Evidence map›Paper›PMID 39168856›Full record

ArticleHealth services research2024

Primary care mental health integration to improve early treatment engagement for veterans who screen positive for depression.

Lucinda B Leung, Karen Chu, Danielle E Rose, Susan E Stockdale, Edward P Post, Jennifer S Funderburk, Lisa V Rubenstein

Abstract read
In one paragraph

Article in Health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Lucinda B LeungCenter for the Study of Healthcare Innovation, Implementation, & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.ORCID 0000-0002-8103-8611
Karen ChuCenter for the Study of Healthcare Innovation, Implementation, & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.
Danielle E RoseCenter for the Study of Healthcare Innovation, Implementation, & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.
Susan E StockdaleCenter for the Study of Healthcare Innovation, Implementation, & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.
Edward P PostVA Ann Arbor, Center for Clinical Management Research, Ann Arbor, Michigan, USA.
Jennifer S FunderburkCenter for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, New York, USA.
Lisa V RubensteinDivision of General Internal Medicine and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, California, USA.

Funding

Leveraging COVID-19 to modernize depression care for VA primary care populationsI01HX003635 · VA · VA GREATER LOS ANGELES HEALTHCARE SYSTEM · PI Lucinda B Leung · 2023 to 2026
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Improving Depression Management in Primary CareIK2HX002867 · VA · VA GREATER LOS ANGELES HEALTHCARE SYSTEM · PI LEUNG, LUCINDA B · 2020 to 2025
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HSRD VA I01 HX003635HSRD VA IK2 HX002867United States Department of Veterans Affairs Health Services Research IK2HX002867United States Department of Veterans Affairs Health Services Research & Development 1I01HX003635
6 · The paper itself

Abstract

objectiveTo examine the relationship between the penetration (or reach) of a national program aiming to integrate mental health clinicians into all primary care clinics (PC-MHI) and rates of guideline-concordant follow-up and treatment among clinic patients newly identified with depression in the Veterans Health Administration (VA). DATA SOURCES/STUDY

setting15,155 screen-positive patients 607,730 patients with 2-item Patient Health Questionnaire scores in 82 primary care clinics, 2015-2019. STUDY

designIn this retrospective cohort study, we used established depression care quality measures to assess primary care patients who (a) newly screened positive (score ≥3) and (b) were identified with depression by clinicians via diagnosis and/or medication (n = 15,155; 15,650 patient-years). Timely follow-up included ≥3 mental health, ≥3 psychotherapy, or ≥3 primary care visits for depression. Minimally appropriate treatment included ≥4 mental health visits, ≥3 psychotherapy, or ≥60 days of medication. In multivariate regressions, we examined whether higher rates of PC-MHI penetration in clinic (proportion of total primary care patients in a clinic who saw any PC-MHI clinician) were associated with greater depression care quality among cohort patients, adjusting for year, healthcare system, and patient and clinic characteristics. DATA COLLECTION/EXTRACTION

methodsElectronic health record data from 82 VA clinics across three states. PRINCIPAL

findingsA median of 9% of all primary care patients were seen by any PC-MHI clinician annually. In fully adjusted models, greater PC-MHI penetration was associated with timely depression follow-up within 84 days (∆P = 0.5; SE = 0.1; p < 0.001) and 180 days (∆P = 0.3; SE = 0.1; p = 0.01) of a positive depression screen. Completion of at least minimal treatment within 12 months was high (77%), on average, and not associated with PC-MHI penetration.

conclusionsGreater PC-MHI program penetration was associated with early depression treatment engagement at 84-/180-days among clinic patients newly identified with depression, with no effect on already high rates of completion of minimally sufficient treatment within the year.

Indexed as

DepressionPrimary Health CareUnited States Department of Veterans AffairsVeteransAdultAgedDelivery of Health Care, IntegratedFemaleHumansMaleMental Health ServicesMiddle AgedRetrospective StudiesUnited Statesaccessdepressionmental healthprimary carescreeningveterans

Identifiers

PMID39168856
PMCPMC11540560

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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.