Abstract
Integrated behavioral healthcare (IBH) is the “standard of care” to address psychosocial factors impacting diabetes outcomes; it is not standard in practice. This longitudinal, retrospective, chart-review examines IBH impact on glycemic control in an adult diabetes clinic. Adults (n = 374) with ≥ 1 behavioral health encounter, ≥ 2 hemoglobin A1c (HbA1c) values, and HbA1c value > 8% at initial IBH visit were included. Mixed effects linear piecewise models examined differences in slope trajectories for 365 days pre- and post-IBH intervention. Pre-intervention slope was not significant (z = − 1.09, p = 0.28). The post-intervention slope was significant (z = − 6.44, p < 0.001), indicating a significant linear decrease in HbA1c values. Results demonstrated that prior to engaging with behavioral health, there was no change in HbA1c. After initial IBH visit, there was a predicted reduction of > 1% in HbA1c over the following year. These results suggest that IBH significantly improves patients’ metabolic status. Next steps for IBH research are offered.
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KLM conceptualized, wrote, and edited the manuscript; KSD analyzed the data and wrote/edited the manuscript; SAB-M conceptualized the study and edited the manuscript; AGD prepared and analyzed the data and edited the manuscript; MJT conceptualized the study and edited the manuscript.
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Kristin L. MacGregor, Kelly S. DeMartini, Samantha A. Barry-Menkhaus, Alan G. Derr, and Michael J. Thompson declare that they have no conflict of interest.
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This research study was conducted retrospectively from data obtained for clinical purposes. We consulted extensively with the IRB of UMass Medical School who determined that our study did not need ethical approval. An IRB official waiver of ethical approval was granted from the IRB of UMass Medical School.
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This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Institutional Review Board approved this study.
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MacGregor, K.L., DeMartini, K.S., Barry-Menkhaus, S.A. et al. The Impact of Integrated Behavioral Healthcare on Glycemic Control. J Clin Psychol Med Settings 29, 636–644 (2022). https://doi.org/10.1007/s10880-021-09817-w
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DOI: https://doi.org/10.1007/s10880-021-09817-w