Implementation of the collaborative care model in France: first quantitative results from registers
Background
Common mental disorders (anxiety and mood disorders), primarily treated in primary care, could be improved with a better coordination between general practitioners (GPs) and specialized care. The collaborative care model (CCM) is recognized as a best practice model to integrate evidence-based mental health care in primary care. In France, a pilot of this model (SESAME) has been deployed from September 2021 to November 2023, with an implementation study (MOSAIQUE) conducted using a mixed method design combining quantitative and qualitative data.
Objectives and methods
Our objectives are to present the implementation of the CCM according to quantitative data from registers (available from February 2024 onwards, N= 200 patients were included in the research), in terms of penetrance (number of patients who received CC compared to all primary care patients during the study period), in terms of acceptability (rate of patients who received CC compared to those referred by GPs, of refusals and loss to follow-up), in terms of fidelity ( demographic and clinical profile of patients included:initial depressive severity, suicidal severity, and type of CC received:number of consultations, percentage of follow-ups at 12 weeks with at least 4 nurse consultations, number of meetings between the nurse and psychiatrist, number of consultations by the GP during follow-up in collaborative care, percentage of patients referred to specialized care, number of patients seen by psychologists, rate of consultations with a psychiatrist in the absence of symptoms improvement) and results (percentage of patients who benefited from adapted pharmacotherapy over 12 weeks, percentage of patients treated for more than 6 months, rate of respondents and of remitted patients).
Findings and perspectives
These outcomes will be compared with quantitative data of US implementation studies on collaborative care. Issues with primary care of common mental health disorders in France will be considered.
Common mental disorders (anxiety and mood disorders), primarily treated in primary care, could be improved with a better coordination between general practitioners (GPs) and specialized care. The collaborative care model (CCM) is recognized as a best practice model to integrate evidence-based mental health care in primary care. In France, a pilot of this model (SESAME) has been deployed from September 2021 to November 2023, with an implementation study (MOSAIQUE) conducted using a mixed method design combining quantitative and qualitative data.
Objectives and methods
Our objectives are to present the implementation of the CCM according to quantitative data from registers (available from February 2024 onwards, N= 200 patients were included in the research), in terms of penetrance (number of patients who received CC compared to all primary care patients during the study period), in terms of acceptability (rate of patients who received CC compared to those referred by GPs, of refusals and loss to follow-up), in terms of fidelity ( demographic and clinical profile of patients included:initial depressive severity, suicidal severity, and type of CC received:number of consultations, percentage of follow-ups at 12 weeks with at least 4 nurse consultations, number of meetings between the nurse and psychiatrist, number of consultations by the GP during follow-up in collaborative care, percentage of patients referred to specialized care, number of patients seen by psychologists, rate of consultations with a psychiatrist in the absence of symptoms improvement) and results (percentage of patients who benefited from adapted pharmacotherapy over 12 weeks, percentage of patients treated for more than 6 months, rate of respondents and of remitted patients).
Findings and perspectives
These outcomes will be compared with quantitative data of US implementation studies on collaborative care. Issues with primary care of common mental health disorders in France will be considered.