scholarly journals The post COVID-19 healthcare landscape and the use of long-acting injectable antipsychotics for individuals with schizophrenia and bipolar I disorder: the importance of an integrated collaborative-care approach

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Christoph U. Correll ◽  
Craig Chepke ◽  
Paul Gionfriddo ◽  
Joe Parks ◽  
Phyllis Foxworth ◽  
...  
Keyword(s):  
Collaborative Care ◽  
Mental Healthcare ◽  
Roundtable Discussion ◽  
Care Model ◽  
Collaborative Care Model ◽  
Bipolar I Disorder ◽  
Fully Integrated ◽  
Increased Risk ◽  
Long Acting ◽  
The Impact

Abstract Background Long-acting injectable antipsychotics (LAIs) are an essential maintenance treatment option for individuals with schizophrenia or bipolar I disorder (BP-I). This report summarizes a roundtable discussion on the impact of COVID-19 on the mental healthcare landscape and use of LAIs for individuals with schizophrenia or BP-I. Methods Ten experts and stakeholders from diverse fields of healthcare participated in a roundtable discussion on the impact of the COVID-19 pandemic, treatment challenges, and gaps in healthcare for individuals with schizophrenia or BP-I, informed by a literature search. Results Individuals with schizophrenia or BP-I are at increased risk of COVID-19 infection and increased risk of mortality after COVID-19 diagnosis. LAI prescriptions decreased early on in the pandemic, driven by a decrease in face-to-face consultations. Mental healthcare services are adapting with increased use of telehealth and home-based treatment. Clinical workflows to provide consistent, in-person LAI services include screening for COVID-19 exposure and infection, minimizing contact, and ensuring mask-wearing by individuals and staff. The importance of continued in-person visits for LAIs needs to be discussed so that staff can share that information with patients, their caregivers, and families. A fully integrated, collaborative-care model is the most important aspect of care for individuals with schizophrenia or BP-I during and after the COVID-19 pandemic. Conclusions The COVID-19 pandemic has highlighted the importance of a fully integrated collaborative-care model to ensure regular, routine healthcare contact and access to prescribed treatments and services for individuals with schizophrenia and BP-I.

scholarly journals The impact of open to collaborative care model in cardiovascular surgical unit

2018 ◽  
Vol 81 (1) ◽  
pp. 64-69 ◽  
Author(s):  
Hsing-Ying Wu ◽  
Heng-Sheng Chao ◽  
Hsin-Chin Shih ◽  
Chun-Che Shih ◽  
Shi-Chuan Chang
Keyword(s):  
Collaborative Care ◽  
Care Model ◽  
Collaborative Care Model ◽  
The Impact ◽  
Surgical Unit

scholarly journals Collaborative care model for depression in rural Nepal: a mixed-methods implementation research study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e048481
Author(s):  
Pragya Rimal ◽  
Nandini Choudhury ◽  
Pawan Agrawal ◽  
Madhur Basnet ◽  
Bhavendra Bohara ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mixed Methods ◽  
Implementation Research ◽  
Collaborative Care ◽  
Mental Healthcare ◽  
Clinical Impact ◽  
Care Model ◽  
Collaborative Care Model ◽  
Rural Nepal

IntroductionDespite carrying a disproportionately high burden of depression, patients in low-income countries lack access to effective care. The collaborative care model (CoCM) has robust evidence for clinical effectiveness in improving mental health outcomes. However, evidence from real-world implementation of CoCM is necessary to inform its expansion in low-resource settings.MethodsWe conducted a 2-year mixed-methods study to assess the implementation and clinical impact of CoCM using the WHO Mental Health Gap Action Programme protocols in a primary care clinic in rural Nepal. We used the Capability Opportunity Motivation-Behaviour (COM-B) implementation research framework to adapt and study the intervention. To assess implementation factors, we qualitatively studied the impact on providers’ behaviour to screen, diagnose and treat mental illness. To assess clinical impact, we followed a cohort of 201 patients with moderate to severe depression and determined the proportion of patients who had a substantial clinical response (defined as ≥50% decrease from baseline scores of Patient Health Questionnaire (PHQ) to measure depression) by the end of the study period.ResultsProviders experienced improved capability (enhanced self-efficacy and knowledge), greater opportunity (via access to counsellors, psychiatrist, medications and diagnostic tests) and increased motivation (developing positive attitudes towards people with mental illness and seeing patients improve) to provide mental healthcare. We observed substantial clinical response in 99 (49%; 95% CI: 42% to 56%) of the 201 cohort patients, with a median seven point (Q1:−9, Q3:−2) decrease in PHQ-9 scores (p<0.0001).ConclusionUsing the COM-B framework, we successfully adapted and implemented CoCM in rural Nepal, and found that it enhanced providers’ positive perceptions of and engagement in delivering mental healthcare. We observed clinical improvement of depression comparable to controlled trials in high-resource settings. We recommend using implementation research to adapt and evaluate CoCM in other resource-constrained settings to help expand access to high-quality mental healthcare.

scholarly journals The Perspectives of Healthcare Professionals and Patients on the Value of Collaborative Care Model for Diabetes in Primary Healthcare settings in Qatar

2020 ◽  
Author(s):  
Sara Hamdi Abdulrhim ◽  
Mohamed Izham Mohamed Ibrahim ◽  
Sowndramalingam Sankaralingam ◽  
Mohammed Issam Diab ◽  
Mohamed Abdelazim Mohamed Hussain ◽  
...  
Keyword(s):  
Primary Healthcare ◽  
Collaborative Care ◽  
Healthcare Professionals ◽  
Health Priorities ◽  
Easy Access ◽  
Care Model ◽  
Hospital System ◽  
Collaborative Care Model ◽  
High Workload ◽  
The Impact

Background: Diabetes mellitus (DM) is one of the top health priorities in Qatar due to its high prevalence of 15.5%, which is projected to increase to 29.7% by 2035. DM management is still challenging despite healthcare advancement, warranting the need for a comprehensive Collaborative Care Model (CCM). Therefore, we aim to evaluate the value of CCM in DM care at a primary healthcare (PHC) setting in Qatar. Methodology: This study was a qualitative exploration of healthcare professionals’ (HCPs’) and patients’ perspectives on the value of CCM provided at the center. Twelve patients and twelve HCPs participated in semi-structured one-toone interviews. Qualitative data were analyzed and interpreted using a deductive coding thematic analysis process. Results: The interviews resulted in 14 different themes under the predefined domains: components of CCM (five themes), the impact of CCM (three themes), facilitators of CCM provision (three themes), and barriers of CCM provision (three themes). The majority of the participants indicated easy access to and communication with HCPs at QPDC. Participants appreciated the extra time spent with HCPs, frequent follow-up visits, and health education, which empowered them to self-manage DM. Generally, participants identified barriers and facilitators related to patients, HCPs, and healthcare system. Conclusion: The providers and users of CCM had an overall positive perception and appreciation of this model in PHC settings. Barriers to CCM such as unpleasant attitude and undesirable attributes of HCPs and patients, unsupportive hospital system, and high workload must be addressed before implementing the model in other PHC settings.

A Pharmacist-Led Collaborative Care Model for Cardiometabolic Risk Reduction: A Case Study

2021 ◽  
pp. 2633559X2199485
Author(s):  
Shawn R. Smith ◽  
Christian W. Ruiz ◽  
Salihah Ali ◽  
Caroline J. Kim ◽  
Michael S. Murchie ◽  
...  
Keyword(s):  
Risk Reduction ◽  
Collaborative Care ◽  
Cardiometabolic Risk ◽  
Care Model ◽  
Collaborative Care Model

scholarly journals Integrated Community Collaborative Care for Seniors with Depression/Anxiety and any Physical Illness

2021 ◽  
Vol 24 (3) ◽  
pp. 251-257
Author(s):  
Richard Shulman ◽  
Reenu Arora ◽  
Rose Geist ◽  
Amna Ali ◽  
Julia Ma ◽  
...  
Keyword(s):  
Collaborative Care ◽  
Rating Scales ◽  
Qualitative Interviews ◽  
Geriatric Medicine ◽  
Physical Illness ◽  
Fee For Service ◽  
Case Review ◽  
Care Model ◽  
Collaborative Care Model ◽  
Community Collaborative

Background We report on the feasibility and effectiveness of an integrated community collaborative care model in improving the health of seniors with depression/anxiety symptoms and chronic physical illness. Methods This community collaborative care model integrates geriatric medicine and geriatric psychiatry with care managers (CM) providing holistic initial and follow-up assessments, who use standardized rating scales to monitor treatment and provide psychotherapy (ENGAGE). The CM presents cases in a structured case review to a geriatrician and geriatric psychia­trist. Recommendations are communicated by the CM to the patient’s primary care provider. Results 187 patients were evaluated. The average age was 80 years old. Two-thirds were experiencing moderate-to-severe depres­sion upon entry and this proportion decreased significantly to one-third at completion. Qualitative interviews with patients, family caregivers, team members, and referring physicians indicated that the program was well-received. Patients had on average six visits with the CM without the need to have a face-to-face meeting with a specialist. Conclusion The evaluation shows that the program is feasible and effect­ive as it was well received by patients and patient outcomes improved. Implementation in fee-for-service publicly funded health-care environments may be limited by the need for dedicated funding.

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