Impact of Integrated Care Pathways Within the Framework of Collaborative Care on Older Adults With Anxiety, Depression, or Mild Cognitive Impairment.
Am J Geriatr Psychiatry
; 30(7): 834-847, 2022 07.
Article
em En
| MEDLINE
| ID: mdl-35221215
ABSTRACT
OBJECTIVES:
To evaluate the impact of an Integrated Care Pathway (ICP) within a collaborative care framework for anxiety, depression and mild cognitive impairment (MCI) on clinical outcomes, quality of life, and time to treatment initiation.DESIGN:
Prospective Cohort study.SETTING:
Primary care practices in Toronto and Hamilton, Ontario, Canada.PARTICIPANTS:
Patients of participating primary care practices born in the years 1950 to 1958. SAMPLE SIZE Target 150 participants, 75 in ICP and 75 in Treatment-As-Usual (TAU) arm. INTERVENTION ICP within a collaborative care framework and TAU. METHODS ANDRESULTS:
One hundred forty-five participants with anxiety, depression or MCI, from five primary care practices were enrolled 69 were managed as per ICP and 76 as per TAU. All underwent outcome assessments at 6, 12, 18, and 24 months. Compared to TAU, ICP participants had a significantly higher rate of improvement in depression symptoms (ß = -0.620, F (1, 256) = 4.10, p = 0.044), anxiety symptoms (ß = -0.593, F (1, 223) = 4.00, p = 0.047), and quality of life (ß = 1.351, F(1, 358) = 6.58, p = 0.011). The ICP group had also a significantly higher "hazard" of treatment initiation (HR = 3.557; 95% CI [2.228, 5.678]; p < 0.001) after controlling for age, gender and baseline severity of symptoms compared to TAU group.CONCLUSIONS:
Use of an ICP within a collaborative care framework in primary care settings for anxiety, depression and MCI among older adults, results in faster reductions in clinical symptoms and improvement in quality of life compared to usual care, as well as faster access to recommended treatments.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Prestação Integrada de Cuidados de Saúde
/
Disfunção Cognitiva
Tipo de estudo:
Guideline
/
Observational_studies
Limite:
Aged
/
Humans
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article