes were found for depression, anxiety, fatigue, sleep disturbance, pain, pain interference, social function, patient satisfaction with care or medication adherence. The completion of each intervention stage was associated with increases in Practice Integration Profile (PIP) domain scores and were confirmed with modeling using multiple imputation for: Workflow 3.5 (95% CI: 0.9-6.1), Integration Methods 4.6 (95% CI: 1.5-7.6), Patient Identification 2.9 (95% CI: 0.9-5.0), and Total Integration 2.7 (95% CI: 0.7-4.7). Conclusion: A practice-centric flexible practice transformation intervention improved integration of behavioral health in primary care across heterogenous primary care practices treating patients with multiple chronic conditions. Interventions that allow practices to flexibly improve care have potential to help complex patient populations. Future research is needed to determine how to best target patient health outcomes at a population level.

Indexed as

integrated behavioral healthmultiple chronic conditionsprimary care

Identifiers

PMID38370852
PMCPMC10871364

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.