A Retrospective Examination of Symptom Improvements in Primary Care Patients Receiving Behavior Therapy With and Without
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A Retrospective Examination of Symptom Improvements in Primary Care Patients Receiving Behavior Therapy With and Without Concurrent Pharmacotherapy Ana J. Bridges1 · Roselee J. Ledesma1 · Aubrey R. Dueweke1 · Juventino Hernandez Rodriguez1 · Elizabeth A. Anastasia1 · Sasha M. Rojas1
© Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Primary care providers are the biggest prescribers of psychopharmacological medications. In this non-randomized retrospective examination, we asked whether primary care patients receiving behavioral health interventions with and without concurrent pharmacological treatments showed differential symptom improvement. Participants (79.4% women, 61.5% Hispanic, M age = 41.68, SD = 13.50) were 431 primary care patients referred to behavioral health with a primary concern of depression at one of three federally qualified health centers. Thirty-three percent of patients initiated or had an increase in pharmacotherapy concurrently with behavioral therapy; 26.9% had no change in medication during the episode of care, and 39.7% had no concurrent psychotropic medication prescribed during the episode of care. One-way analyses of variance revealed patients in the no medication group had higher global functioning, as measured by Global Assessment of Functioning (GAF) scores, than patients who were taking medication, or who initated or had an increase in medication. There was a significant main effect of time, where patients had significantly higher GAF scores during their last session in comparison to the first session. All three patient groups experienced comparable improvements in GAF scores, but patients in the initiated/ increased medication group were significantly more likely to terminate behavioral health treatment prematurely. Results suggest primary care patients experience improvements in functioning across an episode of behavioral health care, even without concurrent psychotropic medication use. Keywords Primary care behavioral health · Integrated care · Medication · Treatment outcomes Over the past decade, there has been an increased focus on the benefits of including behavioral health care as part of primary medical care services (Hunter, Dobmeyer, & Reiter, 2018; Robinson & Strosahl, 2009). This focus has been in response to changes in health care legislation that have promoted the integration of mental and physical health care, the acknowledgement that most people seek mental health care from medical providers (Wang et al., 2005), and the recognition that many medical conditions are caused or exacerbated by behavioral choices (e.g., smoking, overeating; Sturm, 2002).
* Ana J. Bridges [email protected] 1
Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
Integrated behavioral health care is a form of teambased practice that is characterized by both primary care and behavioral health providers working with patients to provide care in the same system to be more cost-effective and patient-centered (Peek, 2013). Primary ca
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