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全面康复:基层医疗与精神病学协作照护模式的国际综述

Healing the Whole: An International Review of the Collaborative Care Model between Primary Care and Psychiatry.

作者信息

Hernandez Veronica, Nasser Lucy, Do Candice, Lee Wei-Chen

机构信息

John Sealy School of Medicine, University of Texas Medical Branch, Galveston, TX 77555, USA.

Department of Family Medicine, University of Texas Medical Branch, Galveston, TX 77555, USA.

出版信息

Healthcare (Basel). 2024 Aug 22;12(16):1679. doi: 10.3390/healthcare12161679.

Abstract

The collaborative care model (CCM) was created to improve the delivery of mental health care and is reported to improve access, enhance treatment outcomes, and reduce healthcare costs. To understand the impacts of the CCM on symptom management, diverse populations, and sustainability in healthcare systems, a systematic review was conducted. Several databases were searched for articles assessing the CCM. The inclusion criteria limited the studies to those (1) published between January 2008 and January 2024; (2) written in the English language; (3) analyzing adult patients; (4) analyzing symptom improvement in major depressive disorder, generalized anxiety disorder, or post-traumatic stress disorder; and (5) fitting the given definition of a CCM. We identified 9743 articles. Due to missing information or duplication, 4702 were excluded. The remaining articles were screened, yielding 468 articles for full-text analysis, of which 16 articles met the inclusion criteria. Of these articles, five primarily focused on individual patient outcomes, five focused on specific populations, and six reviewed system impacts; eleven articles studied US populations and five studied international populations. An analysis revealed that in 12 of the final articles, the CCM led to a statistically significant improvement in anxiety and depression symptoms with viable implementation and sustainability strategies. The CCM is an effective method for improving patient symptoms and can be potentially affordable in healthcare systems.

摘要

协作护理模式(CCM)旨在改善心理健康护理服务,据报道,该模式能改善就医机会、提高治疗效果并降低医疗成本。为了解CCM对症状管理、不同人群以及医疗系统可持续性的影响,我们进行了一项系统综述。我们在多个数据库中搜索了评估CCM的文章。纳入标准将研究限制为以下这些:(1)2008年1月至2024年1月期间发表;(2)用英语撰写;(3)分析成年患者;(4)分析重度抑郁症、广泛性焦虑症或创伤后应激障碍的症状改善情况;(5)符合CCM的给定定义。我们共识别出9743篇文章。由于信息缺失或重复,排除了4702篇。对剩余文章进行筛选,得到468篇用于全文分析,其中16篇符合纳入标准。在这些文章中,5篇主要关注个体患者的结局,5篇关注特定人群,6篇综述了系统影响;11篇研究了美国人群,5篇研究了国际人群。分析表明,在最终的12篇文章中,CCM通过可行的实施和可持续性策略,在焦虑和抑郁症状方面带来了具有统计学意义的改善。CCM是改善患者症状的有效方法,在医疗系统中可能具有成本效益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa09/11353489/2dc6195936a4/healthcare-12-01679-g001.jpg

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