ackground and Goal: Integrated behavioral health (IBH), which combines behavioral health and primary care, improves patient outcomes and experience. This study evaluated whether a tailored, toolkit-based intervention could improve IBH and patient outcomes in primary care practices serving patients with multiple chronic medical and behavioral health conditions.
Study Approach: The study used a cluster randomized controlled trial design. Practices were randomized into two groups. The intervention arm received a comprehensive toolkit that included four components: workbooks to guide the quality improvement project, online education tailored to specific practice personnel roles, an online learning community to facilitate collaboration, and remote coaching provided by a trained quality improvement professional paired with a psychologist experienced in IBH. The control arm continued with their usual IBH services without receiving additional support.
Main Results: A total of 42 practices were randomized in the study.
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Practices completing more intervention stages showed significant improvements in IBH integration, particularly in workflows, integration methods, and patient identification.
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No significant clinically relevant differences were found in patient health outcomes—including depression, anxiety, fatigue, sleep disturbance, pain, pain interference, and physical function—between the intervention and control groups.
Why It Matters: A practice-centered, flexible intervention may help primary care practices tailor behavioral health integration to their specific needs and lead to better systems of care.
Intervention Stage Completion and Behavioral Health Outcomes: An Integrated Behavioral Health and Primary Care Randomized Pragmatic Trial
Kari A. Stephens, PhD, et al
Department of Family Medicine, University of Washington, Seattle, Washington
Journal
The Annals of Family Medicine