An evaluation of a veterinary-specific mental health service

Background Veterinary professionals are at increased risk of suicide and mental health difficulties compared to the general population. Vetlife Health Support (VHS) is a mental health case management service for veterinarians with mental health difficulties. Aims To evaluate the VHS case management service from the service user’s perspective. Methods Service users (n = 98) completed questionnaires assessing their experience with VHS and current mental health status using the Kessler-6 Scale. A sub-sample was interviewed and the data qualitatively analysed (n = 14). Results The results show that 97% (n = 95) reported a positive experience with VHS and 98% (n = 96) reported VHS staff respected and listened to them. Participants reported significant improvements in relationships with others after VHS (P < 0.001) and were significantly more likely to be in receipt of formal mental health care after VHS than before (P < 0.01). The main emergent themes from the qualitative interviews were (i) positive communication between clinician and service users, (ii) veterinary-specific mental health services were regarded as important to understanding service users’ circumstances, (iii) knowing someone is supporting them positively impacted wellbeing and (iv) confusion with discharge status. Conclusions Most participants reported positive experiences with VHS. Quantitatively, data showed that participants reported significant improvements in relationships and access to formal mental health care after contact with VHS. Interviews with service users revealed that they felt speaking to a mental health professional with veterinary-specific knowledge was beneficial for their wellbeing. Further evaluation assessing whether VHS leads to a measurable impact on psychological wellbeing is recommended.

Kotitori: integroitu palveluohjausmalli yksityisen ja julkisen rajalla

Sosiaali- ja terveyspalveluiden kentältä on mahdollista tunnistaa entistä enemmän toimijoita ja palveluita, joihin perinteiset yksityisen tai julkisen määritelmät eivät enää sovi. Yksi esimerkki tämän kaltaisesta palvelusta on Tampereella vuonna 2009 aloittanut vanhojen ihmisten kotihoidon palveluohjauksesta ja palveluintegraatiosta vastaava Kotitori. Tutkimuskysymyksemme on, millainen palveluintegraation ja -ohjauksen muoto Kotitori on? Erityisesti kysymme, mitä tavoitteita Kotitorin perustamiseen liitettiin, sekä miten julkisen ja yksityisten toimijoiden tehtävät ja niiden väliset suhteet määrittyvät Kotitorin toiminnassa. Vastaamme tutkimuskysymyksiin analysoimalla Kotitorin perustamisasiakirjoja ja palvelun perustamisessa ja aloittamisessa keskeisesti vaikuttaneiden toimijoiden haastatteluita. Kotitorin toiminnassa julkisen ja yksityisen palvelun rajat ja tehtävät määritellään uudelleen. Se edustaa uudentyyppistä julkisrahoitteista palvelua, jossa yksityisen ja julkisen rajat sekoittuvat. Kotitori: Service integrator and case management model in between the public and private sectors Kotitori service integrator is a publicly funded, but privately produced service in the field of eldercare services. It is responsible for case management and service integration of homecare services for the elderly. It started in 2009 in the city of Tampere in Finland. It aims to combine the resources of public and private sectors to better meet the needs of elderly service users. We study in this article, what kind of service integration and case management service Kotitori is. Firstly, we ask, what goals were included in the foundation of the service integrator model. Secondly, how are the tasks and relations between public and private actors defined in Kotitori service model? The research data consists of interviews and municipal documents concerning the foundation of Kotitori service integrator model. We conclude that Kotitori represents a novel service integrator and case management service, in which the tasks and relations between public and private sectors are redefined.

Impact of a specialty pharmacy case management service on adherence in patients receiving oral antineoplastic agents

Background Patients receiving treatment with oral antineoplastic agents encounter several barriers to adherence, which may include high medication costs, limited access to specialty medications, severe adverse effects, complex medication regimens, and special handling precautions. Medication nonadherence not only reduces the efficacy of drug therapy but also has the potential to increase healthcare expenditures due to disease-related hospitalizations. Although several previous studies have examined patient adherence to oral antineoplastic agents, few have examined the impact of a specialty pharmacy case management service. Methods Patient adherence to oral antineoplastic agents was evaluated through a retrospective analysis of pharmacy claims data and medical chart reviews. The medication possession ratio (MPR) was used to quantitatively measure adherence during two 6-month intervals, prior to and following the implementation of a case management service. Patients with an MPR greater than or equal to 0.8 were categorized as adherent, while those with an MPR less than 0.8 were categorized as non-adherent. Results During the first 6-month interval prior to implementation of the case management service (n = 40), a cumulative average MPR of 0.922 was observed. Following implementation of the case management service (n = 56), a non-statistically significant (p = 0.199) increase in MPR to 0.941 was identified. For patients categorized as non-adherent, a nonstatistically significant (p = 0.214) decrease from 15% to 7% was identified following the introduction of the case management service. Conclusion Study results from this retrospective review indicate that case management services provided through an outpatient specialty pharmacy may have the potential to improve patient adherence to oral antineoplastic agents.