Reduction of anxiety symptoms among women within a collaborative care model and women's health settings

Abstract

Aim: The purpose of this study is to focus on changes in anxiety symptoms among women treated in women's health practices and under a collaborative care model.

Background: Research on collaborative care has largely focused on improving depressive and anxiety symptoms among adults in primary care settings. The applicability of collaborative care in other healthcare settings is underreported with limited research investigating if collaborative care has advantages in subpopulations treated in both traditional primary care settings and other healthcare settings, such as women's health practices.

Methods: This study, completed through secondary data analysis of the electronic record of N = 219 women across three women's healthcare centers, evaluated if instituting a collaborative care model is associated with reduced anxiety symptoms and which factors (eg, primary diagnosis, duration of care, and use of psychotropic medications) are associated with anxiety outcomes. Anxiety symptoms were assessed using the Generalized Anxiety Disorder 7-item scale (GAD-7) at entry into and at termination from collaborative care services.

Results: Overall, there was a significant reduction in average anxiety scores from baseline to termination of collaborative care (t(218) = 12.41, P < 0.001). There was a main effect for the duration of time receiving collaborative care services on anxiety score reduction (β = -0.28, SE = 0.06, P < 0.001) with a significant reduction in anxiety symptoms at the 90-day mark (t(218) = 10.58, P < 0.001). Therefore, collaborative care can be useful in women's health practices in reducing anxiety symptoms over a 90-day time period.

Keywords: anxiety; collaborative care; evidence-based practice; primary care; symptom reduction; women’s health.

Figure 1.

Median pre- and post-GAD-7 scores. Figure 1 demonstrates the median, interquartile ranges, and spread of these data. Paired Student’s t-test demonstrated a statistically significant difference between baseline GAD-7 scores and Last GAD-7 score (P < 0.001).

Figure 2.

Baseline GAD-7 scores by clinical cutoffs in comparison to Last GAD-7 scores by clinical cutoffs. Figure 2 demonstrates the frequency of participants categorized using clinical cutoffs of GAD-7 scores at baseline and at last score.

Figure 3.

Reduction in GAD-7 scores from baseline to final score over time (days). Figure 3 demonstrates the regression model output of days enrolled in collaborative care and reduction in anxiety symptoms, using residual change scores (the last score accounting for baseline anxiety score).