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积极社区治疗团队服务对象的初级保健咨询模式对健康的早期影响。

Early Health Impacts of a Primary Care Consultation Model for People Served by Assertive Community Treatment teams.

作者信息

Jaisankar Pavithra, Kingman Emily, LaStella Drew, Chow Elisa, Tabasky Edward, Tse Jeanie

机构信息

Weill Cornell Medical Center, New York, NY, USA.

Institute for Community Living, New York, NY, USA.

出版信息

Community Ment Health J. 2025 Apr;61(3):523-530. doi: 10.1007/s10597-024-01359-3. Epub 2024 Oct 4.

DOI:10.1007/s10597-024-01359-3
PMID:39365513
Abstract

The cardiometabolic health outcomes and life expectancy of people living with serious mental illness (SMI) continue to significantly flag behind that of the general population. This study explores the possibility of using the evidence-based Assertive Community Treatment (ACT) model and infrastructure to increase access to primary care and improve cardiometabolic outcomes of people with SMI. Four ACT teams in a large urban area received the services of a primary care consultant who was co-located at a Federally Qualified Health Center (FQHC), met regularly with ACT team clinicians to review a cardiometabolic registry of participants, and engaged participants in primary care services. Health screening rates, primary care utilization, and cardiometabolic outcomes-body mass index, blood pressure, hemoglobin A1c, cholesterol, and tobacco smoking status-were monitored over the course of a year. The efficacy of this integrated care model was also explored through focus groups with ACT team staff and participants. Significant improvements in screening rates were found for the ACT teams that received this integrated care intervention; however, only modest improvements in cardiometabolic outcomes were found. Future longitudinal, multi-site studies are needed to fully determine the impact of integrated care models on the physical health outcomes of this vulnerable population.

摘要

严重精神疾病(SMI)患者的心脏代谢健康状况和预期寿命仍显著落后于普通人群。本研究探讨了利用循证积极社区治疗(ACT)模式及基础设施来增加初级保健服务可及性并改善SMI患者心脏代谢状况的可能性。大城市地区的四个ACT团队接受了一名初级保健顾问的服务,该顾问驻于一家联邦合格健康中心(FQHC),定期与ACT团队的临床医生会面,审查参与者的心脏代谢登记信息,并促使参与者接受初级保健服务。在一年的时间里,对健康筛查率、初级保健利用率以及心脏代谢指标——体重指数、血压、糖化血红蛋白、胆固醇和吸烟状况进行了监测。还通过与ACT团队工作人员和参与者进行焦点小组讨论,探讨了这种综合护理模式的效果。接受这种综合护理干预的ACT团队在筛查率方面有显著提高;然而,在心脏代谢指标方面仅发现了适度改善。未来需要进行纵向、多地点研究,以全面确定综合护理模式对这一弱势群体身体健康状况的影响。

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