Use of a Mental Health Center Collaborative Care Team to Improve Diabetes Care and Outcomes for Patients With Psychosis

Psychiatr Serv. 2018 Mar 1;69(3):349-352. doi: 10.1176/appi.ps.201700153. Epub 2017 Dec 1.

Abstract

Objective: This study aimed to evaluate the feasibility, acceptability, and preliminary effectiveness (compared with usual care) of a collaborative care model to treat community mental health center (CMHC) patients with psychosis and poorly controlled diabetes.

Methods: Stakeholder input was used to adapt a primary care-based collaborative care intervention for CMHC settings. Thirty-five adult CMHC clients with type II diabetes and hemoglobin A1c (HbA1c) >8% or blood pressure >140/90 were randomized to receive either collaborative care or usual care. Change in HbA1c was evaluated between baseline and three months. Paired t tests were used for within-group comparisons.

Results: After three months, intervention participants had a statistically significant mean decrease in HbA1c of 1.1% (p=.049). There was no significant change in HbA1c in the usual-care group.

Conclusions: This pilot demonstrates the feasibility and acceptability of implementing collaborative care in CMHC settings and its preliminary effectiveness in improving glycemic control in a high-risk population.

Trial registration: ClinicalTrials.gov NCT02011529.

Keywords: Medical morbidity and mortality in psychiatric patients; Research/service delivery integrated care; collaborative care.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Community Mental Health Centers*
  • Community Mental Health Services / methods*
  • Comorbidity
  • Delivery of Health Care, Integrated*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / therapy*
  • Feasibility Studies
  • Female
  • Glycated Hemoglobin
  • Humans
  • Intersectoral Collaboration
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Patient Acceptance of Health Care
  • Patient Care Team*
  • Pilot Projects
  • Primary Health Care / methods*
  • Psychotic Disorders / epidemiology
  • Psychotic Disorders / therapy*
  • Schizophrenia / therapy*

Substances

  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human

Associated data

  • ClinicalTrials.gov/NCT02011529