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The Resource Future research needs for the integration of mental health/substance abuse and primary care : identification of future research needs from Evidence report/technology assessment no. 173, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by RTI-UNC Evidence-based Practice Center; investigators, Timothy S. Carey ... [et al.], (electronic resource)

Future research needs for the integration of mental health/substance abuse and primary care : identification of future research needs from Evidence report/technology assessment no. 173, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by RTI-UNC Evidence-based Practice Center; investigators, Timothy S. Carey ... [et al.], (electronic resource)

Contributor
Summary
In 2008, the Agency for Healthcare Research and Quality (AHRQ), commissioned the University of Minnesota Evidence-based Practice Center (EPC) to conduct a systematic review of the literature evaluating the integration of mental health and substance abuse treatment with primary care. The review addressed six key questions (KQ); Table A lists a summary of findings, limitations, and future recommendations. The report found substantial evidence for improved outcomes through integrated care, although most of the evidence was for treatment of depression in primary care settings. Studies reported positive results for symptom severity, treatment response, and achievement of remission when compared with usual care. The level of integration did not seem to be related to treatment outcomes. Most of the studies addressed the integration of mental health professionals into primary care; few examined the integration of primary care into mental health. The majority of the studies involved older patients. Some studies that found improved outcomes with integrated care have been largely composed of minority populations. The main barriers to a broader use of integrated care include programmatic costs, insurance coverage, and relationships with multiple payers. The U.S. Department of Veterans Affairs (VA) was shown to offer a good model of a sustained program. Key elements of successful models included active support at all levels of the organization and through specific funding. The authors of the 2008 AHRQ review (Evidence Report/Technology Assessment No. 173) identified multiple research gaps and limitations (summarized in Table ES-1), including conditions other than depression or care integration in younger populations. Other gaps included research in rural areas, examination of the use of information technology (IT), and development of financial models. One of the largest gaps was on integrating medical care into mental health care for patients with serious and persistent mental illness. In February 2010, AHRQ commissioned the RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center (RTI-UNC EPC) to work with stakeholders to develop a prioritized list of future research needs in this area that would inform researchers, funders, practitioners, advocacy groups, patients, and family members. A structured approach, including the AHRQ population, intervention, comparator, outcome, timeframe, setting (PICOTS) framework, to future research needs prioritization is new: this project, therefore, also served as a pilot for development and testing of methods to conduct such an evaluation. In the future, it is anticipated that all AHRQ-sponsored comparative effectiveness research systematic reviews will contain a documentation of future research needs
Language
  • eng
  • eng
Work
Publication
Extent
1 online resource (1 PDF file (1 v. (various pagings)))
Note
  • Title from PDF t.p
  • "September 2010."
Instance
Label
Future research needs for the integration of mental health/substance abuse and primary care : identification of future research needs from Evidence report/technology assessment no. 173
Title
Future research needs for the integration of mental health/substance abuse and primary care
Title remainder
identification of future research needs from Evidence report/technology assessment no. 173
Statement of responsibility
prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by RTI-UNC Evidence-based Practice Center; investigators, Timothy S. Carey ... [et al.]
Contributor
Subject
Genre
Language
  • eng
  • eng
Summary
In 2008, the Agency for Healthcare Research and Quality (AHRQ), commissioned the University of Minnesota Evidence-based Practice Center (EPC) to conduct a systematic review of the literature evaluating the integration of mental health and substance abuse treatment with primary care. The review addressed six key questions (KQ); Table A lists a summary of findings, limitations, and future recommendations. The report found substantial evidence for improved outcomes through integrated care, although most of the evidence was for treatment of depression in primary care settings. Studies reported positive results for symptom severity, treatment response, and achievement of remission when compared with usual care. The level of integration did not seem to be related to treatment outcomes. Most of the studies addressed the integration of mental health professionals into primary care; few examined the integration of primary care into mental health. The majority of the studies involved older patients. Some studies that found improved outcomes with integrated care have been largely composed of minority populations. The main barriers to a broader use of integrated care include programmatic costs, insurance coverage, and relationships with multiple payers. The U.S. Department of Veterans Affairs (VA) was shown to offer a good model of a sustained program. Key elements of successful models included active support at all levels of the organization and through specific funding. The authors of the 2008 AHRQ review (Evidence Report/Technology Assessment No. 173) identified multiple research gaps and limitations (summarized in Table ES-1), including conditions other than depression or care integration in younger populations. Other gaps included research in rural areas, examination of the use of information technology (IT), and development of financial models. One of the largest gaps was on integrating medical care into mental health care for patients with serious and persistent mental illness. In February 2010, AHRQ commissioned the RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center (RTI-UNC EPC) to work with stakeholders to develop a prioritized list of future research needs in this area that would inform researchers, funders, practitioners, advocacy groups, patients, and family members. A structured approach, including the AHRQ population, intervention, comparator, outcome, timeframe, setting (PICOTS) framework, to future research needs prioritization is new: this project, therefore, also served as a pilot for development and testing of methods to conduct such an evaluation. In the future, it is anticipated that all AHRQ-sponsored comparative effectiveness research systematic reviews will contain a documentation of future research needs
Member of
Cataloging source
DNLM
http://bibfra.me/vocab/lite/collectionName
Integration of mental health/substance abuse and primary care
Funding information
Contract No. 290-2007-10056-I.
Government publication
federal national government publication
Illustrations
illustrations
Index
no index present
Literary form
non fiction
Nature of contents
  • dictionaries
  • bibliography
NLM call number
WM 30 AA1
http://library.link/vocab/relatedWorkOrContributorName
  • Carey, Tim
  • Effective Health Care Program
  • United States
  • Research Triangle Institute-University of North Carolina at Chapel Hill Evidence-based Practice Center
Series statement
  • Future research needs papers
  • AHRQ Publication
Series volume
  • no. 3
  • no. 10-EHC069-EF
http://library.link/vocab/subjectName
  • Mental Health Services
  • Substance-Related Disorders
  • Primary Health Care
  • United States
Label
Future research needs for the integration of mental health/substance abuse and primary care : identification of future research needs from Evidence report/technology assessment no. 173, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by RTI-UNC Evidence-based Practice Center; investigators, Timothy S. Carey ... [et al.], (electronic resource)
Instantiates
Publication
Note
  • Title from PDF t.p
  • "September 2010."
Bibliography note
Includes bibliographical references
Color
multicolored
Dimensions
unknown
Extent
1 online resource (1 PDF file (1 v. (various pagings)))
Form of item
online
Specific material designation
remote
System control number
  • 1557900
  • (DNLM)BKSHLF:NBK51247
System details
Mode of access: Internet
Label
Future research needs for the integration of mental health/substance abuse and primary care : identification of future research needs from Evidence report/technology assessment no. 173, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by RTI-UNC Evidence-based Practice Center; investigators, Timothy S. Carey ... [et al.], (electronic resource)
Publication
Note
  • Title from PDF t.p
  • "September 2010."
Bibliography note
Includes bibliographical references
Color
multicolored
Dimensions
unknown
Extent
1 online resource (1 PDF file (1 v. (various pagings)))
Form of item
online
Specific material designation
remote
System control number
  • 1557900
  • (DNLM)BKSHLF:NBK51247
System details
Mode of access: Internet

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