Participants’ and staffs’ evaluation of the Illness Management and Recovery program: a randomized clinical trial

Dalum, Helle Stentoft; Waldemar, Anna Kristine; Korsbek, Lisa; Hjorthøj, Carsten; Mikkelsen, John Hagel; Thomsen, Karin; Kistrup, Kristen; Olander, Mette; Lindschou, Jane; Nordentoft, Merete; Eplov, Lene Falgaard

doi:10.1080/09638237.2016.1244716

Cited by 18 publications

(33 citation statements)

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“…In this paper, the results on the clinical outcomes: functioning, symptom severity, social functioning, drug/alcohol abuse, and service utilization will be presented. Results regarding self-perceived recovery have been presented elsewhere [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Illness management and recovery: Clinical outcomes of a randomized clinical trial in community mental health centers

et al. 2018

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ObjectiveIllness Management and Recovery (IMR) is a psychosocial intervention with a recovery-oriented approach. The program has been evaluated in different settings; however evidence for the effects of IMR is still deficient. The aim of this trial was to investigate the benefits and harms of the IMR program compared with treatment as usual in Danish patients with schizophrenia or bipolar disorder.MethodThe trial was designed as a randomized, assessor-blinded, multi-center, clinical trial investigating the IMR program compared with usual treatment. 198 people diagnosed with schizophrenia or bipolar disorder participated. The primary outcome was the Global Assessment of Functioning (GAF-F) at the end of intervention and the secondary and explorative outcomes included severity of symptoms and service utilization.ResultsIMR had no significant effect on functioning, symptoms, substance use or service utilization.ConclusionThis randomized trial contributes to the evidence base of IMR by providing a methodological solid base for its conclusions; however the trial has some important limitations. More research is needed to get a firm answer on the effectiveness of the IMR.

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Section: Introductionmentioning

confidence: 99%

Illness management and recovery: Clinical outcomes of a randomized clinical trial in community mental health centers

et al. 2018

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“…A review [8] showed IMR is advantageous to treatment as usual, according to observer ratings of psychiatric symptoms, as well as consumer and clinician ratings. Two randomized studies with active control groups have found significant improvements but no significant differences between the groups [10, 11]. However, the studies had weaknesses such as low participation rates, non-blinded staff and high drop out rates.…”

Section: Introductionmentioning

confidence: 99%

“…The toolkit has not been statistically tested and evaluated. Studies examining the implementation of IMR have generally used these strategies, which include IMR-specific training and supervision, intervention fidelity monitoring [8, 10, 11], as well as external facilitation such as in situ audits [14] or technical assistance [7, 15, 16]. An essential weakness of these studies is the lack of documentation and reporting on fidelity to the implementation strategies.…”

Section: Introductionmentioning

confidence: 99%

How to implement Illness Management and Recovery (IMR) in mental health service settings: evaluation of the implementation strategy

Egeland

Ruud

Ogden

et al. 2017

Int J Ment Health Syst

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BackgroundThe purpose of this study was to evaluate the implementation strategy used in the first-phase of implementation of the Illness Management and Recovery (IMR) programme, an intervention for adults with severe mental illnesses, in nine mental health service settings in Norway.MethodsA total of 9 clinical leaders, 31 clinicians, and 44 consumers at 9 service settings participated in the implementation of IMR. Implementation was conducted by an external team of researchers and an experienced trainer. Data were gathered on fidelity to the intervention and implementation strategy, feasibility, and consumer outcomes.ResultsAlthough the majority of clinicians scored within the acceptable range of high intervention fidelity, their participation in the implementation strategy appeared to moderate anticipated future use of IMR. No service settings reached high intervention fidelity scores for organizational quality improvement after 12 months of implementation. IMR implementation seemed feasible, albeit with some challenges. Consumer outcomes indicated significant improvements in illness self-management, severity of problems, functioning, and hope. There were nonsignificant positive changes in symptoms and quality of life.ConclusionsThe implementation strategy appeared adequate to build clinician competence over time, enabling clinicians to provide treatment that increased functioning and hope for consumers. Additional efficient strategies should be incorporated to facilitate organizational change and thus secure the sustainability of the implemented practice. Trial registration ClinicalTrials.gov NCT02077829. Registered 25 February 2014

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“…Online samples, no matter how large, are unlikely to contain groups of people who are struggling to concentrate, have decided to remove themselves from social media to recover or do not even have access to digital services. Dalum et al (2018), for example, noted that the level of "missing" data was "high due to the high dropout rate." This does not necessarily invalidate their results, but it is unlikely that dropouts from a sample of people with severe mental distress are purely random.…”

Section: Does Size Matter?mentioning

confidence: 99%

Can we trust observational data? Keeping bias in mind

Wykes

Sweeney

Guha

2019

Journal of Mental Health

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Participants’ and staffs’ evaluation of the Illness Management and Recovery program: a randomized clinical trial

Abstract: IMR appears not to be better than treatment as usual in any of the outcomes. Further studies with a longer follow-up period, better assessments of recovery and a systematic review of the existing trials are needed to assess if the program is effective.

Cited by 18 publications

References 32 publications

Illness management and recovery: Clinical outcomes of a randomized clinical trial in community mental health centers

Illness management and recovery: Clinical outcomes of a randomized clinical trial in community mental health centers

How to implement Illness Management and Recovery (IMR) in mental health service settings: evaluation of the implementation strategy

Can we trust observational data? Keeping bias in mind

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