Best Practice Case Management for Improved Medical Adherence

Abstract

Less than optimal treatment adherence for many health conditions impedes clinical progress, leading to increased morbidity, mortality and health care costs, particularly for low-income and racial and ethnic minority patients. When properly understood as a complex phenomenon involving patient, provider, and health system interacting factors, adherence improvement is a natural target for social work's multi-system model of case management. We present five key elements for a generic "best practice" case management blueprint applicable to a range of medical settings. The theory and evidence base for the elements are discussed and illustrated with SAFe, a tested social work case management program to improve adherence following abnormal cancer screens.

Problems in functioning from the patient perspective using the International Classification of Functioning, Disability and Health (ICF) as a reference

“…The reports of negative experiences with health care providers that are not trained in treating and diagnosing sleep disorders (Papp et al, 2002), or wrongly diagnosing these patients, and suggesting different treatment options (Buysse et al, 1997;Chokroverty, 2003;Kapur et al, 2002) are evident based on our study. The importance of education, caregiver relationship and social networks, however, remains underestimated (Aloia, 2009;Brostro¨m et al, 2009;Collins et al, 2007;Ell, 1996;Vourlekis and Ell, 2007). Our study added further evidence to support the interrelation and importance of the factors mentioned earlier.…”

“…, 2009; Collins et al. , 2007; Ell, 1996; Vourlekis and Ell, 2007). Our study added further evidence to support the interrelation and importance of the factors mentioned earlier.…”

Pediatric Dental-Focused Interprofessional Interventions

“…52 Social Work's “multi-system model of case management” also addresses the complexities of adherence to recommended behaviors. 53 As such, social workers are ideally prepared to facilitate families of children with ECC or at risk for ECC to adopt and implement tailored strategies that include goal setting, action planning, and self-management. MSWs have been engaged in dental care, for example addressing psychosocial barriers to care in Columbia University's student clinics; retaining patients in care at the State University of New York at Buffalo student clinics; 54 and assisting parents whose young children are at risk for early childhood caries at the University of Washington Center for Pediatric Dentistry.…”

From Distress Guidelines to Developing Models of Psychosocial Care: Current Best Practices

“…Further, it is vital that reciprocal processes be developed among members of the psychosocial care team, clinical team, managers, and administrative entities (Loscalzo et al, 2011;Talib, Rahman, & Azam, 2011;Vourlekis & Ell, 2007). Involvement of multiple stakeholders also will serve to educate them about patient distress and reinforce the notion that social workers are an essential front line responder to patients in distress.…”