scholarly journals Assessing the evidence on case management

2002 ◽  
Vol 181 (1) ◽  
pp. 17-21 ◽  
Author(s):  
S. J. Ziguras ◽  
G. W. Stuart ◽  
A. C. Jackson

BackgroundEvidence on the impact of case management is contradictory.AimsTo discuss two different systematic reviews (one conducted by the authors and one conducted through the Cochrane collaboration) that came to contradictory conclusions about the impact of case management in mental health services.MethodWe summarised the findings of the two reviews with respect to case management effectiveness, examined key methodological differences between the two approaches and discuss the impact of these on the validity of the results.ResultsThe differences in conclusions between the two reviews result from the differences in inclusion criteria, namely non-randomised trials, data from unpublished scales and data from variables with skewed distributions. The theoretical and empirical effects of these are discussed.ConclusionsSystematic reviewers may face a trade-off between the application of strict criteria for the inclusion of studies and the amount of data available for analysis and hence statistical power. The available research suggests that case management is generally effective.

Author(s):  
Jennifer Boddy ◽  
Maddy Slattery ◽  
Jianqiang Liang ◽  
Hilary Gallagher ◽  
Amanda Smith ◽  
...  

Abstract The natural environment is increasingly used in therapeutic psychosocial interventions for young people who have experienced trauma. However, as the research in this area has yet to be synthesised, very little is known about the types and outcomes of interventions. This prevents the optimisation of social work interventions in outdoor settings. Consequently, a scoping review of peer-reviewed research published from 2008 to 2018 was undertaken to examine how nature is being used in psychosocial interventions with young people aged ten to twenty-four years who have experienced trauma and the impact of these interventions on young people’s mental health. The database search identified 5,425 records; however, only ten papers met the inclusion criteria. These papers suggested that positive changes across a range of mental health outcomes for young people were achieved in psychosocial interventions which were situated in, or made use of the natural environment, although it is unclear whether the environment influenced the outcomes. The scoping review also highlighted the need for conducting further research that examines how environmental factors contribute to clinical change for young people who have experienced trauma.


2004 ◽  
Vol 28 (8) ◽  
pp. 277-278
Author(s):  
Frank Holloway

In an era of evidence-based medicine, policy-makers and researchers are preoccupied by the task of ensuring that advances in research are implemented in routine clinical practice. This preoccupation has spawned a small but growing research industry of its own, with the development of resources such as the Cochrane Collaboration database and journals such as Evidence-Based Mental Health. In this paper, I adopt a philosophically quite unfashionable methodology – introspection – to address the question: how has research affected my practice?


2018 ◽  
Vol 62 (2) ◽  
pp. 94-107
Author(s):  
Yung-Chen Jen Chiu ◽  
K. B. Boomer ◽  
Liza M. Conyers

Despite medical advancements that have significantly improved the health outcomes of people living with HIV (PLWH), many do not achieve optimal health outcomes due to psychosocial barriers. This 5-year retrospective longitudinal study draws upon the International Classification of Functioning, Disability, and Health (ICF) framework to conceptualize the relationships between personal and environmental factors and health and retention outcomes among a sample of 704 PLWH in Pennsylvania. A generalized estimated equations (GEE) model was used to model retention in care outcomes (at least one medical visit every 6 months) and a general linear mixed (GLM) model was used to analyze immune system health outcomes (CD4%). This exploratory study reveals that gender, age, race, use of antiretroviral (ARV) medications, use of case management service, mental health diagnosis, and alcohol use were significantly associated with retention in care, whereas race, ethnicity, gender, mental health treatment, use of ARV medications, use of case management services, and retention in care status were significantly associated with the immune system health outcome of CD4%. The results suggest a need for rehabilitation interventions to address key psychosocial issues, as rehabilitation counselors have a unique skill set to address the medical case management needs of individuals with HIV. Implications for rehabilitation counselors and educators are discussed.


Author(s):  
S. Barber ◽  
P. C. Gronholm ◽  
S. Ahuja ◽  
N. Rüsch ◽  
G. Thornicroft

Abstract Aims This review aims to understand the scope of the literature regarding mental health-related microaggressions towards people affected by mental health problems. Methods A scoping review was conducted to explore this question. Four electronic health-oriented databases were searched alongside Google Scholar. As per scoping review principles, the inclusion criteria were developed iteratively. The results of included studies were synthesised using a basic narrative synthesis approach, utilising principles of thematic analysis and thematic synthesis where appropriate. Results A total of 1196 records were identified, of which 17 met inclusion criteria. Of these, 12 were peer-reviewed journal articles, three were research degree theses and two were book chapters. Six included empirical studies were qualitative, four were quantitative and two employed a mixed-methods design. Within these, five qualitative studies aimed to describe the nature of mental health microaggressions experienced by people with mental health problems. Themes identified in a thematic synthesis of these five studies included stereotypes about mental illness, invalidating peoples' experience and blaming people with mental illness for their condition. The included publications informed on the perpetration of mental health microaggressions by family, friends, health professionals and social workers. In addition, two studies created scales, which were then used in cross-sectional surveys of the general public and community members to assess characteristics, such as right-wing political views, associated with endorsement of mental health microaggressions. A consensus definition of microaggressions emerged from the included studies: microaggressions are brief, everyday slights, snubs or insults, that may be subtle or ambiguous, but communicate a negative message to a target person based on their membership of a marginalised group, in this case, people affected by mental illness. Conclusions The study of mental health microaggressions is an emerging, heterogeneous field, embedded in the wider stigma and discrimination literature. It has been influenced by earlier work on racial microaggressions. Both can be ambiguous and contradictory, which creates difficulty defining the boundaries of the concept, but also underpins the key theoretical basis for the negative impact of microaggressions. Mental illness is a more concealable potential type of identity, so it follows that the reported perpetrators of microaggressions are largely friends, family and professionals. This has implications for intervening to reduce the impact of microaggressions. There are several challenges facing research in this area, and further work is needed to understand the impact of mental health microaggressions on people affected by mental health problems.


2017 ◽  
Vol 49 (12) ◽  
pp. 943-950 ◽  
Author(s):  
Marieke Velema ◽  
Aline de Nooijer ◽  
Vivian Burgers ◽  
Ad. Hermus ◽  
Henri Timmers ◽  
...  

AbstractThe aim of this review was to determine the impact of primary aldosteronism on health-related quality of life (HRQoL) and mental health. We performed a systematic literature search up to July 2017 in six electronic databases. First, we screened the articles derived from this search based on title and abstract. Second, the selected studies were systematically reviewed and checked for our predefined inclusion criteria. The search yielded 753 articles, of which 15 studies met our inclusion criteria. Untreated patients with primary aldosteronism showed an impaired physical and mental HRQoL as compared to the general population. Multiple domains of HRQoL were affected. This applied to patients with both an aldosterone-producing adenoma and bilateral adrenal hyperplasia. Adrenalectomy improves HRQoL. Conflicting results have been reported on the extent of this improvement, the improvement after initiation of medical treatment, and whether there is a difference in HRQoL after both treatments. Similarly, psychopathological symptoms of anxiety, demoralization, stress, depression and nervousness were more frequently reported in untreated patients with primary aldosteronism than in the general population and patients with hypertension. Also an impaired sleep quality has been reported. Improvement of these symptoms was observed after treatment with both adrenalectomy and mineralocorticoid receptor antagonists. This review shows that HRQoL is impaired and psychopathology is more frequently reported in patients with primary aldosteronism. This seems to be at least partly reversible after treatment but the extent of improvement remains unknown. To assess HRQoL in these patients more precisely a primary aldosteronism-specific HRQoL questionnaire is required.


2019 ◽  
Vol 10 (2) ◽  
pp. 17 ◽  
Author(s):  
ShuYing Ng ◽  
Robert Buckner Jones ◽  
Laura Schwartzwald ◽  
Meena Murugappan ◽  
Amy Pittenger ◽  
...  

Purpose: The purpose of this article is to describe how an innovative partnership between a rural community mental health center, community independent pharmacy and College of Pharmacy and integration of a mental health pharmacist lead to identification of medication therapy problems (MTP’s) and interprofessional team partnerships with center mental health professionals. Methods: A contractual arrangement was initiated between Northern Pines Mental Health Center (NPMHC), GuidePoint Pharmacy Services GPS) and the University of Minnesota College of Pharmacy (UMN CoP) to place a PGY1 resident at NPMHC.  The resident was assigned to work closely with the Chief Medical Officer and provide initial comprehensive medication management (CMM) services to individuals who were enrolled in Assertive Community Treatment (ACT). A retrospective chart review was conducted to evaluate the impact of services provided. Patient inclusion criteria included ACT enrollees 18 years or older, a diagnosis of SPMI, taking at least one psychotropic medication, and participation in at least one resident-led CMM visit. Additional findings included the relationship between the pharmacist, the psychiatric physician, and other members of the ACT team. Descriptive statistics were used to document the findings. Findings: N = 30 met the inclusion criteria: 18 males and 12 females, age ranged from 24 - 69 with average of 44 years old. 110 MTPs were identified ranging from no MTPs to 10 MTPs per patient, with a mean of 4 MTPs/patient. There was an uneven distribution of MTPs between psychiatric and medical conditions, with a disproportionately high occurrence of “Needs Additional Drug Therapy” in medical conditions and “Adverse Drug Reaction” in psychiatric conditions. In addition, the services were valued by members on the ACT team. Conclusion: Rural residents with SPMI in intensive community treatment have complex medication needs that require the training and skills of a clinical pharmacist. Despite the inclusion of a medication list as part of the ACT fidelity standards MTPs may go unrecognized and unresolved without the services of a clinical pharmacist conducting CMM. The pharmacist and psychiatric physician formed a collaborative partnership to address medication issues. We conclude that there is a need for integrating clinical pharmacist services into rural mental health centers.   Article Type: Original Research


2018 ◽  
Author(s):  
Jennifer M Reingle Gonzalez ◽  
Michael S Businelle ◽  
Darla Kendzor ◽  
Michele Staton ◽  
Carol S North ◽  
...  

BACKGROUND There is a significant revolving door of incarceration among homeless adults. Homeless adults who receive professional coordination of individualized care (ie, case management) during the period following their release from jail experience fewer mental health and substance use problems, are more likely to obtain stable housing, and are less likely to be reincarcerated. This is because case managers work to meet the various needs of their clients by helping them to overcome barriers to needed services (eg, food, clothing, housing, job training, substance abuse and mental health treatment, medical care, medication, social support, proof of identification, and legal aid). Many barriers (eg, limited transportation, inability to schedule appointments, and limited knowledge of available services) prevent homeless adults who were recently released from incarceration from obtaining available case management, crisis management, substance abuse, and mental health services. OBJECTIVE The aim of the Link2Care study is to assess the effectiveness of a smartphone app for increasing case management and treatment service utilization, and in turn reduce homelessness and rearrest. The goals of this research are to (1) assess the impact of an innovative smartphone app that will prompt and directly link recently incarcerated homeless adults to community-based case management services and resources and (2) utilize in-person and smartphone-based assessments to identify key variables (eg, alcohol or drug use, social support, psychological distress, and quality of life) that predict continued homelessness and rearrest. METHODS Homeless adults (N=432) who enroll in a shelter-based Homeless Recovery Program after release from the Dallas County Jail will be randomly assigned to one of the three treatment groups: (1) usual case management, (2) usual case management plus smartphone, and (3) usual case management with a study-provided smartphone that is preloaded with an innovative case management app (smartphone-based case management). Those assigned to smartphone-based case management will receive smartphones that prompt (twice weekly) connections to shelter-based case managers. The app will also offer direct links to case managers (available during normal business hours) and crisis interventionists (available 24 hours a day, 7 days a week) with the touch of a button. RESULTS Recruitment began in the spring of 2018, and data collection will conclude in 2021. CONCLUSIONS This research represents an important step toward integrated service connection and health care service provision for one of the most underserved, high need, and understudied populations in the United States. CLINICALTRIAL ClinicalTrials.gov NCT03399500; https://clinicaltrials.gov/ct2/show/NCT03399500 (Archived by WebCite at http://www.webcitation.org/6zSJwdgUS) REGISTERED REPORT IDENTIFIER RR1-10.2196/9868


2019 ◽  
Author(s):  
Hilda Bastian ◽  
Jenny Doust ◽  
Mike Clarke ◽  
Paul Glasziou

ABSTRACTBackgroundThe Cochrane Collaboration has been publishing systematic reviews in the Cochrane Database of Systematic Reviews (CDSR) since 1995, with the intention that these be updated periodically.ObjectivesTo chart the long-term updating history of a cohort of Cochrane reviews and the impact on the number of included studies.MethodsThe status of a cohort of Cochrane reviews updated in 2003 was assessed at three time points: 2003, 2011, and 2018. We assessed their subject scope, compiled their publication history using PubMed and CDSR, and compared them to all Cochrane reviews available in 2002 and 2017/18.ResultsOf the 1,532 Cochrane reviews available in 2002, 11.3% were updated in 2003, with 16.6% not updated between 2003 and 2011. The reviews updated in 2003 were not markedly different to other reviews available in 2002, but more were retracted or declared stable by 2011 (13.3% versus 6.3%). The 2003 update led to a major change of the conclusions of 2.8% of updated reviews (n = 177). The cohort had a median time since publication of the first full version of the review of 18 years and a median of three updates by 2018 (range 1–11). The median time to update was three years (range 0–14 years). By the end of 2018, the median time since the last update was seven years (range 0–15). The median number of included studies rose from eight in the version of the review before the 2003 update, to 10 in that update and 14 in 2018 (range 0–347).ConclusionsMost Cochrane reviews get updated, however they are becoming more out-of-date over time. Updates have resulted in an overall rise in the number of included studies, although they only rarely lead to major changes in conclusion.


Author(s):  
Zubair Ahmed Ratan ◽  
Anne-Maree Parrish ◽  
Sojib Bin Zaman ◽  
Mohammad Saud Alotaibi ◽  
Hassan Hosseinzadeh

Background: Smartphones play a critical role in increasing human–machine interactions, with many advantages. However, the growing popularity of smartphone use has led to smartphone overuse and addiction. This review aims to systematically investigate the impact of smartphone addiction on health outcomes. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to carry out the systematic review. Five electronic databases including Medline, Web of Science, PsycINFO, PubMed, and Scopus were searched to identify eligible studies. Eligible studies were screened against predetermined inclusion criteria and data were extracted according to the review questions. This review is registered in PROSPERO (CRD42020181404). The quality of the articles was assessed using the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Results: A total of 27 of 2550 articles met the inclusion criteria. All of the studies were cross-sectional and focused on physical, mental, and neurological health outcomes. The majority of the studies focused on mental health outcomes and consistent associations were observed between smartphone addiction and several mental health outcomes. Anxiety and depression were commonly found to mediate mental health problems. A wide range of physical health sequelae was also associated with smartphone addiction. Furthermore, there was an association between smartphone addiction and neurological disorders. Conclusions: Our findings suggest that there are consistent associations between smartphone addiction and physical and mental health, especially mental health. Social awareness campaigns about smartphone addiction and its impact on physical and mental health are needed. Further studies, especially randomized controlled trials, are warranted to validate the impacts of smartphone addiction.


2021 ◽  
pp. 000486742110314
Author(s):  
Nagesh Pai ◽  
Shae-Leigh Vella

Background: Loneliness is known to be associated with both poorer physical and mental health, being associated with increased mortality. Responses throughout the world to the current COVID-19 pandemic all incorporate varying degrees of social distancing and isolation. There is an imperative to provide a timely review and synthesis of the impact of COVID-19 on loneliness in the general population. Methods: PubMed was searched using the key terms ‘COVID-19’, ‘coronavirus’, ‘SARS-COV2’ and ‘loneliness’. Fifty-four articles were identified and screened against the inclusion criteria. The inclusion criteria stipulated that the study needed to incorporate a measure of loneliness with participants being drawn from the general adult population. Twenty-four studies met the inclusion criteria. Results: The key data extracted from the 24 reviewed studies are presented and summarised with a focus on key demographics of participants, the research designs utilised, the measures of loneliness employed and the other variables assessed in the studies. Overall, the findings indicate that loneliness has been a significant issue during the current COVID-19 pandemic and loneliness is positively associated with mental health symptoms. However, there were inconsistencies in the results evident across studies. Conclusion: To our knowledge, this is the first systematic review of research investigating loneliness during the current COVID-19 pandemic in the general adult population. Despite the inconsistencies evident in some of the results across the studies, it is clearly apparent that loneliness is having an impact on the mental health and wellbeing of the general adult population. Furthermore, it is apparent that the current COVID-19 pandemic has had an impact on loneliness in the general adult population and that loneliness is significantly positively associated with mental illness symptomatology. Thus, there is an imperative to address loneliness through public policy and interventions. The limitations of this review are noted and directions given for future research.


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