Effectiveness of Early Psychosis Intervention: Comparison of Service Users and Nonusers in Population-Based Health Administrative Data

Anderson, Kelly K.; Norman, Ross; MacDougall, Arlene; Edwards, Jordan; Palaniyappan, Lena; Lau, Cindy; Kurdyak, Paul

doi:10.1176/appi.ajp.2017.17050480

Cited by 89 publications

(75 citation statements)

References 39 publications

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“…In the second article, Anderson et al (11) address the complementary challenge of assessing program performance using real-world regional administrative data. Data from participants in an early psychosis intervention (EPI) program in Ontario were compared with a carefully matched comparison group over a 2-year acute treatment period and an additional 2-to 5-year follow-up period.…”

Section: Foundations For Disseminationmentioning

confidence: 99%

Toward Dissemination of Secondary Prevention for Psychosis

Rosenheck

2018

AJP

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Prevention is a long-sought goal in psychiatry, and while primary prevention requires etiological knowledge we do not yet possess, secondary prevention, to minimize adverse illness effects, is a feasible objective. In the early 1990s, researchers identified long delays, averaging many years, between the onset of psychosis and the initiation of treatment (1) and found extended duration of untreated psychosis to be associated with more severe symptoms and poorer outcomes (2, 3). The effects were small in magnitude and did not affect quality of life, employment, or hospitalization (3), and researchers were clear that while prolonged duration of untreated psychosis was a possible cause of poor outcomes, prolonged untreated psychosis and poor outcomes might both be caused by other factors, such as lack of insight and/or motivation for treatment.

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Section: Foundations For Disseminationmentioning

confidence: 99%

Toward Dissemination of Secondary Prevention for Psychosis

Rosenheck

2018

AJP

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“… 26 Finally, less than half of young people with psychotic disorders who are receiving care from specialised services have ongoing contact with primary care services. 27 This concurrent contact is needed to monitor risk factors associated with psychotic disorders and antipsychotic treatment, such as smoking and obesity, and to manage medical comorbidities.…”

Section: The Family Physician and Early Psychosismentioning

confidence: 99%

Understanding the role of the family physician in early psychosis intervention

et al. 2018

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BackgroundThe family physician is key to facilitating access to psychiatric treatment for young people with first-episode psychosis, and this involvement can reduce aversive events in pathways to care. Those who seek help from primary care tend to have longer intervals to psychiatric care, and some people receive ongoing psychiatric treatment from the family physician.AimsOur objective is to understand the role of the family physician in help-seeking, recognition and ongoing management of first-episode psychosis.MethodWe will use a mixed-methods approach, incorporating health administrative data, electronic medical records (EMRs) and qualitative methodologies to study the role of the family physician at three points on the pathway to care. First, help-seeking: we will use health administrative data to examine access to a family physician and patterns of primary care use preceding the first diagnosis of psychosis; second, recognition: we will identify first-onset cases of psychosis in health administrative data, and look back at linked EMRs from primary care to define a risk profile for undetected cases; and third, management: we will examine service provision to identified patients through EMR data, including patterns of contacts, prescriptions and referrals to specialised care. We will then conduct qualitative interviews and focus groups with key stakeholders to better understand the trends observed in the quantitative data.DiscussionThese findings will provide an in-depth description of first-episode psychosis in primary care, informing strategies to build linkages between family physicians and psychiatric services to improve transitions of care during the crucial early stages of psychosis.Declaration of interestNone.

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“…Targeted case identification interventions (TCIs) have been conducted to improve access to care of those experiencing a first episode of psychosis (FEP) and its clinical high-risk state (CHR), since a sizeable proportion of those with such conditions remain unidentified (Addington et al, 2008;Anderson et al, 2018). Targeted case identification interventions (TCIs) have been conducted to improve access to care of those experiencing a first episode of psychosis (FEP) and its clinical high-risk state (CHR), since a sizeable proportion of those with such conditions remain unidentified (Addington et al, 2008;Anderson et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Does an integrated outreach intervention targeting multiple stages of early psychosis improve the identification of individuals at clinical high risk?

McIlwaine

Jordan

Pruessner

et al. 2018

Early Intervention Psych

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Aims: To explore the impact of a targeted case identification intervention, with training and education regarding first-episode psychosis and clinical high-risk syndromes, on the referral and identification of those at high risk.Methods: Using a historical control design, referral information from pre-intervention and postintervention periods was collected via administrative data and clinician notes from a catchmentbased early psychosis service.Results: A significant increase in the number of referrals sent to the service's clinical high-risk unit was observed following the intervention (P = 0.01). The proportion of referrals eligible was significantly higher post-intervention (P = 0.03), with the majority (26/44, 59.1%) referred via the first-episode psychosis service unit.Conclusions: An integrated outreach intervention for both first-episode psychosis and the clinical high-risk state was effective in increasing referrals of eligible cases to the service's at-risk unit. Rather than being stage-specific, targeted case identification strategies and service integration should span across the early stages of psychosis. K E Y W O R D Sclinical high risk for psychosis, early case identification, first-episode psychosis, specialized early intervention services, targeted case identification

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Effectiveness of Early Psychosis Intervention: Comparison of Service Users and Nonusers in Population-Based Health Administrative Data

Cited by 89 publications

References 39 publications

Toward Dissemination of Secondary Prevention for Psychosis

Toward Dissemination of Secondary Prevention for Psychosis

Understanding the role of the family physician in early psychosis intervention

Does an integrated outreach intervention targeting multiple stages of early psychosis improve the identification of individuals at clinical high risk?

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