Evidence map›Paper›PMID 41491563›Full record

Trial reportJournal of the American Board of Family Medicine : JABFM

Degree of Behavioral Health Integration and Patient Outcomes.

Benjamin Littenberg, Levi Bonnell, Peter Callas, Juvena Hitt, C R Macchi, Matt Martin, Mindy L McEntee, Daniel J Mullin, Gail L Rose, Constance van Eeghen

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American Board of Family Medicine : JABFM. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Women's Health, Social Issues, and Quality of Care in Family Medicine.Journal of the American Board of Family Medicine : JABFM
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Benjamin LittenbergFrom the University of Vermont, Burlington, VT (BL, PC, JH, GLR, CE); Society of Thoracic Surgeons, Chicago, IL (LB); Arizona State University, Phoenix, AZ (MM, MLM); UMass Chan Medical School, Worcester, MA (DJM). benjamin.littenberg@uvm.edu.
Levi BonnellFrom the University of Vermont, Burlington, VT (BL, PC, JH, GLR, CE); Society of Thoracic Surgeons, Chicago, IL (LB); Arizona State University, Phoenix, AZ (MM, MLM); UMass Chan Medical School, Worcester, MA (DJM).
Peter CallasFrom the University of Vermont, Burlington, VT (BL, PC, JH, GLR, CE); Society of Thoracic Surgeons, Chicago, IL (LB); Arizona State University, Phoenix, AZ (MM, MLM); UMass Chan Medical School, Worcester, MA (DJM).
Juvena HittFrom the University of Vermont, Burlington, VT (BL, PC, JH, GLR, CE); Society of Thoracic Surgeons, Chicago, IL (LB); Arizona State University, Phoenix, AZ (MM, MLM); UMass Chan Medical School, Worcester, MA (DJM).
C R MacchiFrom the University of Vermont, Burlington, VT (BL, PC, JH, GLR, CE); Society of Thoracic Surgeons, Chicago, IL (LB); Arizona State University, Phoenix, AZ (MM, MLM); UMass Chan Medical School, Worcester, MA (DJM).
Matt MartinFrom the University of Vermont, Burlington, VT (BL, PC, JH, GLR, CE); Society of Thoracic Surgeons, Chicago, IL (LB); Arizona State University, Phoenix, AZ (MM, MLM); UMass Chan Medical School, Worcester, MA (DJM).
Mindy L McEnteeFrom the University of Vermont, Burlington, VT (BL, PC, JH, GLR, CE); Society of Thoracic Surgeons, Chicago, IL (LB); Arizona State University, Phoenix, AZ (MM, MLM); UMass Chan Medical School, Worcester, MA (DJM).
Daniel J MullinFrom the University of Vermont, Burlington, VT (BL, PC, JH, GLR, CE); Society of Thoracic Surgeons, Chicago, IL (LB); Arizona State University, Phoenix, AZ (MM, MLM); UMass Chan Medical School, Worcester, MA (DJM).
Gail L RoseFrom the University of Vermont, Burlington, VT (BL, PC, JH, GLR, CE); Society of Thoracic Surgeons, Chicago, IL (LB); Arizona State University, Phoenix, AZ (MM, MLM); UMass Chan Medical School, Worcester, MA (DJM).
Constance van EeghenFrom the University of Vermont, Burlington, VT (BL, PC, JH, GLR, CE); Society of Thoracic Surgeons, Chicago, IL (LB); Arizona State University, Phoenix, AZ (MM, MLM); UMass Chan Medical School, Worcester, MA (DJM).

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrimary care practices with greater integration of behavioral health care have better patient-reported outcomes. We sought to identify whether there is a threshold effect in the relationship between the degree of Integrated Behavioral Health (IBH) and patient-reported outcomes.

methodsSecondary analysis of survey results from Integrating Behavioral Health and Primary Care, a multistate longitudinal randomized, controlled study of 3,929 adults with multiple chronic medical and behavioral conditions. Patient outcomes included Patient-Reported Outcomes Measurement Information System-29 (PROMIS-29) functional status (PROMIS-29), depression (PHQ-9), anxiety (GAD-7), the Duke Activity Status Index, Consultation and Relational Empathy (CARE), patient centeredness, and utilization. IBH was measured by the Practice Integration Profile (PIP) version 1.0. The optimal threshold was identified by examining the relationship of PIP to PROMIS-29. The discriminatory power of the threshold was examined using multilevel linear regression with adjustment for potential confounders.

resultsFifteen of 44 practices with 1,237 patients were highly integrated (PIP ≥ 65). All outcomes tended to be better in patients from practices with high integration. After adjustment for potential confounders, the relationship remained beneficial for all outcomes, with Pain Intensity (-0.51 [95% CI -0.97, 0.04]), patient centeredness (2.52 [0.88, 4.16]), and CARE (1.62 [0.62, 2.61]) statistically significant.

conclusionsPatients in high integration practices report better outcomes. A measurable target for IBH, such as a PIP total score ≥ 65, provides a focus for practice leadership and guidance on the time and resources needed to achieve integration associated with positive patient outcomes. The results of this analysis provide further evidence of the broad, beneficial impacts of integrating behavioral health and primary care services.

Indexed as

Delivery of Health Care, IntegratedMental Health ServicesPatient Reported Outcome MeasuresPrimary Health CareAdultAgedFemaleHumansLongitudinal StudiesMaleMiddle AgedPatient-Centered CareBehavioral MedicineIntegrated Delivery of Health CarePatient Reported OutcomesPractice ManagementPrimary Health CarePsychometricsSurveys and Questionnaires

Identifiers

PMID41491563
PMCPMC12978598

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.