title: A Randomized Clinical Trial Investigating the Effect of a Healthcare Access Model for Individuals with Severe Psychiatric Disabilities.
abstract: We conducted a randomized trial to examine a model for integrating primary care into a community mental health setting. Two hundred individuals were recruited and randomly assigned to receive primary care delivered by a nurse practitioner (n = 94) or services-as-usual (n = 106), assessed on health and mental health outcomes, and followed for 12 months. Intent-to-Treat and exposure analyses were conducted and suggest that participants who engaged with the nurse practitioner experienced gains in perceptions of primary care quality. Health benefits accrued for individuals having receiving nurse practitioner services in a mental health setting to address primary care needs.
authors.affiliation: Center for Psychiatric Rehabilitation, Boston University, 940 Commonwealth Ave, West, Boston, MA, USA. erogers@bu.edu.
authors.forename: E Sally
authors.initials: ES
authors.lastname: Rogers
authors.affiliation: Center for Psychiatric Rehabilitation, Boston University, 940 Commonwealth Ave, West, Boston, MA, USA.|Boston University School of Social Work, Boston, MA, USA.
authors.forename: Mihoko
authors.initials: M
authors.lastname: Maru
authors.affiliation: Center for Psychiatric Rehabilitation, Boston University, 940 Commonwealth Ave, West, Boston, MA, USA.|Institute of Child Health, University College London (UCL), London, England.
authors.forename: Megan
authors.initials: M
authors.lastname: Kash-MacDonald
authors.affiliation: Center for Psychiatric Rehabilitation, Boston University, 940 Commonwealth Ave, West, Boston, MA, USA.|Sharp HealthCare, San Diego, CA, USA.
authors.forename: Mariah
authors.initials: M
authors.lastname: Archer-Williams
authors.affiliation: Center for Psychiatric Rehabilitation, Boston University, 940 Commonwealth Ave, West, Boston, MA, USA.|Genzyme, Sanofi, Boston, MA, USA.
authors.forename: Lobat
authors.initials: L
authors.lastname: Hashemi
authors.affiliation: Northeast Health Systems/Health and Education Services, Inc., Beverly, MA, USA.|Salem State University, Salem, MA, USA.
authors.forename: Judith
authors.initials: J
authors.lastname: Boardman
mesh_terms: D000328:Adult; D003156:Community Mental Health Services / Q000458:organization & administration; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration; D006233:Persons with Disabilities / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D057194:Intention to Treat Analysis; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D017146:Models, Organizational; D009722:Nurse Practitioners / Q000458:organization & administration; D011320:Primary Health Care / Q000458:organization & administration; D011581:Psychological Tests; D011795:Surveys and Questionnaires
keywords: Coordination of care; Integrated care; Morbidity and mortality; Nurse practitioner; Physical health; Primary care