Table S2 Summary of Findings From 26 Randomized Controlled Trials Testing the Efficacy of Integrated Care

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1 Table S2 Summary of From 26 Randomized Controlled Trials Testing the Efficacy of Integrated Care Study Angeles et al., 2013 Béland et al., 2006 Bellantonio et al., SF Health care use: # of clinic visits due to chronic pain Requests for early medication refills or dosage increases Visits to allied health professions for chronic pain 1. Admissions 2. Service utilization 3. Alternate level of care 4. Home health 5. Social care 6. Total institutional and community costs 7. Overall total costs 8. Health status 9. Satisfaction with care 10. Caregiver burden 1. Time to any unanticipated transition out of assisted living 2. Permanent nursing facility admission 3. First ED visit 4. First hospitalization 2, 6 A. GH: No significant group differences at post intervention in functional quality of life (SF-36); however, a significant improvement in the mean change in the SF-36 subscale score for bodily pain at 6M. C. Use: Significant decrease in the mean number of clinic visits at 6M (d =.53, CI [.01, 1.05], p =.04), and approaching significance to be less likely to fill medications early at the 6M postintervention period (d =.47, [.06,.99], p =.08). No significant differences on clinic visits and medication dosage (d =.07, [.44,.58]) use between the two groups. 12 Day 7, 1, 3, 10 A. GH: No significant change in health status or mortality. C. Use: Significant higher home health and home social care. 50% reduction in the number treatment group participants who received alternative level of care compared to control. No significant differences in admissions, utilization, or costs for the other components of institutional care. No significant group differences in patient s reported satisfaction; however, significant caregiver reported satisfaction. D. Cost: No significant difference in total overall costs per person. A. GH: DNM C. Use: No significant group differences found, yet the intervention group reduced the risk of unanticipated transitions (13%), permanent relocation to a nursing facility (11%), ER visits (12%), and hospitalization (45%)

2 Boult, Rassen, Rassen, Moore, & Robison, 2000 Boult et al., Payment records of health care costs (included use of services provided by hospitals, specialist physicians, outpatient facilities, skilled nursing facilities, ERs, ambulances, home health agencies, hospice programs, medical supply companies, laboratories, treatment case-management program) 1. Sickness Impact Profile: Physical Functioning Dimension (SIP: PFD) item Geriatric Depression Scale (GDS) 3. Use of nursing home and home health services 4. Bed disability days (BDDs) 5. Restricted Activity Days (RADs) 6. Health Care Financing Administration records of payments for participants Medicare covered health care 7. Mortality 12 A. GH: DNM C. Use: Significant more case-management services used by the experimental group than the control group (3.2% vs. 0.7%, d =.85, CI [.59, 1.11], p <.001). D. Cost: No significant group differences in total health care payments. In addition, no significant evidence showing that the treatment reduced the use or the cost of health care for high-risk older people. 6, 12, 18 A. GH: Significant group differences on SIP: PFD at 6M (d = 0.19, CI [.35,.02], p <.05); 12M (d = 0.22, CI [.39,.06], p <.05); and 18M (d = 0.18, CI [.35,.02], p <.05). Significant difference between the two groups on BDD only at 18M (d = 0.22, CI [.38,.05], p <.05). Significant group differences on RAD only at 12M (d =.17, CI [.34,.01], p <.05). No significant differences in mortality rates (18M d =.04, CI [.35,.26]). B. BH: Significant group differences in GDS clinically significant scores for 12M (d =.40, CI [.67,.12], p <.05) and 18M (d =.46, CI [.74,.19], p <.05), with treatment group having lower GDS scores. C. Use: No significant differences in use of nursing home and home health services. D. Cost: No significant group differences among any of the Medicare payments for health services during 18M

3 (a) Counsell et al., 2007 (b) Counsell, Callahan, Tu, Stump, & Arling, 2009 Counsell et al., SF AHEAD (ADLS) 3. ER visits 4. Assessing Care of Vulnerable Elders (ACOVE) Counsell et al., Chronic and preventive care costs 2. Acute care costs 3. Total cost (a) 6, 12, 18, 24 (b) 24, 36 Counsell et al., 2007 A. GH: Significant improvements for intervention patients compared with usual care at 24M in 4 of 8 SF-36 scales: general health (d = 0.03, CI [.10,.15], p =.045); vitality (d = 0.10, CI [.03,.23], p <.001); social functioning (d = 0.15, CI [.02,.28], p =.008); and mental health (d = 0.13, CI [.004,.26], p =.001); and in the SF-36 Mental Component Summary (d = 0.16, CI [.03,.29], p <.001). No significant group differences for SF-36 Physical Component Summary (d =.02, CI [.15,.10]); SF-36 Physical Functioning (d = 0, CI [.13, 13]); SF-36 Role Physical (d =.07, CI [.06, 19]; SF-36 Physical Pain (d =.03, CI [.16,.10]); SF-36 Role Emotion (d =.05, CI [.07,.18]); ADLs (d = 0, CI [.13,.13]); or death (d =.06, CI [.33,.20]). C. Use: No significant group differences in hospital admission rates per 1,000. However, the cumulative 2-year ER visit rate per 1,000 was lower in the intervention group. (a) 2 (b) 2 Counsell et al., 2009 D. Cost: No significant group differences in average 2-year total costs.

4 (a) Ell et al., 2008 (b) Ell, Xie, et al., 2011 Ell et al., PHQ-9 2. Functional Assessment of Cancer Therapy Scale (FACT-G) 3. BSI 4. The Brief Pain Inventory Short Form (BPI) 5. SF-12 Ell, Xie, et al., Repeated at 24M (a) 6, 12 (b) 18, 24 Ell et al., 2008 A. GH: Significantly better quality-of-life outcomes, including social/family at 12M (d = 0.42, CI [.18,.67], p <.001); emotional (d = 0.30, CI [.05,.54], p =.01); functional (d = 0.24, CI [.004,.47], p =.04); and physical well-being at 6M (d = 0.30, CI [.05,.54], p =.01). Intervention patients had higher SF-36 physical function at 12M (d = 0.27, CI [.04,.50], p =.02). B. BH: More intervention patients reported a 50% or greater reduction in depressive symptoms (PHQ-9; d = 0.29, CI [.02,.57], p =.01). Improvement was also found for 5-point decrease in PHQ-9 score among intervention patients compared to enhanced usual care patients (d = 0.31, CI [.02,.60], p =.02). C. Use: Intervention patients received greater rates of depression treatment (d = 1.72, CI [1.33, 2.10], p <.001). (a) 2.5 (b) 2.5 Ell, Xie et al., 2011 A. GH: Similarly, significantly better social and family (d = 0.04, CI [.31,.24], p =.03) and functional (d = 0.16, CI [.11,.42], p =.01) well-being at 24M for the intervention group. B. BH: Significantly greater reduction in depressive symptoms of 50% (d = 0.44, CI [.13,.85], p =.02) at 24M for the intervention group. No significant differences between the two groups in depression recurrence (d =.07, CI [.38,.24]). C. Use: No significant differences in treatment rates at 24M. Among patients with depression recurrence, intervention patients were significantly more likely to receive treatment (d = 0.85, CI [.42, 1.26], p =.03).

5 (a) Ell et al., 2010 (b) Ell, Katon et al., 2011 (c) Hay, Katon, Ell, Lee, & Guterman, 2012 Ell et al., PHQ-9 2. SCL Depression treatment receipt 4. BSI 5. Sheehan Disability Scale (SDS) 6. SF-12 (PCS and MCS) 7. Whitty 9-item diabetes questionnaire 8. Summary of Diabetes Self-Care Activities Questionnaire 9. Self-reported weight and height (body mass index) 10. Diabetes complications and comorbid physical illness. 11. Self-reported socioeconomic stressors (a) 6, 12, 18 (b) 24 (c) 18 Ell et al., 2010 A. GH: Significantly greater improvement in functional impairment (SDS) at 6M (d = 0.17, CI [.39,.06], p =.01) but not 12M and 18M. Significant improvement in the SF-12 Physical Component Summary at 6M (d =.13, CI [.10,.35], p <.05), but not at 12M or 18M. No significant group differences in A1C (d =.08, CI [.31,.16]); diabetes complications (d =.07, CI [.16,.31]); mean self-care management scores; or BMI. B. BH: Significantly greater improvement in depression (SCL-20; p <.001) at 6M (d = 0.46, CI [.21,.72], p <.001); 12M (d = 0.44, CI [.18,.70], p <.001); and 18M (d = 0.40, CI [.14,.67], p <.001). Significantly greater improvement of SF-12 MCS at 6M (d = 0.35, CI [.12,.58], p <.001); 12M (d = 0.31, CI [.07,.54], p <.001); and 18M (d = 0.14, CI [.10,.37], p =.03). C. Use: Significantly more antidepressant medication and/or counseling/psychotherapy for intervention group patients at 12M (d = 1.31, CI [1.0, 1.63], p <.001) and 18M (d = 0.54, CI [.26,.82], p <.001). (a) 2.5 (b) 2.5 (c) 2.5 Ell, Katon et al., Repeated at 24 months Hay et al., Depression-free days 2. Health related quality of life (QoL) 3. Quality adjusted life-years (QALYs) 4. Brazier and Roberts SF-6D 5. Medicare Resource Based Relative Value Scale Ell, Katon et al., 2011 A. GH: No difference in diabetes symptoms (d =.10, CI [.34,.14]) and diabetes self-care management (d =.11, CI [.13,.35]) at 24M. B. BH: Sustained depression symptom improvement SCL-20 (d = 0.20, CI [.07,.46], p =.05); PHQ-9 (d = 0.04, CI [.22,.31], p <.05) at 24M. Significant differences in remission rates based on SCL-20 at 24M (d =.02, CI [.26,.30], p <.03). C. Use: Significant more intervention patients received ongoing antidepressant medication treatment (d = 0.33, CI [.04,.62], p <.05), but no significant differences were observed in depressive treatment other than medications (d =.27, CI [0.0,.55]). Hay et al., 2012 A. Cost: Significantly greater SF-12 utility improvement from baseline compared with controls and a corresponding significant improvement in depression-free days. No significant difference in medical cost. The program s cost-effectiveness averaged $4,053 per quality-adjusted life-year per MDDP recipient and was more than 90% likely to fall below $12,000 per quality-adjusted life-year.

6 Engelhardt, Toseland, Gao, & Banks, 2006 Farmer, Clark, Drewel, Swenson, & Ge, 2011 Fortinsky, Kulldorff, Kleppinger, & Kenyon- Pesce, Outpatient service utilization 2. Inpatient utilization 3. Cost 4. Survival 1. Shared Responsibilities Tool Kit 2. Parent reported satisfaction with health services 3. Family Support Scale 4. Family Needs Survey 5. Impact on Family Scale 6. Parent reported BDI-II 7. Parent reported ability to meet work or other daily responsibilities 8. Child health status 9. Functional Status II 10. Missed school days 1. Nursing home admission 2. Symptom management self-efficacy score 3. Support service self-efficacy 4. CES-D (reported about caregiver) 5. Zarit burden score 6. Hopkins Symptoms Checklist (caregiver s physical health symptoms) 8, 16, 24, 32, 40, 48 Treatment condition: 6 Control condition: 6, A. PH: No significant group differences in mortality rates. GH: No significant group differences in mortality rates. C. Use: Control group had a greater number of ER visits that treatment group. No significant group differences in hospital admissions between groups across all six time periods (d =.03.26); however, control group had greater length of hospital stay at 24M (d =.34, CI [.03,.65], p <.05). D. Cost: Significantly lower overall treatment health care costs than control participants by 24M. Cost savings plateaued during the 24- to 48-month period. Cost savings were due primarily to fewer hospital days used by the treatment group. A. GH: Significant improvement after treatment in children s overall health, but no difference between groups. C. Use: Treatment group had greater satisfaction with MH services (d =.33, CI [.80,.14], p <.05) and therapies (d =.31, CI [.78,.16], p <.05). Trend toward improved rating of satisfaction of care coordination (d =.42, CI [.89,.05], p =.058). Treatment group reported significantly less need for information about child s condition after intervention compared to control (d =.65, CI [ 1.13,.17], p <.05). A. GH: DNM C. Use: The treatment group was less likely to be admitted to a nursing home and approached significance (d = 0.52, CI [ 1.10,.06], p =.10). No significant group differences in caregiver burden (d =.28, CI [.72,.18])

7 Grote et al., SCL Work and Social Adjustment Scale (WSAS) 3. PTSD Checklist Civilian Version (PCL- C) 4. PHQ 5. Perception of Quality of MH care 3, 6, 12, 18 A. GH: Significant improvement of intervention WSAS scores compared to control condition at 18M (9.4 vs. 13.3, d =.42; CI [.73,.11], p <.01); however, no significant differences were observed at 3M, 6M, or 12M. B. BH: Participants in treatment group attained lower levels of depression severity (.79 vs. 1.03; d =.35, CI [.66,.04] p <.01) and PTSD severity (31.6 vs. 36.7, d =.40, CI [.71,.09], p <.01) and had higher rates of depression remission (48% vs. 29%, d = 0.45, CI [.10,.81], p <.01) at 18M. A lower proportion of the treatment group reported generalized anxiety symptoms than the control group at 12M and 18M (10% vs. 22%, d =.52, CI [.1.0,.03], p <.01). C. Use: Significantly greater likelihood of receiving more than 4 MH visits at 3M (d = 2.08, CI [1.54, 2.61], p <.001); 6M (d = 1.00, CI [.57, 1.42], p <.001); 12M (d = 1.11, CI [.69, 1.51], p <.001); and 18M (d =.90, CI [.35, 1.45], p <.001). Significantly more likely to adhere to antidepressants for intervention group at 3M (d =.82, CI [.34, 1.29], p <.001) and 12M (d =.65, CI [.18, 1.12], p <.01). Significantly more likely to report satisfaction with services at 3M (d =.66, CI [.20, 1.12], p <.001); 6M (d =.57, CI [.11, 1.04], p <.05); and 12M (d =.55, CI [.10,.99], p <.05) for treatment group; however, no significant group differences at 18M. 2.5

8 Hedrick et al., 2003 Huffman et al., SCL Veterans Short Form (SF) Sheehan Disability Scale (SDS) 4. Veterans Administration electronic medical record system (assessed prescriptions) 5. Satisfaction of services 1. SF-12 MCS 2. PHQ-9 3. HADS-A 4. Duke Activity Status Index (DASI) 5. Adherence to Health Behaviors (Medical Outcomes Study Specific Adherence Scale) 6. SF-12 PCS 7. EuroQol 8. Cardiac readmission 3, 9 A. GH: Significant improvements of treatment group SDS scores from baseline to 3M compared to control group; however, no significant group differences at 9M. Significant treatment mean score difference on the SF-36 physical health component between baseline and 3M; however no significant group differences. B. BH: Significant larger decrease in treatment depression symptoms (SCL-20) at 3M (.34 vs.14, p <.05), but no significant differences occurred at 9M. Significant improvement on the treatment SF-36 MCS at both 3M and 9M in unadjusted analysis; however, results were attenuated in adjusted analyses. C. Use: Significant increase proportion of treatment patients receiving depression prescriptions and CBT; however, no significant group differences in no-shows or cancellations of appointments. No significant group differences in satisfaction of services. 24 A. GH: Significant group difference in functional outcomes (DASI; vs , d =.34, p <.01) and overall health related quality of life (EuroQol, d =.34, p <.05). No significant group differences on the SF-12 PCS (d =.22). B. BH: Significant greater improvements on treatment mean scores at 24 weeks as d by the SF-12 MCS than the control group (11.21 vs. 5.53; d =.61; p <.01). Significant improvements in treatment depressive symptoms (PHQ-9; 8.06 vs. 6.01, d =.45, p <.05). No significant group differences on the HADS-A (d =.10). C. Use: No significant difference in treatment adherence. No significant difference on cardiac readmissions (d =.03, CI [.37,.32])

9 Katon et al., 2001 Kwong, Chung, Cheal, Chou, & Chen, Antidepressant medication adherence 2. SCL The Longitudinal Interval Follow-up Evaluation (incidence and duration of depression episode) 1. PHQ-9 2. Beck Anxiety Scale 3. SF Quality of Life, Enjoyment, and Satisfaction Questionnaire (Q-LES-Q) 5. Perceived stigma of treatment 6. Treatment adherence 3, 6, 9, 12 A. GH: DNM B. BH: Significantly fewer depressive symptoms for treatment group, but not fewer episodes of relapse/recurrence over the 12M follow-up period. C. Use: Significant greater adherence to adequate dosage of antidepressant medication for treatment group for 90 days or more within the first and second 6-month periods and significant more likely to refill medication prescriptions during the 12M follow-up compared with usual services condition. 4 A. GH: No significant group differences on SF-12. B. BH: No significant group differences in reported symptoms (PHQ-9; BAI), although both groups reported reduction of depressive symptoms and improved mental health functioning from baseline to follow-up. No significant group differences on Q-LES-Q. C. Use: The treatment group had increased number of primary care physician visits (d = 0.66, CI [.12, 1.19], p <.05); however, no significant differences in treatment adherence (d =.07, CI [.45,.60]). No significant group differences on perceived treatment stigma

10 Leung, Liu, Chow, & Chi, Hong Kong version of the Minimum Data Set Home Care (MDS-HC) 2. Hospitalization record 3. Cost 6 A. GH: No significant differences in nurse-reported health status of intervention participants on informal support (MDS- HC, 6M d =.07, CI [.31,.17]). No significant group differences in nurse-reported health status in the number of health problems (d =.06, CI [.30,.19]) or mental functioning (d =.29, CI [.53,.04]). Significant improvements for incontinence for intervention participants (d = 0.33, CI [.58,.09], p <.05). B. BH: No significant group differences in nurse-reported health status in behavioral symptoms (d =.02, CI [.27,.22]). C. Use: For the intervention group, total number of acute hospital bed days was lower than the control group (3.8 vs. 4.7, d =.13, CI [.37,.12]); however, it was not significantly different between groups. D. Cost: Compared with the control group, $170,448 was saved in acute hospital care and community health services in the intervention group. 2

11 (a) Melville et al., 2014 (b) Katon et al., 2014 Melville et al., SCL SDS 3. Patient Global Improvement (PGI) Scale 4. Satisfaction with depression care 5. Use of mental health services Katon et al., SCL PGI 3. Satisfaction with care (a) 6, 12, 18 (b) 6, 12, 18 Melville et al., 2014 A. GH: Significant improvement functioning over 18M (p <.05; SDS) for intervention group. B. BH: Significant greater improvement in depressive symptoms (SCL- 20) for intervention group at 12M (d = 0.63, CI [.33,.93], p <.001) and 18M (d =.46, CI [.17,.76], p<.01). Significantly more likely to have an at least 50% decrease in depressive symptoms (SCL-20) at 12M (d =.56, CI [.22,.89], p <.01) for intervention group. Depression remission rates were greater in treatment group at 18 M (d =.51, CI [.06,.95], p <.01), but not at 6M or 12M. Significantly more likely to report improvement in symptoms (PGI) for intervention group at 12M (77.0% vs. 37.2%, d =.95, CI [.60, 1.31], p <.001) and 18M (69.9% vs. 37.9%, d =.74, CI [.38, 1.09], p <.01). C. Use: Intervention group had a greater likelihood of at least 4 specialty mental health visits at 6M (79.1% vs. 29.3%, d = 1.22, CI [.85, 1.59], p <.001) and 12M (74.9% vs. 30.8%, d = 1.05, CI [.59, 1.41], p <.001),; adequate dose of antidepressant at 6M (51.6% vs. 31.5%, d =.46, CI [.13,.80], p <.05) and 12M (57.1% vs. 33.3%, d =.54, CI [.21,.87], p <.05); and greater satisfaction with care at 6M (89.0% vs. 52.2%, d = 1.10, CI [.68, 1.53], p <.01) and 12M (89.5% vs. 39.6%, d = 1.41, CI [.97, 1.86], p <.001). (a) 2.5 (b) 3 Katon et al., 2014 A. GH: DNM B. BH: The treatment effect for depressive symptoms was significantly associated with insurance status. Those with no insurance or with public coverage had greater recovery from depression symptoms with the intervention than with UC at 18M. At 12M, the effect size for depression improvement compared with UC among women with no insurance or with public coverage was 0.81, whereas it was 0.39 for women with commercial insurance. Participants with commercial insurance reported improvement on PGI at 6M; however, no significant differences in PGI between insurance groups at 12M and 18M. C. Use: No significant difference in number of care-manager sessions by insurance group. No significant difference on satisfaction of depression care between insurance groups.

12 Richardson et al., 2014 Ross, Roberts, Campbell, Solomon, & Brouhard, CDRS-R 2. PHQ-9 3. Columbia Impairment Scale (CIS) 4. Quality of care 5. Satisfaction with treatment 1. Inappropriate utilization of ER (i.e., number of visits for ER care) 2. Appropriate well-child care utilization (i.e., number of routinely scheduled visits with a primary care provider) 6, 12 A. GH: DNM B. BH: Significantly greater treatment decreases in mean CDRS-R scores at 6M and 12M than control group (27.5 vs. 34.6, d =.52, CI [.91,.12], p <.001). Significantly more likely to achieve depression response at 6M (PHQ-9, 48.4% vs. 23.4%, d =.62, CI [.15, 1.0], p <.05) and 12 M (PHQ-9, 67.6% vs. 38.6%; d =.66, CI [.21, 1.11], p <.01); and significant more likely to achieve depression remission at both 6M (PHQ-9, 36.6% vs. 10.2%, d =.90, CI [.30, 1.49], p <.01) and 12M (PHQ-9, 50.4% vs. 20.7%, d =.75, CI [.27, 1.23], p <.01) for treatment group than control group. Both groups reported improvements on the CIS with no significant differences between groups at 12M (16.3 vs. 13.4, d = 0.32, CI [.07,.71]). C. Use: The treatment group was significantly more likely to receive 4 or more sessions of treatment at 6M (84% vs 15.7%, d = 1.84, CI [1.25, 2.43], p <.001) and to receive psychotherapy and medication that met quality standards (d =.83, CI [.09, 1.57]. Significantly greater satisfaction of services for intervention group at 6M (85% vs. 50%, d =.96, CI [.43, 1.48], p <.001), but no significant group differences at 12M (82.2% vs. 68.5%, d =.41, CI [.10,.93]). NR A. GH: DNM C. Use: Significant group differences in ER visits (.94 vs. 1.81, p <.01) and scheduled visits with a primary care provider (1.86 vs..46, p <.001) for the treatment compared to control in the postintervention period

13 Roy-Byrne et al., BSI (anxiety and somatization subscales) 2. PHQ-8 3. SF SDS 5. Satisfaction with treatment 6. Quality of care 7. Anxiety Sensitivity Index 6, 12, 18 A. GH: Significant improvements were reported on SDS at all time points favoring the treatment group (6M d =.32, CI [.46,.19]; 12M d =.44, CI [.59,.32]; 18M d =.35, CI [.47,.19]; p <.001). No significant group differences for SF-12 PCS (6M, d = 0.05, CI [.07,.17]; 12M, d =.01, CI [.16,.14]; 18M, d =.08, CI [.05,.22]. B. BH: Significantly more likely to report BSI treatment response (6M, d =.46, CI [.32,.60], p <.01; 12M, d =.42, CI [.28,.56], p <.01; 18M, d =.30, CI [.16,.44], p <.01) and remission of symptoms (6M, d =.39, CI [.24,.53], p <.01; 12M, d =.39, CI [.24,.53], p <.001; 18M, d =.32, CI [.18,.46], p <.001) among the treatment group. Significant group differences on the PHQ-8 (6M, d =.31, CI [.44,.18], p <.001; 12M, d =.34, CI [.47,.21], p <.001; 18M, d =.26, CI [.39,.13], p <.01); SF-12 MCS (6M, d =.34, CI [.21,.47], p <.001; 12M, d =.47, CI [.33,.61], p <.001; 18M, d =.39, CI [.24,.54], p <.001), and Anxiety Sensitivity Index (6M, d =.31, CI[.44,.18], p <.001; 12M, d =.34, CI [.47,.21], p <.001; 18M, d =.26, CI [.39,.13], p <.01). C. Use: Significantly greater satisfaction with mental health services at 6M (d =.72, CI [.59,.86], p <.001) and 12M (d =.48, CI [.34,.62], p <.001) for the treatment. Significant group differences for satisfaction in overall health care at 6M (d =.40, CI [.27,.54], p <.001) and 12M (d =.22, CI [.08,.37], p =.03), but not 18M (d =.09, CI [.06,.24]). 2.5

14 Roy-Byrne et al., 2014 Safren, O Cleirigh, Skeer, Elsesser, & Mayer, ASI 2. ASI-Drug subscale score 3. Days of self-reported drug use 4. Health service use 5. Mortality 6. Felony or gross misdemeanor charges 7. HIV TRB 1. HIV TRB 2. PHQ-9 3. Alcohol use 4. Drug use 3, 6, 9, 12 3, 6, 9, 12 A. GH: No significant group differences in rates of mortality (d = 0, CI [.52,.52]) or HIV TRB (d = 0, CI [.15,.15]). B. BH: No significant group differences in self-reported use of the most common problem drug at 3M post intervention (d =.18, CI [.05,.31]). No significant group differences in mean ASI Drug Use composite score at 3M (d =.11, CI [.02,.24]). C. Use: No significant group differences in health service use (e.g., ER visits, d =.02, CI [.12,.17]; chemical dependency treatment services, d = 0, CI [.14,.14]). No significant group differences in the number of felony or misdemeanor charges (d =.06, CI [.17,.31]). A. GH: No significant group differences in HIV TRB over the study time period (3M, d =.03, CI [.31,.25]; 6M, d =.08, CI [.19,.36]; 9M, d =.23, CI [.05,.50]; 12M, d =.08, CI [.20,.36]). B. BH: When examining moderators, the intervention was differentially effective in reducing HIV TRB for those who screened higher for baseline depression. No significant moderator effects of alcohol or drug use on the treatment effect. C. Use: DNM 2.5 2

15 (a) Saitz et al., 2013 (b) Park et al., 2015 Saitz et al., ASI 2. PHQ-9 3. Short Inventory of Problems for alcohol use (SIP-2R or SIP-Alcohol) 4. A modified version of the SIP for drugs (SIP-Drug) 5. SF-12 PCS and MCS 6. Self-reported abstinence of substances 7. Hospitalization or ER use 8. Biomarkers of substance use 9. Addiction treatment use 10. HIV TRB Park et al., ASI 2. PHQ-9 3. BAI 4. Short Inventory of Problems for alcohol use [SIP-2R or SIP-alcohol]; 5. A modified version of the SIP for drugs [SIP-drug]) 6. Treatment Services Review (a) 3, 6, 12 (b) 3, 6, 12 Saitz et al., 2013 A. GH: No group significant differences on SF-12 PCS (12M, d =.13, CI [.04,.29] or HIV TRB. B. BH: No significant group differences on abstinence from opioids, stimulants, or heavy drinking (44% vs. 42%, d =.05, CI [.14,.23]). No significant group differences on the ASI-Alcohol (12M, d =.07, CI [.29,.16]), ASI-Drug (12M, d = 0, CI [.23,.23]), SF-12 MCS (12M, d = 0, CI [.17,.17]) were found. C. Use: Any addiction treatment (d =.23, CI [.02,.47], p <.01) and addiction medication treatment (d =.11, CI [.07,.30], p <.001) were higher among the intervention group compared to the UC group; however, no significant differences for mutual help group attendance (d =.05, CI [.23,.14]). Park et al., 2015 A. GH: DNM B. BH: Among all participants, 79% met criteria for major depressive disorder, and 36% met criteria for PTSD at baseline. No significant effects of the intervention were observed within either subgroup for any outcome. C. Use: Marginally fewer days in the ER for intervention participants with depression that did not meet statistical significance (p =.06). (a) 2 (b) 1

16 Samet et al., 2003 Sommers, Marton, Barbaccia, & Randolph, Time to linkage to primary medical care 2. ASI 3. SF-36 (PCS; MCS) 4. Risk Assessment Battery (RAB) 5. Use of medical and addiction services 1. Use of medical services 2. Health Activities Questionnaire 3. GDS 4. SF Cost 6, 12, 18, 24 12, 24, 36 A. GH: No significant group differences on SF-36 MCS (24M, d =.18, CI [.05,.42]) or PCS (24M, d =.14, CI [.10,.38]). No group differences on the RAB Sex (24M, d =.12, CI [.12,.35]) or RAB Drug (24M, d =.06, CI [.18,.29]) component. B. BH: No significant group differences on ASI-Alcohol (24M, d =.08, CI [.16,.31]) or ASI-Drug (24M, d =.08, CI [.16,.31]) components. C. Use: Significant greater linkage to PCP for treatment than control (69% vs. 53%, d = 0.38 CI [.18,.57], p <.001). Alcohol use and cocaine/heroin groups equally likely to receive treatment. A. GH: No significant group differences for observed physical, emotional, or nutritional status (SF-36), or number of medications. B. BH: No significant difference on GDS. Significant increase in social activities for treatment group. C. Use: Significant increase in the hospitalization rate of the control group after 12M, but the rate of the intervention group stayed the same (d =.36 CI [.55,.17], p <.05). The proportion of intervention patients with readmissions decreased (from 6% to 4%), whereas the rate of the control group doubled from 4% to 9% (d =.48, CI [.88,.07]; p =.03). Significant group differences on the mean office visits. No significant group difference in proportions of patients with 1 or more ER visits, home care visits, or skilled nursing facility admissions. D. Cost: Savings were estimated at $90 per participant. 2 2 Note. Effect sizes (Cohen s d) were calculated when sufficient data were presented in studies; effect sizes were not calculated for cost data because no study reported adequate information. The sign of the effect size reflects the direction of the outcome hypothesis. Exact p values are reported when available. A1C = glycosylated hemoglobin (hemoglobin A1c); ASI = Addiction Severity Index (the ASI has subscale scores for medical status, employment and support, drug use, alcohol use, legal status, family/social status, and psychiatric status); BAI = Beck Anxiety Inventory; BSI = Brief Symptom Inventory; CES-D = Center for Epidemiologic Studies Depression Scale; CI = 95% confidence intervals; DNM = did not ; ER = emergency room or emergency department; GDS = Geriatric Depression Scale; HIV TRB = HIV transmission risk behavior; ITT = intent-to-treat analysis protocol; M = months; MH = mental health; NR = not reported; PHQ-9 = Patient Health Questionnaire-9; SCL-20 = Symptom Checklist-20; SDS = Sheehan Disability Scale; SF-12 = Medical Outcomes Study Short-Form Health Survey-12 item; SF-36 = Medical Outcomes Study Short-Form Health Survey-36 item; SF-36 Subscales: vitality, physical functioning

17 (PCS = Physical Component Scale), bodily pain, general health perceptions, physical role functioning, emotional role functioning, social role functioning, and mental health (MCS = Mental Component Scale); U = unclear information provided. In this study, statistical significance was reported based on an adjusted model including covariates. However, the study reported unadjusted means and unadjusted standard deviations. These were extracted to calculate effect sizes and confidence intervals. As a result, it is possible that adjusted analyses were significant while the calculated confidence intervals for the effect sizes based on unadjusted means and standard deviations contain zero. 1 Jadad scores rely on three criteria to assess the quality of studies: (a) use of an unbiased treatment allocation procedure, (b) masking of study participants, and (c) analysis based on intent-to-treat. Each criterion carried a 1-point value. Studies that masked participants and data collectors (i.e, doubly blind studies) were scored as 1 point, whereas studies that masked either participants or data collectors (i.e., singly blind studies) were scored as.5 points. Scores were summed, with higher values indicating greater rigor.