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

Lydia A Chwastiak, Mina Luongo, Joan Russo, Lisa Johnson, Jessica M Lowe, Gail Hoffman, Michael G McDonell, Brent Wisse

Journal: Psychiatric services (Washington, D.C.) 2019;69(3):349-352

PMID: 29191136

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.

Address: Dr. Chwastiak, Dr. Russo, Ms. Lowe, and Ms. Hoffman are with the Department of Psychiatry and Behavioral Sciences, and Dr. Wisse is with the Department of Medicine, Division of Metabolism, Endocrinology and Nutrition, University of Washington, Seattle. Ms. Luongo and Ms. Johnson are with the Harborview Medical Center, Seattle. Dr. McDonell is with the Addictions and Behavioral Health Innovations Department, Elson S. Floyd College of Medicine, Washington State University, Pullman.

DOI: 10.1176/appi.ps.201700153

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MeSH Terms: Community Mental Health Centers, Community Mental Health Services, Comorbidity, Delivery of Health Care, Integrated, Diabetes Mellitus, Type 2, 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, Psychotic Disorders, Schizophrenia