CIHS Offers New, Notable Integrated Care Research

New (and Notable) Integrated Care Research
Being at the forefront of a new(er) approach to care, it is important to stay up-to-date on the latest research regarding integrated care. Providing quality coordinated care involves understanding the newest information and trends regarding co-occurring physical and behavioral health conditions, models of integrated care, and treatment of mental and physical illnesses and substance use disorders.  

As the ‘national home’ of integration, the SAMHSA-HRSA Center for Integrated Health Solutions (CIHS) strives to share a variety of new, notable, and seminal research associated with integrated health services design, delivery, client experience, and cost. We share this research via direct technical assistance, the CIHS website, the monthly newsletter eSolutions, and these quarterly research emails.  

In addition, the Agency for Healthcare Research and Quality (AHRQ) focused on the latest trends in integrating behavioral health and primary care in the new edition of their Innovations Exchange newsletter.  

Below are a few recent and notable journal articles pertaining to integrated healthcare-though the list is far from exhaustive as research evolves daily. 
Please note that many of the following links require a membership or payment to view the entire article and that the following references are for informational purposes only and do not constitute endorsement or recommendation by SAMHSA or HRSA.

Integrated Care

Enhanced Case Management versus Substance Abuse Treatment Alone among Substance Abusers with Depression, Social Work Research, 2013

This pilot study evaluated the effectiveness of enhanced case management for individuals with substance abuse and comorbid major depression, which was an integrated approach to care. 
Integrated Behavioral Health: Implications for Individual and Family Counseling Practice, The Family Journal, 2013

This article describes the need for an integrated form of behavioral health, including the theoretical basis and medical offset effect. Emerging trends in psychotherapy practice are also noted, as well as the implications of integrated behavioral health for individual mental health and family counseling practice. 
Integrating Substance Abuse Care with Community Diabetes Care: Implications for Research and Clinical Practice, Substance Abuse and Rehabilitation, 2013

This commentary discusses the scope and clinical implications of the public health problem of coexisting substance use and diabetes, including suggestions for future research. 
Integration of Depression and Primary Care: Barriers to Adoption, Journal of Primary Care & Community Health, 2013

Despite the prevailing consensus as to its value, the adoption of integrated care models is not widespread. Thus, the objective of this article it to examine the barriers to the adoption of depression and primary care models in the United States. 
Lessons Learned from a Colocation Model Using Psychiatrists in Urban Primary Care Settings, Journal of Primary Care & Community Health, 2013

The providers found the experience highly rewarding and colocation was financially sustainable under certain conditions. The colocation model was effective in identifying and treating psychiatric comorbidities. 
A Behavioral Weight-Loss Intervention in Persons with Serious Mental Illness, New England Journal of Medicine, 2013

People with serious mental illnesses such as schizophrenia, bipolar disorder and major depression can lose weight and keep it off through a modified lifestyle intervention program called Achieve.  
Smoking Cessation, Depression, and Exercise: Empirical Evidence, Clinical Needs, and Mechanisms, Nicotine and Tobacco Research, 2013

This narrative review describes research on exercise and depression and exercise and smoking cessation. This review suggests that exercise may reduce depressive symptoms following cessation and provide a useful strategy for managing withdrawal symptoms in smokers with major depressive disorder.


Co-Occurring Physical and Behavioral Health Conditions 
Diabetes and Depression in the Hispanic/Latino Community, Diabetes Advocacy, 2013

This article briefly describes depression in the Hispanic community; the relationship between diabetes, depression, and culture; and how advocacy can play a role in addressing this problem.  
Association of Anxiety and Depression With AllCause Mortality in Individuals With Coronary Heart Disease, Journal of the American Heart Association, 2013

This study found an increased mortality risk in heart disease patients with depression and anxiety.
Entry Into Primary Care-Based Buprenorphine Treatment Is Associated with Identification and Treatment of Other Chronic medical Problems, Addiction Science & Clinical Practice, 2012

This study shows that offering treatment for opioid dependence with buprenorphine in a primary care practice is associated with the identification and treatment of other chronic medical conditions. 
The Co-Occurrence of Common Mental and Physical Disorders within Australian Families: A National Population-based Study, Australian & New Zealand Journal of Psychiatry, 2013

The aim of this research was to describe the within-family co-occurrence of selected common physical and mental disorders in a population-based sample. 
The Development of a Patient-Centered Program Based on the Relaxation Response, Psychosomatics, 2013

Chronic daily stress has significant physical, emotions, and financial implications. This paper describes the foundation and development of an 8-session multimodal treatment program for coping with chronic stress: the Relaxation Response Resiliency Program (3RP). 
Treating Mental Illness 
A Primary Care - Public Health Partnership Addressing Homelessness, Serious Mental Illness, and Health Disparities, Journal of the American Board of Family Medicine, 2013

People with histories of homelessness and serious mental illness experience profound health disparities. Housing First is an evidenced-based practice that is working to end homelessness for these individuals through a combination of permanent housing and community-based supports. 
Adverse Childhood Experiences: Retrospective Study to Determine their Impact on Adult Health Behaviours and Health Outcomes in a UK Population, Journal of Public Health, 2013

Adverse childhood experiences (ACEs) contribute to poor life-course health and social outcomes in a UK population. Study findings that show ACEs are linked to involvement in violence, early unplanned pregnancy, incarceration, and unemployment suggest a cyclic effect where those with higher ACE counts have higher risks of exposing their own children to ACEs. 
Efficacy and Safety of Screening for Postpartum Depression, Effective Health Care Program Comparative Effectiveness Review, 2013

The potential effectiveness of screening for postpartum depression appears to be related to the availability of systems to ensure adequate follow-up of women with positive results. The ideal characteristics of a screening test for postpartum depression, including sensitivity, specificity, timing, and frequency, have not been defined. Because the balance of benefits and harms, at both the individual level and health system level, is highly dependent on these characteristics, broad consensus on these characteristics is needed. 
Managing Adolescent Depression: The Complete Guide for Primary Care Clinicians, Civic Research Institute, 2012

This book compiles the latest research, assessment tools, and treatment strategies, contributed by nationally recognized clinicians and researchers, in regards to adolescent depression. The book is primarily written for primary care providers.  
Pilot Study of a Statewide Initiative to Enhance Depression Care Among Older Home Care Patients, An Interdisciplinary Focus to Home Health Care Management & Practice, 2013

This pilot study, part of a statewide initiative to enhance depression care, evaluated the influence of a 2-hour depression screening and intervention workshop on home care professionals’ knowledge, self-efficacy, and attitudes related to depression in older home care patients.
Substance Use and Treatment 
Brain Imaging Biomarkers to Predict Relapse in Alcohol Addiction, JAMA Psychiatry, 2013
Distinct patterns of brain activity are linked to greater rates of relapse among alcohol dependent patients in early recovery. 
Chronic Alcohol Remodels Prefrontal Neurons and Disrupts NMDAR-Mediated Fear Extinction Encoding, Nature Neuroscience, 2012

These findings suggest that alcohol may increase risk for trauma-related anxiety disorders by disrupting mPFC-mediated extinction of fear. 
Recent Trends in Substance Abuse among Persons with Disabilities Compared to those Without Disabilities, Disability and Health Journal, 2013

Given that substance abuse among persons with disabilities is markedly more prevalent than among other persons for most substances, findings indicate a need for accessible, targeted prevention programs and a potentially overwhelming demand for accessible SA treatment services and facilities. 
Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse, U.S. Preventive Services Task Force, 2013

The USPSTF recommends that clinicians screen adults aged 18 years or older for alcohol misuse and provide persons engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce alcohol misuse.  
Tobacco Cessation
Carbon Monoxide Meter: The Essential Clinical Tool - the ‘Stethoscope’ - of Smoking Cessation, Journal of Smoking Cessation, 2013

This article states that carbon monoxide monitors offer the tobacco treatment specialist an independent clinical tool that provides valuable evidence in identifying, educating, assessing and treating the tobacco dependent patient.  
Do Symptoms and Cognitive Problems Affect the Use and Efficacy of a Web-Based Decision Support System for Smokers With Serious Mental Illness? Journal of Dual Diagnosis, 2012

Previous research has shown that a web-based motivational decision support system tailored for people with serious mental illnesses is associated with increased use of evidence-based cessation treatment. The study examines how user characteristics, including cognitive functioning and psychiatric symptoms, impact use and outcomes of the website. 
Sustainment of Smoking Cessation Programs in Substance Use Disorder Treatment Organizations, Nicotine & Tobacco Research, 2013

These findings provide empirical support for theoretical perspectives regarding the importance of leadership and staff expertise in promoting sustainment of innovations over time. Although the majority of SUD treatment organizations sustained their smoking cessation programs, the 40% rate of discontinuation highlights the ongoing challenges faced by tobacco control efforts in substance abuse treatment. 
Shared Decision-Making 
Association of Patient Preferences for Participation in Decision Making With Length of Stay and Costs Among Hospitalized Patients, JAMA Internal Medicine, 2013

This study examined the relationship between patient preferences for participation in medical decision making and health care utilization. The study examined factors such as education and the influence of other decision makers in the care.