清晰思考:将预防性认知健康访视纳入初级保健。

IF 3 Q1 PRIMARY HEALTH CARE
Amy L Buchanan, Rachana Kotecha
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引用次数: 0

摘要

目的:大流行导致精神和认知健康问题增加,预防和治疗护理的利用率降低。推迟治疗可能会导致不良的临床结果,包括精神和认知健康问题的严重性增加,而早期干预则会使患者受益。我们推出了一种新的就诊类型,旨在为可能需要护理的患者提供服务,并支持认知和心理健康问题的早期识别:我们开发了 "Healthy Mind "门诊,这是一种由初级保健提供者(PCP)在门诊中实施的预防性门诊。健康心理就诊包括使用就诊前心理健康筛查器以及简短的计算机化认知评估。临床互动的重点是识别心理和认知健康问题,并制定健康计划。结果数据的收集历时近 2.5 年,重点分析了预约模式、抑郁症筛查和随访,以及健康信心和就诊后动力等临床结果:结果:该就诊在支持抑郁症筛查和随访方面效果显著,29.6% 的 "健康心灵 "就诊者接受了 PHQ-9,82.5% PHQ-9 得分较高的患者接受了初级保健医生的后续就诊。就诊后,患者对健康的信心增强,就诊动机高涨,这些都是其他显著的临床结果。该访问还促进了医疗服务的利用率,73.5% 参加健康心灵访问的患者是诊所的新患者或在过去 6 个月中未参加过预约的患者:结论:以心理和认知健康为重点的 "健康心理 "就诊成功地帮助了那些可能不会寻求医疗服务的患者,并取得了积极的临床效果,包括早期识别和治疗抑郁症以及增强健康信心:这些研究结果反映了制定创新计划将患者与医疗服务联系起来的重要性,尤其是那些可能因各种因素而推迟就医的患者。通过使用计算机化评估等创新工具来关注心理和认知健康,可以提高患者对护理服务的兴趣,并支持积极的临床结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Thinking Clearly: A Preventative Cognitive Health Visit Integrated in Primary Care.

Objective: The pandemic contributed to increased mental and cognitive health concerns as well as reduced utilization of preventive and treatment focused care. Deferred care can contribute to negative clinical outcomes, including increased acuity of mental and cognitive health concerns that benefit from early intervention. A new visit type was launched with the aim of reaching patients who may need care and supporting early identification of cognitive and mental health issues.

Methods: We developed the Healthy Mind visit, a preventative visit administered by Primary Care Providers (PCPs) within outpatient clinics. The Healthy Mind visit included use of a pre-visit mental health screener as well as a brief computerized cognitive assessment. The clinical interaction focused on identifying mental and cognitive health concerns and developing a plan for wellness. Outcomes data collection occurred over nearly 2.5 years and focused on analyzing booking patterns, depression screening and follow-up, and clinical outcomes such as health confidence and post-visit motivation.

Results: The visit was effective in supporting depression screening and follow-up with 29.6% of those participating in a Healthy Mind visit receiving a PHQ-9, and 82.5% of patients with elevated PHQ-9 scores attending a subsequent visit with their PCP. Improvements in health confidence and high patient reported motivation post-visit represent other notable clinical outcomes. The visit also promoted care utilization, with 73.5% of patients who attended a Healthy Mind visit being new to the practice or those who had not attended an appointment in the past 6 months.

Conclusions: The Healthy Mind visit, with a focus on mental and cognitive health, was successful in reaching patients who may not have otherwise sought care and supported positive clinical outcomes including early identification and treatment of depression and increased health confidence.

Recommendations: These findings reflect the importance of developing innovative programs to connect patients with care, especially those who may have deferred care due to a variety of factors. Focusing on mental and cognitive health with the use of innovative tools such as a computerized assessment, can drive patient interest in care offerings and support positive clinical outcomes.

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来源期刊
CiteScore
4.80
自引率
2.80%
发文量
183
审稿时长
15 weeks
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