Lecture Discussion 402

Lance Kelley, PhD 

Family Medicine physicians are uniquely situated to provide high-quality, patient-centered, behavioral health care—a critical need where access to psychiatric support is limited. Although guidelines from authoritative mental health professional organizations exist, these guidelines often do not translate easily to Primary Care.  To improve access and quality of primary care behavioral health, a community-based family medicine residency program, in close consultation with psychiatry faculty from a vanguard academic medical center, created 40 primary care focused Psychopharmacology Decision Support tools that are free for use by primary care clinicians. Tools range from Adult Bipolar Disorder to Pediatric ADHD, from Adult Fibromyalgia to Postpartum Generalized Anxiety Disorder.  Tool development and refinement—commencing two years ago and continuing at present—involves biweekly consultation that merges evidence-based medicine with expert opinion tailored to high-level primary care for vulnerable patients in areas with a dearth of psychiatry access. Using branching algorithms and primary-care-oriented content, the tools have improved physician decision-making competency and comfort in treating the broad range of psychopathology seen in primary care—while clearly delineating cases that warrant specialty care—for adult, pediatric, and perinatal patients. The tool is free to use and access and will be provided in book, web, and mobile app formats to participants. We will discuss how to apply the tool in primary care—including integration into electronic health records, provide updates on the future of the tools, and identify strengths and limitations of this unique take on the hub and spokes model.     

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