Collaborative care model versus usual care for the management of musculoskeletal and co-existing mental health conditions: a randomised feasibility mixed-methods study.
Journal article
Cardoso Teixeira, M., Ahmed, R., Tehrany, R., Jaggi, A. and Ramanuj, P. (2024). Collaborative care model versus usual care for the management of musculoskeletal and co-existing mental health conditions: a randomised feasibility mixed-methods study. BMJ Open. 14 (2), p. e079707. https://doi.org/10.1136/bmjopen-2023-079707
| Authors | Cardoso Teixeira, M., Ahmed, R., Tehrany, R., Jaggi, A. and Ramanuj, P. |
|---|---|
| Abstract | This study aimed to assess the feasibility of a future trial comparing the collaborative care model with usual care for patients with musculoskeletal conditions and co-existing symptoms of anxiety and depression. A single-centre, parallel-arm, one-to-one, randomised controlled trial design using a mixed-methods approach was used. semistructured interviews and focus groups were conducted post intervention with all participants and staff respectively to explore acceptability towards the model and identify recommendations for improvements. An orthopaedic rehabilitation outpatient tertiary hospital. Adult patients with musculoskeletal conditions and co-existing moderate or severe symptoms of anxiety and depression attending outpatient therapy appointments. The collaborative care model consisted of a tailored management programme to facilitate the integration of care provided by physical and mental healthcare professionals. A case manager screened and coordinated targeted mental health support for participants. Participants allocated to usual care had no support from the case manager. Feasibility indicators (rates of recruitment, randomisation and retention), acceptability of clinical outcome measures, usage of additional resources and cost of intervention implementation. Of the 89 patients who provided consent to take part, 40 participants who matched the eligibility criteria were randomised to either the intervention (n=20) or usual care arm (n=20). Overall adherence to the intervention was 58.82%, while the withdrawal rate was 37.5% at 6 months. All of the 27 participants who were retained completed self-reported outcomes. Qualitative data highlighted that integrated mental health support was favourably perceived. In addition to prenegotiating protected psychology time, the need for operationalised communication between the case manager and clinicians was identified as a recommendation for a future trial. The trial and intervention were acceptable to patients and healthcare professionals. While the findings demonstrate the feasibility of trial recruitment, a future trial will require optimised retention strategies to improve adherence and withdrawal rates. NCT05018039. [Abstract copyright: © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.] |
| Keywords | MENTAL HEALTH; Cost-Benefit Analysis; Humans; Randomized Controlled Trial; Musculoskeletal disorders; Adult; Quality of Life; Mental Health; Depression & mood disorders; Anxiety - therapy; Anxiety disorders; Physical Therapy Modalities; Musculoskeletal Diseases - complications - therapy; Feasibility Studies |
| Year | 2024 |
| Journal | BMJ Open |
| Journal citation | 14 (2), p. e079707 |
| Publisher | BMJ |
| ISSN | 2044-6055 |
| Digital Object Identifier (DOI) | https://doi.org/10.1136/bmjopen-2023-079707 |
| Publication dates | |
| Online | 21 Feb 2024 |
| Publication process dates | |
| Accepted | 26 Jan 2024 |
| Deposited | 15 Mar 2024 |
| Publisher's version | License File Access Level Open |
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