title: Improving Physical Health in Patients With Chronic Mental Disorders: Twelve-Month Results From a Randomized Controlled Collaborative Care Trial.
abstract: Persons with chronic mental disorders are disproportionately burdened with physical health conditions. We determined whether Life Goals Collaborative Care compared to usual care improves physical health in patients with mental disorders within 12 months.
  
  
  
  This single-blind randomized controlled effectiveness study of a collaborative care model was conducted at a midwestern Veterans Affairs urban outpatient mental health clinic. Patients (N = 293 out of 474 eligible approached) with an ICD-9-CM diagnosis of schizophrenia, bipolar disorder, or major depressive disorder and at least 1 cardiovascular disease risk factor provided informed consent and were randomized (February 24, 2010, to April 29, 2015) to Life Goals (n = 146) or usual care (n = 147). A total of 287 completed baseline assessments, and 245 completed 12-month follow-up assessments. Life Goals included 5 weekly sessions that provided semistructured guidance on managing physical and mental health symptoms through healthy behavior changes, augmented by ongoing care coordination. The primary outcome was change in physical health-related quality of life score (Veterans RAND 12-item Short Form Health Survey [VR-12] physical health component score). Secondary outcomes included control of cardiovascular risk factors from baseline to 12 months (blood pressure, lipids, weight), mental health-related quality of life, and mental health symptoms.
  
  
  
  Among patients completing baseline and 12-month outcomes assessments (N = 245), the mean age was 55.3 years (SD = 10.8; range, 25-78 years), and 15.4% were female. Intent-to-treat analysis revealed that compared to those in usual care, patients randomized to Life Goals had slightly increased VR-12 physical health scores (coefficient = 3.21; P = .01).
  
  
  
  Patients with chronic mental disorders and cardiovascular disease risk who received Life Goals had improved physical health-related quality of life.
  
  
  
  ClinicalTrials.gov identifiers: NCT01487668 and NCT01244854.
authors: VA Center for Clinical Management Research, 2215 Fuller Rd, Mailstop 152, Ann Arbor, MI 48105. amykilbo@umich.edu.|VA Center for Clinical Management Research, Ann Arbor, Michigan, USA.|Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA.
authors: Amy M
authors: AM
authors: Kilbourne
authors: VA Center for Clinical Management Research, Ann Arbor, Michigan, USA.
authors: Michelle M
authors: MM
authors: Barbaresso
authors: VA Center for Clinical Management Research, Ann Arbor, Michigan, USA.|Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA.|Department of Pathology, Beaumont Health System, Royal Oak, Michigan, USA.
authors: Zongshan
authors: Z
authors: Lai
authors: VA Center for Clinical Management Research, Ann Arbor, Michigan, USA.|Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA.
authors: Kristina M
authors: KM
authors: Nord
authors: VA Center for Clinical Management Research, Ann Arbor, Michigan, USA.
authors: Margretta
authors: M
authors: Bramlet
authors: VA Center for Clinical Management Research, Ann Arbor, Michigan, USA.|Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA.
authors: David E
authors: DE
authors: Goodrich
authors: VA Center for Clinical Management Research, Ann Arbor, Michigan, USA.|Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.
authors: Edward P
authors: EP
authors: Post
authors: Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.
authors: Daniel
authors: D
authors: Almirall
authors: VA Center for Healthcare Organization and Implementation Research, Boston, Massachusetts, USA.|Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.
authors: Mark S
authors: MS
authors: Bauer
mesh_terms: D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D002908:Chronic Disease; D015897:Comorbidity; D015444:Exercise; D005260:Female; D006304:Health Status; D006801:Humans; D033183:Interdisciplinary Communication; D000070516:Intersectoral Collaboration; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011788:Quality of Life / Q000523:psychology; D016037:Single-Blind Method; D016896:Treatment Outcome