Implementation of Treatment Guidelines for Specialist Mental Health Care

Barbui, Corrado; Girlanda, Francesca; Ay, Esra; Cipriani, Andrea; Becker, Thomas; Koesters, Markus

doi:10.1093/schbul/sbu065

Cited by 45 publications

(5 citation statements)

References 51 publications

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“…Cognitive remediation therapies for psychosis are recommended in the recently updated Australian and New Zealand College of Psychiatrists clinical practice guidelines [ 1 ]. Translating clinical guideline recommendations for psychosocial interventions into routine practice has been a challenge [ 3 , 4 ]. Implementation science provides a framework to guide the translation of evidence based therapies into routine care [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Implementing cognitive remediation and social cognitive interaction training into standard psychosis care

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Harris

Gore‐Jones

et al. 2018

BMC Health Serv Res

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BackgroundTo evaluate the planned implementation of group based Cognitive Remediation therapy (CR) and Social Cognitive Interaction Training (SCIT) into routine psychosis care in a mental health service in Australia.MethodThe study was conducted over 3 years in a mental health service in a metropolitan city in Australia. Participants were 22 program facilitators and 128 patients attending the programs. Implementation outcomes were assessed using administrative data, staff surveys and program audits.ResultsThere was fidelity to the particular therapies at a program level. Programs were assessed as being feasible within the study setting with each hospital district developing a capacity to run CR and SCIT. The establishment of new programs improved the reach, but waiting lists indicate a need to expand capacity. There was a relatively high dropout and several factors impacted on completion of the programs - notably, acute exacerbation of psychosis. Once initiated the therapies were acceptable with no-one ceasing SCIT due to loss of interest and only 10% of participants ceasing CR due to loss of interest. Annual audits of programs found programs established were maintained and facilitators were retained.ConclusionSCIT and CR programs were successfully implemented in three hospital districts. Several factors impeded participants receiving the recommended “dose” of the programs. The maintenance of the programs in the short term is encouraging in regards to organisational fit. Dissemination of cognitive rehabilitation programs to a service population takes planning. An implementation plan is essential for guiding development and maintenance of programs. These therapies are best suited to people in a stable phase of illness. Service user co-production is recommended to improve recruitment in future studies.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3240-5) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Implementing cognitive remediation and social cognitive interaction training into standard psychosis care

Dark

Harris

Gore‐Jones

et al. 2018

BMC Health Serv Res

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“…Collaborative care has also been shown to be feasible, acceptable and effective in the prevention and reducing suicidal ideation [29]. A Cochrane review indicated that the implementation of treatment guidelines succeeds better if nurses are trained with that purpose [36]. In this study, collaborative care will be embedded in pillar two and four.…”

Section: Methodsmentioning

confidence: 99%

A regional systems intervention for suicide prevention in the Netherlands (SUPREMOCOL): study protocol with a stepped wedge trial design

et al. 2019

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BackgroundIn the Netherlands, suicide rates showed a sharp incline and this pertains particularly to the province of Noord-Brabant, one of the southern provinces in the Netherlands. This calls for a regional suicide prevention effort.Methods/designStudy protocol. A regional suicide prevention systems intervention is implemented and evaluated by a stepped wedge trial design in five specialist mental health institutions and their adherent chain partners. Our system intervention is called SUPREMOCOL, which stands for Suicide Prevention by Monitoring and Collaborative Care, and focuses on four pillars: 1) recognition of people at risk for suicide by the development and implementation of a monitoring system with decision aid, 2) swift access to specialist care of people at risk, 3) positioning nurse care managers for collaborative care case management, and 4) 12 months telephone follow up. Eligible patients are persons attempting suicide or expressing suicidal ideation. Primary outcome is number of completed suicides, as reported by Statistics Netherlands and regional Public Health Institutes. Secondary outcome is number of attempted suicides, as reported by the regional ambulance transport and police. Suicidal ideation of persons registered in the monitoring system will, be assessed by the PHQ-9 and SIDAS questionnaires at baseline and 3, 6, 9 and 12 months after registration, and used as exploratory process measure. The impact of the intervention will be evaluated by means of the RE-AIM dimensions reach, efficacy, adoption, implementation, and maintenance. Intervention integrity will be assessed and taken into account in the analysis.DiscussionThe present manuscript presents the design and development of the SUPREMOCOL study. The ultimate goal is to lower the completed suicides rate by 20%, compared to the control period and compared to other provinces in the Netherlands. Moreover, our goal is to provide specialist mental health institutions and chain partners with a sustainable and adoptable intervention for suicide prevention.Trial registrationNetherlands Trial Register under registration number NL6935 (5 April 2018). This is the first version of the study protocol (September 2019).

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“…In a Cochrane Review, the effect on guideline implementation for patients with psychotic disorders was studied. The authors identified five studies and report methodological problems and only uncertain effects of guideline implementations (4). Other studies examined how to better implement guideline requirements in medical practice (5,6).…”

Section: Introductionmentioning

confidence: 99%

Follow-Up Treatment After Inpatient Therapy of Patients With Unipolar Depression—Compliance With the Guidelines?

et al. 2020

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Objective: To date, there is only a limited number of studies evaluating the implementation and effects of treatment guidelines. Therefore, this study aimed to determine how many patients diagnosed with a major depression were treated in compliance with the German treatment guideline after hospital treatment, and whether a deviation from the guideline resulted in a less favorable development. Methods: Five hundred two patients, which originally participated in the INDDEP-study, were included. Data were collected at admission and discharge from eight different psychosomatic (psychotherapeutic) hospitals in Germany as well as 3 months and 1 year after hospital treatment. Data on depressive symptomatology were assessed by QIDS-C (clinical interviews). By phone interviews, the clinical course and the outpatient treatments were assessed. Statistical analyses compared patients who were treated in compliance with the German treatment guideline with those who were not. Results: Seventy-nine point one percent of the outpatient treatments complied with the treatment guideline. Eleven point eight percent of the patients were treated with medication only, 60.2% with psychotherapy only, and 28.0% with a combination. There was no difference in the clinical outcome (depression) with regard to guideline compliance. Cases in which deviation from the guideline occurred (20.9%) were younger and had a less severe depressive symptomatology at admission and after hospital treatment. Conclusion: After treatment in a psychosomatic hospital or day hospital, the majority of patients with a depressive disorder received adjacent treatment in accordance with the German guideline and with a clear focus on psychotherapy. Deviations from the guideline did not result in a less favorable course of the illness.

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Implementation of Treatment Guidelines for Specialist Mental Health Care

Cited by 45 publications

References 51 publications

Implementing cognitive remediation and social cognitive interaction training into standard psychosis care

Implementing cognitive remediation and social cognitive interaction training into standard psychosis care

A regional systems intervention for suicide prevention in the Netherlands (SUPREMOCOL): study protocol with a stepped wedge trial design

Follow-Up Treatment After Inpatient Therapy of Patients With Unipolar Depression—Compliance With the Guidelines?

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