Randomized Clinical Trial of the Effectiveness of a Home-Based Advanced Practice Psychiatric Nurse Intervention: Outcomes for Individuals with Serious Mental Illness and HIV

Abstract

Individuals with serious mental illness have greater risk for contracting HIV, multiple morbidities, and die 25 years younger than the general population. This high need and high cost subgroup face unique barriers to accessing required health care in the current health care system. The effectiveness of an advanced practice nurse model of care management was assessed in a four-year random controlled trial. Results are reported in this paper. In a four-year random controlled trial, a total of 238 community-dwelling individuals with HIV and serious mental illness (SMI) were randomly assigned to an intervention group (n=128) or to a control group (n=110). Over 12 months, the intervention group received care management from advanced practice psychiatric nurse, and the control group received usual care. The intervention group showed significant improvement in depression (P=.012) and the physical component of health-related quality of life (P=.03) from baseline to 12 months. The advanced practice psychiatric nurse intervention is a model of care that holds promise for a higher quality of care and outcomes for this vulnerable population.

A systems approach to healthcare: Agent-based modeling, community mental health, and population well-being

“…Initial data analysis provided insights into the basic trends on mental health patients and initial distributions for percent of agents flowing over time around the pathways of Figure 5 as a function of health status (GAF score) and social attributes. We also verified parameters using research on the SMI population such as Folsom et al [27], Brown et al [28], Hanrahan et al [29,30] . Using all this data, we analyzed the overall sample population and then focused on populations with similar disease severities (earlier Quadrants I -IV).…”

“…To illustrate, we examine results from a randomized control trial (RCT) that used a sample of individuals with serious mental illness [29]. The purpose of the RCT was to examine the effect of a nurse intervention on lowering readmission rates.…”

Determining the Cost-Savings Threshold for HIV Adherence Intervention Studies for Persons with Serious Mental Illness and HIV

“…Our other data source was from the University of Pennsylvania HIV intervention trial PATH+ 15,24,26 . The PATH+ study goal was to improve the immune function of participants living with HIV and a serious mental illness (SMI).…”

“…The goal of this study was to develop a synthetic method to estimate the potential cost saving threshold associated with medication adherence using, as a case study, co-morbid individuals with HIV and serious mental illness who participated in a University of Pennsylvania effectiveness trial known as Preventing AIDS Through Health for Positives (PATH+) 15,24,26 . This adherence trial collected CD4 and viral load biomarker data at baseline and follow-up, a common set of data elements in these types of studies.…”

Umsorgt werden und umsorgen: Leben mit mehreren Langzeiterkrankungen (Leila) – Eine qualitative Studie zum Beitrag von APN in integrierter Versorgung

“…Die Zuweisenden bezeichneten das umfassende Einschätzen des Pflegebedarfs als Teil eines notwendigen, pflegerischen APN Casemanagements. Vorgängige Studien belegten die Notwendigkeit pflegerischer APN Casemanagementfunktionen und deren Nutzen wurde nachgewiesen (Bachus, 1995;Berkman, Glass, Brissette & Seeman, 2000;Bodenheimer, MacGregor & Stothart, 2005;Brooten et al, 2003;Bryant-Lukosius, 2010;Bryant-Lukosius, Dicenso, Browne & Pinelli, 2004;Newhouse et al, 2011 (Hanrahan, Wu, Kelly, Aiken & Blank, 2011;Neff, Madigan & Narsavage, 2003). Patient(inn)en zeigten effektive «Lebensveränderungen» wie gezielte Einhaltung therapeutischer Regimes und erhöhte Selbstpflegefähigkeiten.…”