Telephone-based psychiatric referral-care management intervention health outcomes.
OBJECTIVE
This study examined the effectiveness of a telephone-based referral-care management (TBR-CM) intervention on psychiatric health outcomes.


METHODS
Between September 2005 and May 2006, primary care patients (n = 169) at the Philadelphia Veterans Affairs Medical Center completed a psychiatric interview over the telephone, of which 113 gave consent and were randomized into the TBR-CM usual care or intervention groups (n = 40 [39%] depression, n = 40 [39%] substance abuse, and n = 33 [22%] comorbid condition: depression and substance abuse). Usual care consisted of participants receiving a psychiatric appointment, followed up with standard institutional reminders. The intervention care group received the same, with the addition of brief motivational telephone sessions. Baseline and 6-month interviews were used to obtain study data.


RESULTS
Results indicated that there was improvement in mental health functioning (p < 0.0001), depression (p < 0.0001), and binge (p < 0.0332) outcomes over the 6-month interview (78% retention). However, there was no change observed for physical health functioning and drinks per week outcomes. For mental health functioning, depression, and binge rates there were no randomization group assignment effects, indicating that the intervention care group did not show better health outcomes despite showing higher levels of psychiatric appointment attendance.


CONCLUSIONS
Patients who are exposed to the intervention have similar health outcomes as patients in usual care. In conclusion, the TBR-CM intervention does not lead to relatively improved psychiatric health outcomes. Further research is necessary to examine the efforts needed to extend increased treatment engagement into improved health outcomes for intervention recipients.
Zanjani
Faika
F
Graduate Center for Gerontology, University of Kentucky, Lexington, Kentucky 40536, USA. f.zanjani@uky.edu
Bush
Heather
H
Oslin
David
D
D003866:Depressive Disorder / Q000175:diagnosis / Q000628:therapy; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D005500:Follow-Up Studies; D006787:Hospitals, Veterans; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D015143:Philadelphia; D015397:Program Evaluation; D011570:Psychiatry / Q000458:organization & administration*; D011614:Psychotherapy, Brief; D012017:Referral and Consultation / Q000458:organization & administration*; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000628:therapy; D013689:Telephone; D014728:Veterans