TY - JOUR
KW - community psychiatry
KW - Medical morbidity and mortality in psychiatric patients
KW - Behavioral health home
KW - cardiometabolic outcomes
KW - Peer support
KW - self-management and peer support
KW - serious mental illness
AU - K. L. Fortuna
AU - P. R. DiMilia
AU - M. C. Lohman
AU - B. P. Cotton
AU - J. R. Cummings
AU - S. J. Bartels
AU - J. A. Batsis
AU - S. I. Pratt
A1 - 
AB - OBJECTIVE: This systematic review examined the impact of health homes on cardiometabolic risk among adults with serious mental illness. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures were used to conduct the systematic review. Databases were searched for peer-reviewed articles published between 1946 and August 2018 that compared health homes with a control condition (e.g., usual care and secondary data analyses using matched samples). Participants, interventions, comparisons, outcomes, and study design criteria were used to assess study eligibility. Studies were assessed for methodological quality by using the Quality Assessment of Before and After Studies With No Control Group and the Quality Assessment of Controlled Intervention Studies. RESULTS: Eighteen studies (i.e., 11 observational studies, four quasi-experimental studies, and three randomized controlled trials) reported on 17 health homes. Most studies reported increases in receipt of screening for cardiometabolic risk factors and service use. There was a modest reduction in selected cardiometabolic risk factors among people with serious mental illness, but clinical outcomes varied widely among studies. CONCLUSIONS: Improvement in cardiometabolic risk factors varied across the studies, and the clinical significance of these reductions was not clear. Peer support and self-management training may represent strategies to improve cardiometabolic risk factors. Colocation of services may not be enough to significantly affect cardiometabolic risk factors. Health homes that include standardized screening, peer support and self-management training, and intervention components that target interdependent risk factors may have a greater impact on clinical outcomes.
AD - CDC Health Promotion Research Center at Dartmouth (Fortuna, Pratt) and Department of Psychiatry, Geisel School of Medicine at Dartmouth (Fortuna, DiMilia, Pratt), Lebanon, New Hampshire; Arnold School of Public Health, University of South Carolina, Columbia (Lohman); College of Nursing, University of Rhode Island, Kingston (Cotton); Department of Health Policy and Management, Emory University, Atlanta (Cummings); Mongan Institute at Massachusetts General Hospital, Harvard University, Boston (Bartels); Section of General Internal Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, and the Dartmouth Institute at the Geisel School of Medicine at Dartmouth, Hanover, New Hampshire (Batsis).; CDC Health Promotion Research Center at Dartmouth (Fortuna, Pratt) and Department of Psychiatry, Geisel School of Medicine at Dartmouth (Fortuna, DiMilia, Pratt), Lebanon, New Hampshire; Arnold School of Public Health, University of South Carolina, Columbia (Lohman); College of Nursing, University of Rhode Island, Kingston (Cotton); Department of Health Policy and Management, Emory University, Atlanta (Cummings); Mongan Institute at Massachusetts General Hospital, Harvard University, Boston (Bartels); Section of General Internal Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, and the Dartmouth Institute at the Geisel School of Medicine at Dartmouth, Hanover, New Hampshire (Batsis).; CDC Health Promotion Research Center at Dartmouth (Fortuna, Pratt) and Department of Psychiatry, Geisel School of Medicine at Dartmouth (Fortuna, DiMilia, Pratt), Lebanon, New Hampshire; Arnold School of Public Health, University of South Carolina, Columbia (Lohman); College of Nursing, University of Rhode Island, Kingston (Cotton); Department of Health Policy and Management, Emory University, Atlanta (Cummings); Mongan Institute at Massachusetts General Hospital, Harvard University, Boston (Bartels); Section of General Internal Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, a(TRUNCATED)
BT - Psychiatric services (Washington, D.C.)
C5 - Healthcare Disparities; Medical Home
CP - 1
CY - United States
DO - 10.1176/appi.ps.201800563
IS - 1
JF - Psychiatric services (Washington, D.C.)
M1 - Journal Article
N2 - OBJECTIVE: This systematic review examined the impact of health homes on cardiometabolic risk among adults with serious mental illness. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures were used to conduct the systematic review. Databases were searched for peer-reviewed articles published between 1946 and August 2018 that compared health homes with a control condition (e.g., usual care and secondary data analyses using matched samples). Participants, interventions, comparisons, outcomes, and study design criteria were used to assess study eligibility. Studies were assessed for methodological quality by using the Quality Assessment of Before and After Studies With No Control Group and the Quality Assessment of Controlled Intervention Studies. RESULTS: Eighteen studies (i.e., 11 observational studies, four quasi-experimental studies, and three randomized controlled trials) reported on 17 health homes. Most studies reported increases in receipt of screening for cardiometabolic risk factors and service use. There was a modest reduction in selected cardiometabolic risk factors among people with serious mental illness, but clinical outcomes varied widely among studies. CONCLUSIONS: Improvement in cardiometabolic risk factors varied across the studies, and the clinical significance of these reductions was not clear. Peer support and self-management training may represent strategies to improve cardiometabolic risk factors. Colocation of services may not be enough to significantly affect cardiometabolic risk factors. Health homes that include standardized screening, peer support and self-management training, and intervention components that target interdependent risk factors may have a greater impact on clinical outcomes.
PP - United States
PY - 2020
SN - 1557-9700; 1075-2730
SP - 57
EP - 74
EP - 
T1 - Systematic Review of the Impact of Behavioral Health Homes on Cardiometabolic Risk Factors for Adults With Serious Mental Illness
T2 - Psychiatric services (Washington, D.C.)
TI - Systematic Review of the Impact of Behavioral Health Homes on Cardiometabolic Risk Factors for Adults With Serious Mental Illness
U1 - Healthcare Disparities; Medical Home
U2 - 31500547
U3 - 10.1176/appi.ps.201800563
VL - 71
VO - 1557-9700; 1075-2730
Y1 - 2020
Y2 - Jan 1
ER -