Effectiveness of telephone-based referral care management, a brief intervention to improve psychiatric treatment engagement.
Effectiveness of telephone-based referral care management, a brief intervention to improve psychiatric treatment engagement.
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基于电话的转诊护理管理的有效性，这是提高精神科治疗参与度的简短干预措施。
DOI：
10.1176/ps.2008.59.7.776
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
Oslin,David
中科院分区：
文献类型：
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作者：
Zanjani,Faika;Miller,Bree;Turiano,Nicholas;Ross,Jennifer;Oslin,David
方法2005年9月至2006年5月，费城退伍军人医疗中心169名初级保健患者完成精神科诊断性访谈，确定需要精神科护理。在符合条件的患者总数中，113名(67%)给予知情同意，并被随机分配接受常规护理或干预。通常的护理包括参与者被安排在行为健康护理预约时间，然后是一封信和电话提醒。干预组接受同样的治疗，外加一到两次简短的励志电话会议。参与者访谈和医疗记录提供了研究数据。结果研究参与者主要是22-83岁的非裔美国人。在样本中，40名患者(39%)患有严重抑郁症，40名(39%)有药物使用问题，33名(22%)同时患有严重抑郁和药物滥用。总体而言，干预组有40名参与者(70%)，而常规护理组有18名参与者(32%)至少接受了一次精神治疗(P<；001)。分析还表明，平均而言，与常规护理组(不到两次)相比，干预组参加了更多的预约(超过三次)(p=。结论TBR-CM干预计划在提高精神疾病治疗参与度方面是有效的。未来的研究是必要的，以检验TBR-CM在更多异质和更大样本中的有效性，并评估干预提供的经济效益和成本(精神病学服务59：776-781,2008)。
ObjectiveThis study examined the effectiveness of a telephone-based referral care management (TBR-CM) intervention for improving engagement in psychiatric treatment.MethodsFrom September 2005 to May 2006, 169 primary care patients at the Philadelphia Veterans Affairs Medical Center completed a psychiatric diagnostic interview and were identified as needing psychiatric care. From this total of eligible patients, 113 (67%) gave informed consent and were randomly assigned to receive either usual care or the intervention. Usual care consisted of participants’ being schedule for a behavioral health care appointment, followed by a letter and reminder by telephone. The intervention group received the same, plus one or two brief motivational telephone sessions. Participant interviews and medical records provided study data.ResultsResearch participants were primarily African American and 22–83 years old. In the sample, 40 patients (39%) had severe depression, 40 (39%) had substance use problems, and 33 (22%) had co-occurring severe depression and substance abuse. Overall, 40 participants (70%) in the intervention group compared with 18 (32%) in the usual care group engaged in at least one psychiatric treatment appointment (p<. 001). Analyses also indicated that on average the intervention group attended more appointments (more than three) compared with the usual care group (less than two)(p=. 008).ConclusionsThe TBR-CM intervention program was effective at improving psychiatric treatment engagement. Future research is necessary to examine effectiveness of TBR-CM in more heterogeneous and larger samples and to evaluate economic benefits versus costs of intervention delivery.(Psychiatric Services 59: 776–781, 2008)