• Winston Liaw, Thomas F Northrup, Angela L Stotts, Christine Bakos-Block, Robert Suchting, Alvin Chen, Abigail Hernandez, Lisandra Finzetto, Charles Green, and Thomas Murphy.
• From the Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Texas (WL); Department of Family & Community Medicine, University of Texas Health Science Center at Houston, McGovern Medical School (TFN, ALS, TM); School of Biomedical Informatics, University of Texas Health Science Center at Houston (CBB); Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston (RS); University of Texas Health Science Center at Houston, McGovern Medical School, (AC); Department of Medicine, University of Texas Health Science Center at Houston (AH); Department of Counseling, Wake Forest University, Winston-Salem, North Carolina (LF); Department of Pediatrics, University of Texas Health Science Center at Houston (CG). wliaw@central.uh.edu.
• J Am Board Fam Med. 2023 May 8; 36 (3): 414424414-424.

PurposeTo determine whether an immediate referral to a medical-legal partnership (MLP), compared with a 6-month waitlist control, improved mental health, health care use, and quality of life.MethodsThis trial randomly assigned individuals to an immediate referral or a wait-list control. The MLP involved a collaboration between the primary care clinic and a legal services organization. The primary outcome was stress (6 months) as measured by the Perceived Stress Scale (PSS). Secondary measures included the Center for Epidemiologic Studies Depression Scale; Generalized Anxiety Disorder scale (GAD-7); Patient-Reported Outcomes Measurement Information System (PROMIS); and emergency department (ED), urgent care, and hospital visits. Assessments were at baseline and 3-, 6-, and 9-month follow-ups. Bayesian statistical inference and a 75% posterior probability threshold were used to identify noteworthy differences.ResultsImmediate referral was associated with lower PSS scores and higher GAD-7 scores. PROMIS scores were higher for the immediate referral group with respect to several subdomains. At 6 months, the immediate referral group demonstrated 21% fewer ED visits and 75.6% more hospital visits.ConclusionImmediate referral to the MLP was associated with lower stress and a lower rate of ED visits but higher anxiety and a higher rate of hospital visits.Trial RegistrationClinicalTrials.gov Identifier: NCT03805126.© Copyright by the American Board of Family Medicine.

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