Impact of the mental health and dynamic referral for oncology (MHADRO) program on oncology patient outcomes, health care utilization, and health provider behaviors: A multi-site randomized control trial
Impact of the mental health and dynamic referral for oncology (MHADRO) program on oncology patient outcomes, health care utilization, and health provider behaviors: A multi-site randomized control trial
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DOI：
10.1016/j.pec.2019.10.006
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发表时间：
2020-03-01
影响因子：
3.5
通讯作者：
Boudreaux，Edwin D.
中科院分区：
文献类型：
--
作者：
O'Hea，Erin;Kroll-Desrosiers，Aimee;Boudreaux，Edwin D.
MHADRO评估心理社会和医疗需求，提供量身定制的反馈报告，并将患者与心理健康提供者联系起来。本研究探讨了MHADRO的影响，对患者的结果，医疗保健的利用，和肿瘤提供者的文件和behaviors.Methods836例患者的一部分，一个多站点随机对照试验和评估进行了基线，2，6和12 months.ResultsThe干预组从事较少的紧急呼叫供应商。在随访评估中，心理社会结局无差异。干预组患者的提供者更有可能：记录心理社会症状和病史;参考心理社会服务;鼓励支持团体;在访问期间寻求心理评估。同意心理健康转诊的患者住院率降低，心理健康护理互动增加，咨询潜在益处评级更高。这组还报告增加心理困扰在所有后续assessment.ConclusionThe MHADRO可能会增加获得精神卫生保健，减少利用，并改善供应商的心理社会需求的管理，但似乎并没有影响整体功能随着时间的推移。因为它们可能会影响患者心理社会需求的筛查和管理。
ObjectiveThe MHADRO assesses psychosocial and medical needs, provides tailored feedback reports, and connects patients to mental health providers. This study examined the MHADRO’s effect on patient outcomes, health care utilization, and oncology provider documentation and behaviors.Methods836 patients were part of a multi-site RCT and assessments were conducted at baseline, 2, 6 and 12 months.ResultsThe intervention group engaged in less emergency calls to providers. There were no differences in psychosocial outcomes at follow up assessments. Providers of patients in the intervention group were more likely to: document psychosocial symptoms and history; refer to psychosocial services; encourage support groups; seek psychological evaluations during visits. Patients who agreed to a mental health referral had decreased hospitalizations, increased mental health care interactions, and stronger ratings of counseling potential benefits. This group also reported increased psychosocial distress at all follow-up assessments.ConclusionThe MHADRO may increase access to mental health care, lessen utilization, and improve providers’ management of psychosocial needs, but does not appear to impact overall functioning over time.Practice ImplicationsProviders are encouraged to consider incorporating programs, like the MHADRO, into patient care as they may have the potential to impact screening and management of patients’ psychosocial needs.