Operationalizing Integrated Care on a Clinical Level: the INTERMED Project

Stiefel, F.; Huyse, Frits J.; Söllner, Wolfgang; Slaets, Joris P. J.; Lyons, John S.; Latour, Corine; Wal, Nynke van der; Jonge, Peter de

doi:10.1016/j.mcna.2006.05.006

Cited by 80 publications

(67 citation statements)

References 41 publications

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“…The results of this study support the strategy to utilize the INTERMED to screen and assess case complexity and to orient patient care. The INTERMED is already utilized on a routine basis in different clinical settings [55]; this study confirms these clinical experiences and adds evidence with regard to the validity of the INTERMED.…”

Section: Discussionsupporting

confidence: 80%

“…The fact that the INTERMED can be considered as an instrument which is more inspired by ‘clinimetrics’ and ‘communimetrics’ than ‘psychometrics’ may also explain these benefits [54]. In addition, the INTERMED allows, in contrast to case management and disease management plans, not only to assess bio-psycho-social case complexity but also to direct individualized care [55]. Ouwens et al [56], who discussed 13 systematic reviews of integrated care programs for chronically ill patients, found that only 1 review reported a significant positive effect on functional health status and only 3 reported a significant positive effect on hospital readmissions or length of stay.…”

Section: Discussionmentioning

confidence: 99%

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Effects of a Multifaceted Psychiatric Intervention Targeted for the Complex Medically Ill: A Randomized Controlled Trial

Stiefel¹,

Zdrojewski²,

Hadj³

et al. 2008

Psychother Psychosom

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Background: This study evaluated a multifaceted psychiatric intervention targeted at the complex medically ill identified by means of the INTERMED, an instrument to assess case complexity. Methods: Of 885 rheumatology inpatients and diabetes outpatients who were assessed for eligibility, 247 were identified as complex (INTERMED score >20) and randomized to the intervention (n = 125, 84 rheumatology and 41 diabetes patients) or care as usual (n = 122, 78 rheumatology and 44 diabetes patients). For the majority of the cases the multifaceted intervention consisted of an intervention conducted by a psychiatric liaison nurse and/or of referral to a liaison psychiatrist, followed by advice to the treating physician or organization of a multidisciplinary case conference. Baseline and follow-up at months 3, 6, 9 and 12 measured prevalence of major depression (Mini-International Neuropsychiatric Interview), depressive symptoms (Center for Epidemiological Studies Depression Rating Scale), physical and mental health (SF-36), quality of life (EuroQol), health care utilization and HbA_1c levels (diabetic patients). Results: Prevalence of major depression was reduced from 61% (T0) to 28% (T4) in the intervention group and remained stable in care as usual (57% at T0 to 50% at T4). Compared to care as usual, significant improvement over time was observed in the intervention group with regard to depressive symptoms (F = 11.9; p = 0.001), perception of physical (F = 5.7; p = 0.018) and mental health (F = 3.9; p = 0.047) and quality of life (F = 21.8; p < 0.001). Effects tended to be stronger in diabetes patients, in patients with baseline major depression and in patients with moderate INTERMED scores. Finally, hospital admissions occurred less often in the intervention group, reaching statistical significance for the period between 6 and 9 months of follow-up (p = 0.02). Conclusions: The results suggest that a psychiatric intervention targeted for complex medical patients can improve health outcomes.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Effects of a Multifaceted Psychiatric Intervention Targeted for the Complex Medically Ill: A Randomized Controlled Trial

Stiefel¹,

Zdrojewski²,

Hadj³

et al. 2008

Psychother Psychosom

View full text Add to dashboard Cite

show abstract

“…The complexity of the patient's status was assessed by means of the INTERMED instrument. The INTERMED is an instrument measuring case and care complexity simultaneously [20,23,24]. It is an effective action-oriented decision support tool for the management of complex medically ill patients in need of case management.…”

Section: Interventionmentioning

confidence: 99%

Cost-effectiveness of a nurse-led case management intervention in general medical outpatients compared with usual care: An economic evaluation alongside a randomized controlled trial

Latour

Bosmans

Tulder

et al. 2007

Journal of Psychosomatic Research

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“…The INTERMED was developed by an international working group over the past 10 years, and has proven to be a valid and reliable instrument to identify elevated health care needs [6][7][8][9][10][11]. The assessment method is based on a semistructured interview that classifies the information into the four domains of a patient's biological, psychological, social, and health care-related characteristics.…”

Section: Introductionmentioning

confidence: 99%

Reliable integrative assessment of health care needs in elderly persons: The INTERMED for the Elderly (IM-E)

Wild¹,

Lechner²,

Herzog³

et al. 2011

Journal of Psychosomatic Research

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Operationalizing Integrated Care on a Clinical Level: the INTERMED Project

Cited by 80 publications

References 41 publications

Effects of a Multifaceted Psychiatric Intervention Targeted for the Complex Medically Ill: A Randomized Controlled Trial

Effects of a Multifaceted Psychiatric Intervention Targeted for the Complex Medically Ill: A Randomized Controlled Trial

Cost-effectiveness of a nurse-led case management intervention in general medical outpatients compared with usual care: An economic evaluation alongside a randomized controlled trial

Reliable integrative assessment of health care needs in elderly persons: The INTERMED for the Elderly (IM-E)

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