Collaborative Care, Community C-L
Significant gaps exist between the demonstration of an intervention’s efficacy and its translation into clinical practice. Pragmatic effectiveness and implementation studies provide crucial evidence that can help bridge the gap between research and practice. Pragmatic clinical trials compare the effectiveness of interventions in heterogeneous, real-world study conditions with the goal of providing results that are directly applicable to clinical practice. Implementation studies are focused on adoption or uptake of evidence-based interventions by providers and systems of care. This Research SIG-sponsored symposium will showcase a broad range of pragmatic effectiveness and implementation studies in the field of C-L psychiatry. Speakers will present the following details about their studies: (1) rationale and conceptualization; (2) attainment of funding; (3) methodology, with an emphasis on the components that define its real-world focus; (4) preliminary results; and (5) challenges and lessons learned from conducting the trial.
Jesse Fann, MD, MPH, FACLP will provide an overview of the key components of pragmatic clinical effectiveness and implementation trials and will present the example of a Patient-Centered Outcomes Research Institute (PCORI) funded multisite randomized comparative effectiveness trial that aims to improve transitions from acute to post-acute care for individuals with traumatic brain injury. The study compares standard transition care to standard care plus telehealth-delivered case management. (20 minutes)
Nancy Byatt, DO, MS, MBA, FACLP will present a cluster-randomized controlled trial in Ob/Gyn practices that compares the effectiveness of two active interventions that aim to improve perinatal depression. The study design combines effectiveness with implementation research designs and integrates critical components of participatory action research. (15 minutes)
Khyati Brahmbhatt, MD will present an implementation study of a pediatric suicide risk screening clinical pathway used in inpatient and ED settings, developed by members of the physically ill child committee of the American Academy of Child and Adolescent Psychiatry and supported by the Abramson Fund. The current study explores the feasibility of implementing the pathway in pediatric hospital settings. (15 minutes)
Kimberly Yonkers, MD will present a randomized clinical trial that compared three different methods for implementing the use of motivational interviewing (MI) for medical inpatients with substance use disorders. Hospital staff and nurses were randomized to a seminar on MI only vs. a seminar and bedside coaching vs. the ability to place an order for an expert to perform MI. (15 minutes)
Mary Amanda Dew, PhD, FACLP will provide a commentary on the presentations in the context of efforts to study and deliver evidence-based behavioral interventions in medically ill populations. The symposium will conclude with a panel discussion and interactive Q&A facilitated by Dr. Dew. (25 minutes)
1. Sox HC, Lewis RJ. Pragmatic Trials: Practical Answers to "Real World" Questions. JAMA 316(11):1205-1206, 2016