Evidence map›Paper›PMID 42706525›Full record

Trial reportBMC health services research2026

Implementing the Primary Care Behavioral Health model into routine practice in Swedish primary care: a pilot trial.

Lise Bergman Nordgren, Kristin Thomas, Erica Skagius Ruiz, Kocher Koshnaw, Mats Fredriksson, Per Nilsen, Hanna Israelsson Larsen

Registry-linked trialAbstract readPragmatic Clinical TrialMulticenter Study
In one paragraph

Trial report in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05633940 (The Effects of Primary Care Behavioral Health in Primary Care in Sweden), which is not on this map. Not yet cited in PubMed.

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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.

NCT05633940 narecruitingnot on this map

The Effects of Primary Care Behavioral Health in Primary Care in Sweden

TypeinterventionalSponsorRegion ÖstergötlandRan2021 to 2026Enrolled500ConditionsPrimary Health Care, Mental Disorder, Behavioral SymptomsArmsImplementation of the service delivery model primary care behavioral health
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

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.

Lise Bergman NordgrenDepartment of Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Kristin ThomasDepartment of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Erica Skagius RuizDepartment of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Kocher KoshnawPrimary Health Care Center, Region Östergötland, Linköping, Sweden.
Mats FredrikssonDepartment of Experimental and Clinical Medicine, Linköping University, Linköping, Sweden.
Per NilsenDepartment of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Hanna Israelsson LarsenDepartment of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden. hanna.israelsson.larsen@liu.se.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMental health problems are an increasing public health concern, and demand for care is exceeding available resources. The Primary Care Behavioral Health (PCBH) service delivery model shows promise for managing mental health problems in primary care, but its effects require further evaluation. This study examined how the implementation of PCBH in standard Swedish primary care was associated with accessibility of behavioral and mental health care and psychotropic prescription patterns.

methodsThis pragmatic multicenter stepped-wedge clinical trial reports results from the first four pilot centers implementing PCBH in southeast Sweden. These centers had 37,100 listed patients. Study participants included all individuals receiving mental health care during the study period (n = 6413, mean age 50 years, 60% women). Data from electronic medical records were analyzed regarding behavioral health consultant (BHC) accessibility (number of appointments and individual patients) and prescriptions of psychotropic drugs (ATC codes: N05A, N05B, N05C, and N06A). Three time periods were compared: baseline (period 1), implementation (period 2), and the year after implementation (period 3).

resultsAfter the implementation of PCBH, mean waiting times for a first BHC appointment decreased between 30% and 39%: from 16 days in period 1 to 10 (period 2) respectively 11 days (period 3), p < 0.001 both comparisons. Waiting times for all BHC appointments decreased between 21% and 24%; from 18 days (period 1) to 13.7 (period 2) respectively 14.2 days (after implementation), p < 0.001 both comparisons. The total number of appointments with a BHC increased between 21% and 34%; from 1762 (period 1) to 2359 (period 2) and then 2127 (period 3), p < 0.001 both comparisons. Individuals receiving care from a BHC increased between 16% and 42%; from 702 (period 1) to 995 (period 2) and 815 (period 3), p < 0.005 both comparisons. The total prescription of psychotropic drugs decreased between 14% and 18%; from 8025 (period 1) to 6570 (period 2) and 6927 (period 3) p < 0.001 both comparisons.

conclusionsThese findings suggest that implementation of PCBH improves access to mental health care and reduces psychotropic prescriptions. However, the improved access to care and reduction in psychotropic medication declined somewhat the year after implementation. Future research should focus on longitudinal outcomes with the use of comparison groups and systematically include patient-reported outcomes, experience measures, and staff perspectives to assess effectiveness and implementation experiences.

trial registrationClinicalTrials.gov (NCT05633940), registered 2021-04-21.

Indexed as

Mental DisordersMental Health ServicesPrimary Health CareAccess to Primary CareAdultFemaleHealth Services AccessibilityHumansMaleMiddle AgedPilot ProjectsPsychotropic DrugsSwedenPsychotropic DrugsClinical trialImplementationMental healthPrimary carePrimary Care Behavioral Health

Identifiers

PMID42706525
PMCPMC13551833

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