Bridging the mental health treatment gap: Effects of a collaborative care intervention (matrix support) in the detection and treatment of mental disorders in a Brazilian city
| Autor: | Alberto Fernández Liria, Matheus Pacheco de Andrade, Max O Bachmann, Sônia A. Leitão Saraiva |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Collaborative Care Logistic regression Drug Prescriptions Odds 03 medical and health sciences 0302 clinical medicine access General Practitioners Internal medicine medicine Humans 030212 general & internal medicine Medical prescription Practice Patterns Physicians' health services Mental disorder diagnosis Original Research Retrospective Studies 030505 public health evaluation Primary Health Care business.industry Mental Disorders Public Health Environmental and Occupational Health Mental health Antidepressive Agents electronic health records Mental Health health care quality 0305 other medical science Family Practice business Brazil Health care quality Cohort study |
| Zdroj: | Family Medicine and Community Health |
| Popis: | ObjectiveTo analyse temporal trends in diagnosis and treatment of mental disorders in primary care following implementation of a collaborative care intervention (matrix support).DesignDynamic cohort design with retrospective time-series analysis. Structured secondary data on medical visits to general practitioners of all study clinics were extracted from the municipal electronic records database. Annual changes in the odds of mental disorders diagnoses and antidepressants prescriptions were estimated by multiple logistic regression at visit and patient-year levels with diagnoses or prescriptions as outcomes. Annual changes during two distinct stages of the intervention (stage 1 when it was restricted to mental health (2005–2009), and stage 2 when it was expanded to other areas (2010–2015)) were compared by adding year–period interaction terms to each model.Setting49 primary care clinics in the city of Florianópolis, Brazil.ParticipantsAll adults attending primary care clinics of the study setting between 2005 and 2015.Results3 131 983 visits representing 322 100 patients were analysed. At visit level, the odds of mental disorder diagnosis increased by 13% per year during stage 1 (OR 1.13, 95% CI 1.11 to 1.14, pConclusionThe matrix support intervention may increase diagnosis and treatment of mental disorders when inter-professional collaboration is adequately supported. Competing demands to the primary care teams can subsequently reduce these effects. Future studies should assess clinical outcomes and identify active components and factors associated with successful implementation. |
| Databáze: | OpenAIRE |
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