TY - JOUR
AU - A. J. Carroll
AU - S. E. Philbin
AU - O. A. Sanuade
AU - E. S. Fu
AU - A. D. Carlo
AU - H. Pedamallu
AU - S. Borisuth
AU - L. J. Rosenthal
AU - J. T. Rado
AU - N. Jordan
AU - I. E. Burnett-Zeigler
AU - C. H. Brown
AU - J. D. Smith
A1 - 
AB - BACKGROUND: Primary care patients with depression or anxiety are at higher risk for cardiovascular disease. Those who engage in integrated mental health treatment may also improve their cardiovascular health. METHODS: We conducted secondary analysis of electronic health record-extracted data related to a pragmatic, implementation trial of the collaborative care model for depression and anxiety (CoCM; NCT04321876). Primary care patients with elevated depressive/anxiety symptoms (N = 3252) in 11 primary care clinics were classified as CoCM Patients (n = 718), Not Referred to CoCM (n = 1348), or Not Engaged in CoCM (n = 1459). Cardiovascular health measures included blood pressure (BP; mmHg), total cholesterol (mg/dL), HbA1c (%), and body mass index (BMI; kg/m(2)). Primary analyses were linear regressions evaluating associations of CoCM treatment (vs. Not Referred, vs. Not Engaged) with changes in cardiovascular health, adjusted for demographics, cardiovascular diagnoses, and medications. RESULTS: At baseline, CoCM Patients had poorer cardiovascular health than Not Referred (higher systolic BP, total cholesterol, BMI) and better cardiovascular health than Not Engaged (lower total cholesterol, HbA1c). CoCM Patients, vs. Not Referred, had small decreases in total cholesterol (B = -0.44, 95 % CI: -0.72, -0.17) and increases in BMI (B = 0.18, 95 % CI: 0.03, 0.34). CoCM Patients did not differ from Not Engaged patients on cardiovascular health outcomes (all ps > 0.05). DISCUSSION: Differences in cardiovascular health profiles were evident prior to treatment. Patients who bengaged in CoCM treatment, compared to patients not referred to CoCM, evidenced small improvements in total cholesterol and increases in BMI. Widespread implementation of integrated mental health treatment may have implications for population cardiovascular health.
AD - Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Center for Dissemination and Implementation Science, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. Electronic address: Allison.carroll@northwestern.edu.; Health Sciences Integrated PhD Program, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.; Department of Population Health Sciences, Division of Health System Innovation and Research, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA.; Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA.; Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; WellBe Senior Medical, Chicago, IL, USA.; Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.; University of Illinois at Chicago School of Medicine, Chicago, IL, USA.; Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.; Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Center of Innovation for Complex Chronic Healthcare, Hines VA Hospital, Hines, IL, USA.
AN - 40541831
BT - J Affect Disord
C5 - Education & Workforce
DA - Jun 18
DO - 10.1016/j.jad.2025.119720
DP - NLM
ET - 20250618
JF - J Affect Disord
LA - eng
N2 - BACKGROUND: Primary care patients with depression or anxiety are at higher risk for cardiovascular disease. Those who engage in integrated mental health treatment may also improve their cardiovascular health. METHODS: We conducted secondary analysis of electronic health record-extracted data related to a pragmatic, implementation trial of the collaborative care model for depression and anxiety (CoCM; NCT04321876). Primary care patients with elevated depressive/anxiety symptoms (N = 3252) in 11 primary care clinics were classified as CoCM Patients (n = 718), Not Referred to CoCM (n = 1348), or Not Engaged in CoCM (n = 1459). Cardiovascular health measures included blood pressure (BP; mmHg), total cholesterol (mg/dL), HbA1c (%), and body mass index (BMI; kg/m(2)). Primary analyses were linear regressions evaluating associations of CoCM treatment (vs. Not Referred, vs. Not Engaged) with changes in cardiovascular health, adjusted for demographics, cardiovascular diagnoses, and medications. RESULTS: At baseline, CoCM Patients had poorer cardiovascular health than Not Referred (higher systolic BP, total cholesterol, BMI) and better cardiovascular health than Not Engaged (lower total cholesterol, HbA1c). CoCM Patients, vs. Not Referred, had small decreases in total cholesterol (B = -0.44, 95 % CI: -0.72, -0.17) and increases in BMI (B = 0.18, 95 % CI: 0.03, 0.34). CoCM Patients did not differ from Not Engaged patients on cardiovascular health outcomes (all ps > 0.05). DISCUSSION: Differences in cardiovascular health profiles were evident prior to treatment. Patients who bengaged in CoCM treatment, compared to patients not referred to CoCM, evidenced small improvements in total cholesterol and increases in BMI. Widespread implementation of integrated mental health treatment may have implications for population cardiovascular health.
PY - 2025
SN - 0165-0327
SP - 119720
ST - Impact of collaborative care model treatment for depression and anxiety on cardiovascular risk factors using electronic health record data
T1 - Impact of collaborative care model treatment for depression and anxiety on cardiovascular risk factors using electronic health record data
T2 - J Affect Disord
TI - Impact of collaborative care model treatment for depression and anxiety on cardiovascular risk factors using electronic health record data
U1 - Education & Workforce
U3 - 10.1016/j.jad.2025.119720
VL - 388
VO - 0165-0327
Y1 - 2025
ER -