Integration of Primary Care and Behavioral Health

Abstract

General Overview and Rationale for Integrated CareOne of the great challenges facing health care over the last 50 years has been how to manage chronic medical problems. Medicine, as a system, has traditionally focused on swiftly addressing life-threatening illnesses, and, as a result, chronic, fluctuating, and slowly progressive disorders are often missed or inconsistently managed (Institute of Medicine, 2001). As medical technology has increased longevity, so too has it increased the number of people living with chronic medical conditions. This has led to a tipping point in the USA wherein many patients are receiving care for chronic medical conditions, but fewer than half of the patients seen for depression, hypertension, or diabetes are receiving appropriate treatment (

Conducting a Pragmatic Trial in Integrated Primary Care: Key Decision Points and Considerations

“…Although modular treatments allow for easy tailoring of treatments to individual patients, they present a significant challenge to defining the “dose” of treatment. While 3–7 visits were recommended for each patient—yet one is the modal number of visits in usual BHC practice (Haack et al, 2020 )—when should we conduct our post- and follow-up assessments? This was not a typical trial with standardized, specific intervention delivery methods, doses, and scheduled assessments.…”