A new primary care model proves effective for patients with severe mental illness
北卡罗来纳大学医学院的博士. 亚历克斯·K. 格特纳和博士. 击败维. Steiner led a study on a new “enhanced primary care” model, which resulted in lower blood pressure and hemoglobin A1c and increased screening for people with severe mental illness.
在过去的几年里， 家庭医学系 和 精神科 in the UNC School of 医学 have been working together to spearhead the development of a new “enhanced primary care” model to provide better primary care for patients who have severe mental illnesses.
A 新的分析 由 Dr. 亚历克斯·K. 特纳, a psychiatry resident at UNC Hospitals, has added further evidence that the new model is effective. 特纳 found that the enhanced primary care model resulted in lower hemoglobin A1c and blood pressure for patients with severe mental illness when compared to other primary care clinics throughout the state of North Carolina that do not use the model.
“What distinguishes enhanced primary care from many prior studies is that this model is specifically adapted to meet the needs of people with severe mental illness,格特纳说。, 谁是这项研究的主要作者. “Many previous studies that have tested the effect of primary care on people with severe mental illness have not achieved improvements in clinical outcomes, 是什么让这些太阳城娱乐令人兴奋.”
The propensity-weighted cohort study was conducted at UNC WakeBrook, 罗利的一家行为健康机构, 发表在《太阳城娱乐》上.”
Cardiometabolic health conditions – such as high blood pressure, 糖尿病, and heart attacks – are more common in American adults with serious mental illness than the general population. 有14.200万成年人患有严重的精神疾病, this represents a major challenge that the United States healthcare system must face head-on.
严重精神疾病被定义为一种精神疾病, 行为, or emotional disorder resulting in serious functional impairment. Patients with serious mental illness have been shown to have lower-quality treatment for these conditions and poor cardiometabolic outcomes, both of which contribute to high-cost medical care down the line.
The clinic at WakeBrook is especially unique in that it is adapted to care for the physical health needs of people with SMIs. The clinic’s enhanced primary care model involves training primary care providers to work with patients with severe mental illness, delivering integrated care with 行为 health providers, and providing longer visits to address patients’ needs.
So far, the use of the new primary care model has produced astounding results. 格特纳之前的一项分析显示， Dr. 击败施泰纳, 家庭医学系的教授, and others found that enhanced primary care reduced hospitalizations for physical health needs among people with SMI compared to usual primary care.
至于这项新研究, re太阳城娱乐城ers started by comparing 234 patients with SMI receiving enhanced primary care at WakeBrook to 4,934 patients with SMI receiving usual primary care using electronic health data. Overall, patients who received care at WakeBrook had reductions in blood pressure and hemoglobin A1c 与其他初级保健诊所相比.
血红蛋白A的减少1c 血压也有临床意义. 血红蛋白A降低的大小1c was comparable to what can be accomplished by starting a patient on insulin, 和 size of the decrease in blood pressure was comparable to what can be accomplished by a moderate reduction in weight or an increase in physical activity.
研究ers were also able to establish that enhanced primary care increased screening patients for hemoglobin A1c, low-density lipoprotein, aka “bad cholesterol”, and blood pressure compared to usual primary care.
“平均, people with SMI die 25 years earlier than the general population, with most of these deaths caused by chronic physical conditions,施泰纳说, 谁也参与了这项新研究. “因此, developing and implementing models for the physical health needs of our patients is a critical healthcare and public health priority.”
