Treating complexity: Collaborative care for multiple chronic conditions

Chwastiak, Lydia; Vanderlip, Erik R.; Katon, Wayne

doi:10.3109/09540261.2014.969689

Cited by 37 publications

(34 citation statements)

References 61 publications

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“…37 These themes recurred repeatedly in both the literature and our discussions with field contacts and are further discussed in Chapter 6.…”

Section: Colocation Of Services (19 Studies)mentioning

confidence: 76%

“…This was supported by more recent published evidence that emphasised the importance of commitment from key leaders and administrators, 37 and the development of a supportive organisational culture. In part, this might be achieved by obtaining staff 'buy-in' and commitment through raising awareness and appropriate incentivisation.…”

Section: Training and Education For Mental Health Practitionersmentioning

confidence: 82%

“…Regulatory barriers that limit information exchange between primary and mental health care have been identified as particularly problematic. 37 It is not clear from the published evidence to what extent such barriers have been overcome by self-contained US funding systems, such as the VA, where integrated registry and EMR data have been used to target the physical health-care needs of people with SMI. 27,33,35,36,52,59 However, a recent plan to merge VA EMRs with US Department of Defence records proved costly and was abandoned in favour of an 'interoperable system'.…”

Section: Regulatory and Medicolegal Issuesmentioning

confidence: 99%

“…32,37,41,52,58,63,67,69 However, these might also be considered 'liaison' services that happen to be colocated; other publications have described similar clinics within virtual 'Health Home' organisations where colocation is not strictly necessary. 62 Therefore, issues relating primarily to liaison are discussed in Liaison services (17 studies).…”

Section: Colocation Of Services (19 Studies)mentioning

confidence: 99%

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Integrated care to address the physical health needs of people with severe mental illness: a rapid review

Rodgers

Dalton

Harden

et al. 2016

Health Serv Deliv Res

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BackgroundPeople with mental health conditions have a lower life expectancy and poorer physical health outcomes than the general population. Evidence suggests that this discrepancy is driven by a combination of clinical risk factors, socioeconomic factors and health system factors.Objective(s)To explore current service provision and map the recent evidence on models of integrated care addressing the physical health needs of people with severe mental illness (SMI) primarily within the mental health service setting. The research was designed as a rapid review of published evidence from 2013–15, including an update of a comprehensive 2013 review, together with further grey literature and insights from an expert advisory group.SynthesisWe conducted a narrative synthesis, using a guiding framework based on nine previously identified factors considered to be facilitators of good integrated care for people with mental health problems, supplemented by additional issues emerging from the evidence. Descriptive data were used to identify existing models, perceived facilitators and barriers to their implementation, and any areas for further research.Findings and discussionThe synthesis incorporated 45 publications describing 36 separate approaches to integrated care, along with further information from the advisory group. Most service models were multicomponent programmes incorporating two or more of the nine factors: (1) information sharing systems; (2) shared protocols; (3) joint funding/commissioning; (4) colocated services; (5) multidisciplinary teams; (6) liaison services; (7) navigators; (8) research; and (9) reduction of stigma. Few of the identified examples were described in detail and fewer still were evaluated, raising questions about the replicability and generalisability of much of the existing evidence. However, some common themes did emerge from the evidence. Efforts to improve the physical health care of people with SMI should empower people (staff and service users) and help remove everyday barriers to delivering and accessing integrated care. In particular, there is a need for improved communication between professionals and better information technology to support them, greater clarity about who is responsible and accountable for physical health care, and awareness of the effects of stigmatisation on the wider culture and environment in which services are delivered.Limitations and future workThe literature identified in the rapid review was limited in volume and often lacked the depth of description necessary to acquire new insights. All members of our advisory group were based in England, so this report has limited information on the NHS contexts specific to Scotland, Wales and Northern Ireland. A conventional systematic review of this topic would not appear to be appropriate in the immediate future, although a more interpretivist approach to exploring this literature might be feasible. Wherever possible, future evaluations should involve service users and be clear about which outcomes, facilitators and barriers are likely to be context-specific and which might be generalisable.FundingThe research reported here was commissioned and funded by the Health Services and Delivery Research programme as part of a series of evidence syntheses under project number 13/05/11. For more information visitwww.nets.nihr.ac.uk/projects/hsdr/130511.

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“…37 These themes recurred repeatedly in both the literature and our discussions with field contacts and are further discussed in Chapter 6.…”

Section: Colocation Of Services (19 Studies)mentioning

confidence: 76%

Section: Training and Education For Mental Health Practitionersmentioning

confidence: 82%

Section: Regulatory and Medicolegal Issuesmentioning

confidence: 99%

Section: Colocation Of Services (19 Studies)mentioning

confidence: 99%

See 2 more Smart Citations

Integrated care to address the physical health needs of people with severe mental illness: a rapid review

Rodgers

Dalton

Harden

et al. 2016

Health Serv Deliv Res

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“…In the end, it is essential to remember that multiple health behaviors are enacted by the same person, reminding us that the behaviors likely influence one another. To that end, our understanding of associations among health behaviors is likely to benefit from what we are learning in the equally nascent field of multiple chronic conditions [57].…”

Section: Conclusion and Cautionsmentioning

confidence: 99%

Integrating knowledge across domains to advance the science of health behavior: overcoming challenges and facilitating success

Klein

Grenen

O’Connell

et al. 2016

Behav. Med. Pract. Policy Res.

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Health behaviors often co-occur and have common determinants at multiple levels (e.g., individual, relational, environmental). Nevertheless, research programs often examine single health behaviors without a systematic attempt to integrate knowledge across behaviors. This paper highlights the significant potential of cross-cutting behavioral research to advance our understanding of the mechanisms and causal factors that shape health behaviors. It also offers suggestions for how researchers could develop more effective interventions. We highlight barriers to such an integrative science along with potential steps that can be taken to address these barriers. With a more nuanced understanding of health behavior, redundancies in research can be minimized, and a stronger evidence base for the development of health behavior interventions can be realized. KeywordsIntegration, Health behavior, Theory, Interventions INTRODUCTION Many chronic diseases in the U.S., including several cancers, cardiovascular disease, diabetes, and obesity, share a common set of behavioral determinants such as tobacco use, excessive use of alcohol, poor dietary habits, and sedentary behavior [1]. These health behaviors relate to one another in multiple ways. First, the behaviors themselves tend to cluster within individuals; for example, tobacco users are often more likely to consume alcohol [2] and less likely to adhere to medical regimens [3]. Second, health behaviors can be driven by shared mechanisms. For example, sensitivity to certain tastes may affect tobacco (e.g., use of menthol) and food behaviors (e.g., avoidance of spicy foods) [4]. Self-regulation efforts in one behavioral domain contribute to the likelihood of successful self-regulation in other domains [5], and failures to appropriately prioritize long-term health consequences over immediate affective or social benefits can contribute to addictive behaviors and unhealthy food choices (e.g., calorie-rich and low-nutrient foods) [6].

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Non-clozapine antipsychotic combinations for treatment-resistant schizophrenia

Yow

Jayaram

2017

Cochrane Database of Systematic Reviews

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Treating complexity: Collaborative care for multiple chronic conditions

Cited by 37 publications

References 61 publications

Integrated care to address the physical health needs of people with severe mental illness: a rapid review

Integrated care to address the physical health needs of people with severe mental illness: a rapid review

Integrating knowledge across domains to advance the science of health behavior: overcoming challenges and facilitating success

Non-clozapine antipsychotic combinations for treatment-resistant schizophrenia

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