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Integrating behavioral care into primary care improves outcomes in children, adolescents

Integrated medical-behavioral primary care improved behavioral health in children and adolescents, compared with those who received usual care, according to recently published data in JAMA Pediatrics.

“This meta-analysis provides the first cross-study demonstration, to our knowledge, of the value of integrating behavioral health care within primary medical care for children and adolescents,” the researchers wrote.

Researchers conducted a systematic review of data from 31 randomized clinical trials to assess the effects of integrated medical-behavioral health care and improved outcomes in children and adults.

Both prevention and treatment trials were included in the analysis. Treatment trials included interventions that incorporated cognitive behavioral therapy, evidence based medication algorithms, parenting, interpersonal psychotherapy, support from primary care provider, medication management or communication training. Prevention trials incorporated cognitive behavioral therapy, primary care provider motivational interventions, parenting interventions, or motivational interviews and counseling.

Overall, participants who received integrated medical-behavioral treatments were more likely to have better health outcomes, compared with those who received usual care.

Results demonstrated that compared with usual care, integrated health care significantly improved behavioral health outcomes (d = 0.32, 95% CI, 0.21-0.44).

Treatment trials that focused on diagnoses and elevated symptoms were more likely to improve outcomes (d = 0.42, 95% CI, 0.29-0.55) compared with prevention trials (d = 0.07, 95% CI, – 0.13-0.28).

“These data … underscore the critical need to strengthen our research base, learn from the real-world experiments happening within our medical and behavioral health care systems, and achieve the triples aims of health care reform: to improve care and patient experience and outcomes of care while reducing per capita costs,” the researchers concluded. – by Casey Hower

Disclosures: Asarnow reports receiving grant funding from the National Institute of Mental Health, American Foundation for Suicide Prevention, the American Psychological Association Committee on Division/APA Relations, and the Society of Clinical Child & Adolescent Psychology. Please see the study for a full list of all authors’ relevant financial disclosures.