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成人初级保健中综合行为健康的患者筛查:有效程序的快速综述。

Patient screening for integrated behavioral health in adult primary care: A rapid review of effective procedures.

机构信息

College of Health Solutions.

Department of Family Medicine and Community Health.

出版信息

Fam Syst Health. 2022 Sep;40(3):383-396. doi: 10.1037/fsh0000700. Epub 2022 Jun 2.

Abstract

PURPOSE

Although many primary care clinics screen for behavioral health (BH) conditions using validated tools, it is not clear whether adult BH screening leads to better patient outcomes. Our objective was to determine the evidence base by reviewing effectiveness research for multiple strategies of BH screening in adult primary care identified in the Practice Integration Profile.

METHOD

We conducted five rapid reviews of effectiveness research supporting BH screening strategies cited in the Practice Integration Profile. Each rapid review was conducted using an adapted REAL (Rapid Evidence Assessment of the Literature) methodology and a standardized search tailored for each screening strategy to identify evidence related to BH screening in primary care.

RESULTS

The database search yielded 931 references. Following eligibility review and extraction, we evaluated data from 20 references examining five screening strategies. Results demonstrated limited support for all five strategies and high risk of bias within most studies. Outcomes associated with various BH screening strategies were rarely the focus of study.

CONCLUSIONS

There is an absence of robust, well-structured evidence supporting many of the BH screening strategies advocated for in primary care. Stakeholders may wish to understand how to ensure value when developing a robust screening program that will improve patient health outcomes. Future research should advance the science of BH screen selection, timing, and implementation by answering new questions about screening strategies. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

摘要

目的

尽管许多初级保健诊所使用经过验证的工具来筛查行为健康(BH)状况,但尚不清楚成人 BH 筛查是否会带来更好的患者结局。我们的目的是通过审查实践整合档案中确定的成人初级保健中多种 BH 筛查策略的有效性研究来确定证据基础。

方法

我们对支持实践整合档案中引用的 BH 筛查策略的有效性研究进行了五次快速审查。每次快速审查都使用了改编的 REAL(文献快速评估)方法,并针对每种筛查策略进行了标准化搜索,以确定与初级保健中的 BH 筛查相关的证据。

结果

数据库搜索产生了 931 条参考文献。经过资格审查和提取后,我们评估了来自 20 项研究的五项筛查策略的数据。结果表明,所有五种策略的支持都很有限,而且大多数研究的偏倚风险都很高。与各种 BH 筛查策略相关的结果很少成为研究的焦点。

结论

缺乏有力的、结构良好的证据来支持初级保健中提倡的许多 BH 筛查策略。利益相关者可能希望了解如何在制定能够改善患者健康结果的强大筛查计划时确保价值。未来的研究应通过回答有关筛查策略的新问题,推进 BH 筛查选择、时间安排和实施的科学。(PsycInfo 数据库记录(c)2022 APA,保留所有权利)。

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