Integrating Primary Medical and Behavioral Health Services: Reducing Medication Side Effects

Integrating Primary Medical and Behavioral Health Services: Reducing Medication Side Effects

The American Psychiatric Association publishes a weekly online newsletter about integrated care, “Integrated Care News Notes.” The Dec. 9 issue includes a summary of an interesting study,Reduction of Patient-Reported Antidepressant Side Effects, by Type of Collaborative Care.” 

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This study compared the outcomes for two groups of patients receiving treatment for medication in primary care settings: one groups received standard “evidence-based” care from a PMP team in on office setting, and the other group received a a combination of the office care and “telemedicine-based collaborative care,” with telephone interviews that helped the patients with their medication side effects. The telephone portion of the latter treatment protocol was provided by pharmacists, psychologists and psychiatrists. The study found that the latter group had significantly fewer side effects at six and twelve months into the study. 

My take: this study supports having psychologists and other behavioral professionals involved in the treatment of depression in primary care settings to help patients manage medication side effects. Behavioral professionals can often spend more time with the patient, can develop a higher level of rapport, can encourage patients to ventilate their concerns about medication, can offer information about adjunctive (to medication) behavioral treatments, and more. They can generally add value to the treatment of depression in the primary care setting,

 

Psychology in the news:  Wall Street Journal article about research about behaviors that help people feel better

Psychology in the news: Wall Street Journal article about research about behaviors that help people feel better

The Wall Street Journal published an article on 11-17-14 which reviewed interesting research about how people can improve their mood with relatively small changes of their behavior. The article, “Walk this Way: Acting Happy Can Make It So,” describe research that has found that people’s mood affects how they walk. The article notes, “when people are happy, they tend walk faster and more upright, swung their arms and move up and down more, in this way less side to side and sad or depressed people.

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Wellness issues: behavioral changes from a program that “prescribes” fruit and veggies

Wellness issues: behavioral changes from a program that “prescribes” fruit and veggies

The New York Times published an article on 12-1-14 about an innovative program in New York which encourages children to increase their consumption of fruits and vegetables in order to respond to childhood health problems, including obesity and diabetes.  The article, “Prescribing Vegetables, Not Pills,” is by the highly regarded health journalist, Jane Brody.  She noted that this program is “a startingly simple idea to deal with complex problem,” and went on to report that outcomes research has found that after just four months in the program 40% of the participating children had a lowered BMI.  

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In addition to “prescribing” fruits and vegetables, the program provides funding to help people with less financial means be able to afford what is well known to be a more expensive meal plan. Obviously, most psychologists and other behavioral specialists don’t have access to the financial resources that this would require. On the other hand, when working with children, and probably people of all ages, with problems related to obesity, it would be advisable for us to inquire about how much fruit and vegetables they, and their family, are consuming and to encourage, or “prescribed,” increasing their intake. Also, being knowledgeable about this research is likely to help us promote expanding the practice of behavioral services by coordinating care with primary medical providers. One of the most common medical problems that they deal with is obesity, and related problems, but they often do not have the time, resources, and skills to help their patients with behavioral changes, and obviously offering collaboration to them could potentially be a winner for all-the PMP’s get help with some of their most complex and challenging patients, we expand the practice of behavioral health services, and, most importantly, the patient’s get help with their health problems. Also, many patients with these types of help problems have mental health concerns that are either a result of the health problems or contributing to the health problems.

In any case, what can sound, the surface, like research that is strictly “medical” can be helpful to behavioral providers who are interested in wellness issues and collaborating with PMP’s.

 

Wellness issues: research on the benefits of running (jogging) vs. walking for all, particularly older people

Wellness issues: research on the benefits of running (jogging) vs. walking for all, particularly older people

The New York Times published an article on 12-3-14 about the benefits of running in comparison to walking, particularly for older people. The article, “Run to Stay Young,” describe research which finds that, “running may reverse aging in certain ways while walking does not.” Also the research found that running promotes better coordination than walking and people who run are able to be more active later in life the people who walk. People are not have to be lifelong runners, and the benefits can be obtained by taking up running later in life. Also, the research was not on more hard-core runners, as the subjects in the running group ran three times a week for 30 minutes or more, but that was all. Most, “moved at a gentle jogging speed.”

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Update on sleep research and learning:  advice for teens – and the rest of us

Update on sleep research and learning: advice for teens – and the rest of us

The New York Times published  “Want to Ace That Test?  Get the Right Kind of Sleep” on 10-16-14.  The article provides an update about the current research on sleep and learning, with a focus on what it means for teens but the benefits of this information certainly are not limited to teens.  The author, who is one of the paper’s science reporters, summarizes the current thinking about sleep: “Sleep is learning, of a very specific kind. Scientists now argue that a primary purpose of sleep is learning consolidation, separating the single from the noise and flagging what is most valuable.” And, “there is research suggesting that different kinds of sleep in a different kinds of learning and by teaching “sleep study skills,” we can let our teenagers enjoy the sense that there gaming the system.”

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Ronald Siegal and colleagues on the benefits of integrating mindfulness into mental health therapy

Ronald Siegal and colleagues on the benefits of integrating mindfulness into mental health therapy

The online newsletter from Mindful.org on 10-14-14 featured an article about potential benefits of mindfulness practice mental health therapists. The article, “3 Ways to Bring Mindfulness into Therapy,” is by Susan Pollak, Ronald Siegal and Thomas Pedulla. Ronald Seigal is a psychologist who is on the faculty of Harvard University and has written several books about integrating mindfulness practice into mental health therapy, and this article is adapted from Sitting Together: Essential Skills for Mindfulness-Based Psychotherapy, by the three authors of the article.

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