TY - JOUR
KW - Adult
KW - Behavioral Medicine/organization & administration
KW - Cardiovascular Diseases/therapy
KW - community mental health
KW - Community Mental Health Centers
KW - Comorbidity
KW - Delivery of Health Care, Integrated/organization & administration
KW - Female
KW - Georgia
KW - Health Home
KW - Humans
KW - integration
KW - internal medicine
KW - Male
KW - Mental Disorders/therapy
KW - Middle Aged
KW - Outcome Assessment (Health Care)/organization & administration
KW - Patient-Centered Care/organization & administration
KW - primary care
KW - Primary Health Care/organization & administration
KW - Quality Improvement/organization & administration
KW - Single-Blind Method
AU - B. G. Druss
AU - S. A. von Esenwein
AU - G. E. Glick
AU - E. Deubler
AU - C. Lally
AU - M. C. Ward
AU - K. J. Rask
A1 - 
AB - OBJECTIVE: Behavioral health homes provide primary care health services to patients with serious mental illness treated in community mental health settings. The objective of this study was to compare quality and outcomes of care between an integrated behavioral health home and usual care. METHOD: The study was a randomized trial of a behavioral health home developed as a partnership between a community mental health center and a Federally Qualified Health Center. A total of 447 patients with a serious mental illness and one or more cardiometabolic risk factors were randomly assigned to either the behavioral health home or usual care for 12 months. Participants in the behavioral health home received integrated medical care on-site from a nurse practitioner and a full-time nurse care manager subcontracted through the health center. RESULTS: Compared with usual care, the behavioral health home was associated with significant improvements in quality of cardiometabolic care, concordance of treatment with the chronic care model, and use of preventive services. For most cardiometabolic and general medical outcomes, both groups demonstrated improvement, although there were no statistically significant differences between the two groups over time. CONCLUSIONS: The results suggest that it is possible, even under challenging real-world conditions, to improve quality of care for patients with serious mental illness and cardiovascular risk factors. Improving quality of medical care may be necessary, but not sufficient, to improve the full range of medical outcomes in this vulnerable population.
BT - The American Journal of Psychiatry
C5 - Education & Workforce
CP - 3
CY - United States
DO - 10.1176/appi.ajp.2016.16050507
IS - 3
JF - The American Journal of Psychiatry
N2 - OBJECTIVE: Behavioral health homes provide primary care health services to patients with serious mental illness treated in community mental health settings. The objective of this study was to compare quality and outcomes of care between an integrated behavioral health home and usual care. METHOD: The study was a randomized trial of a behavioral health home developed as a partnership between a community mental health center and a Federally Qualified Health Center. A total of 447 patients with a serious mental illness and one or more cardiometabolic risk factors were randomly assigned to either the behavioral health home or usual care for 12 months. Participants in the behavioral health home received integrated medical care on-site from a nurse practitioner and a full-time nurse care manager subcontracted through the health center. RESULTS: Compared with usual care, the behavioral health home was associated with significant improvements in quality of cardiometabolic care, concordance of treatment with the chronic care model, and use of preventive services. For most cardiometabolic and general medical outcomes, both groups demonstrated improvement, although there were no statistically significant differences between the two groups over time. CONCLUSIONS: The results suggest that it is possible, even under challenging real-world conditions, to improve quality of care for patients with serious mental illness and cardiovascular risk factors. Improving quality of medical care may be necessary, but not sufficient, to improve the full range of medical outcomes in this vulnerable population.
PP - United States
PY - 2017
SN - 1535-7228; 0002-953X
SP - 246
EP - 255
EP - 
T1 - Randomized Trial of an Integrated Behavioral Health Home: The Health Outcomes Management and Evaluation (HOME) Study
T2 - The American Journal of Psychiatry
TI - Randomized Trial of an Integrated Behavioral Health Home: The Health Outcomes Management and Evaluation (HOME) Study
U1 - Education & Workforce
U2 - 27631964
U3 - 10.1176/appi.ajp.2016.16050507
VL - 174
VO - 1535-7228; 0002-953X
Y1 - 2017
ER -