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Health Services Research & Development

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2007 HSR&D National Meeting Abstract

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National Meeting 2007

3063 — Telephone Based Referral-Care Management Treatment Outcomes

Zanjani F (VISN 4 MIRECC) , Miller B (VISN 4 MIRECC), Turiano NA (VISN 4 MIRECC), Ross JT (VISN 4 MIRECC), Eakin AC (VISN 4 MIRECC), Gerlach LB (VISN 4 MIRECC), Beswick CE (VISN 4 MIRECC), Oslin DW (VISN 4 MIRECC)

Telephone Based Referral Care Management (TBR-CM) is a study designed to improve engagement in mental health/substance care (MH/SA) by implementing a brief telephone-based motivational session. The aim of this investigation is to compare 6-month MH/SA behavioral treatment attendance rates between the treatment and treatment-as-usual group.

During September 2005—May 2006, a total of N=169 patients of Philadelphia Veterans Medical Center completed a psychiatric diagnostic interview at the Behavioral Health Lab and were identified as in need of an MH/SA appointment. From this total number of eligible subjects, N= 42 (24%) refused the study and N=14 (8%) refused to accept a MH/SA appointment. The remaining N=113 (67%) were randomized into either usual or TBR-CM care. Usual care consisted of the patient getting an appointment mailed to them with contact numbers for any problems. TBR-CM consisted of the patient participating in one or more brief telephone interventions designed to increase engagement in MH/SA treatment.

Participants were primarily African American, ranging in age between 22-83 years, and their diagnostic distribution was: 39% depression, 39% substance abuse, and 22% co-occurring depression and substance abuse. Results indicate positive intervention effects on improving MH/SA treatment initiation (p=.0056); 73% of subjects in the intervention vs. 45% of subjects in control group engaged in at least one MH/SA treatment appointment within 6-months of randomization. When examining total number of MH/SA Behavioral Appointments, a statistical trend (p=.0624) indicated that the intervention group had attended more appointments (2.47) compared to the control group (1.58). Further analyses showed no age or diagnostic categorization effects on treatment attendance.

Telephone Based Referral Care Management intervention program shows the ability to considerably improve rates of MH/SA behavioral treatment engagement. These effects are not mitigated by individual age or diagnosis factors.

A brief-motivational session can effectively improve the likelihood that an individual presenting with depression and or substance abuse symptoms will receive necessary care.

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