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Systematic Review of Behavioral Health Homes Impact on Cardiometabolic Risk Factors for Adults with Serious Mental Illness
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1 01 2020
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Source: Psychiatr Serv. 71(1):57-74
[PDF-453.61 KB]
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Alternative Title:Psychiatr Serv
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Description:Objective
This systematic review examined the impact of health homes on cardiometabolic risk in adults with serious mental illness.
Methods
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures were used to conduct the systematic review. Databases were searched for peer-reviewed articles published between 1946 and August 2018 that compared health homes to a control condition (e.g., usual care, secondary data analyses using matched samples). Participants, interventions, comparisons, outcomes, and study design criteria were used to assess study eligibility. Studies were assessed for methodological quality using the Quality Assessment of Before and After Studies With No Control Group, and the Quality Assessment of Controlled Intervention Studies.
Results
Eighteen studies (i.e., eleven observational, four quasi-experimental, three randomized controlled trials) reported on 17 health homes. Most studies reported increases in receipt of screening for cardiometabolic risk factors and service use. There was a modest reduction in selected cardiometabolic risk factors among people with serious mental illness, but clinical outcomes varied widely among studies.
Discussion
Health homes are associated with increased rates of cardiometabolic screening and service use. However, improvement in cardiometabolic risk factors varied across the studies and the clinical significance of these reductions is not clear. Peer support and self-management training may represent strategies to improve cardiometabolic risk factors.
Conclusions
Co-location of services may not be enough to significantly impact cardiometabolic risk factors. Health homes may have a greater impact on clinical outcomes if they include: standardized screening; peer support and self-management training; intervention components that target interdependent risk factors.
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Pubmed ID:31500547
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Pubmed Central ID:PMC6939136
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