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Refining a model of collaborative care for people with a diagnosis of bipolar, schizophrenia or other psychoses in England : a qualitative formative evaluation
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Baker, Elina, Gwernan-Jones, Ruth, Britten, Nicky, Cox, Maria, McCabe, Catherine, Retzer, Ameeta, Gill, Laura, Plappert, Humera, Reilly, Siobhan, Pinfold, Vanessa, Gask, Linda, Byng, Richard and Birchwood, Max (2019) Refining a model of collaborative care for people with a diagnosis of bipolar, schizophrenia or other psychoses in England : a qualitative formative evaluation. BMC Psychiatry, 19 (1). 7. doi:10.1186/s12888-018-1997-z ISSN 1471-244X.
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Official URL: https://doi.org/10.1186/s12888-018-1997-z
Abstract
Background
Many people diagnosed with schizophrenia, bipolar or other psychoses in England receive the majority of their healthcare from primary care. Primary care practitioners may not be well equipped to meet their needs and there is often poor communication with secondary care. Collaborative care is a promising alternative model but has not been trialled specifically with this service user group in England. Collaborative care for other mental health conditions has not been widely implemented despite evidence of its effectiveness. We carried out a formative evaluation of the PARTNERS model of collaborative care, with the aim of establishing barriers and facilitators to delivery, identifying implementation support requirements and testing the initial programme theory.
Methods
The PARTNERS intervention was delivered on a small scale in three sites. Qualitative data was collected from primary and secondary care practitioners, service users and family carers, using se mi-structured interviews, session recordings and tape-assisted recall. Deductive and inductive thematic analysis was carried out; themes were compared to the programme theory and used to inform an implementation support strategy.
Results
Key components of the intervention that were not consistently delivered as intended were: interaction with primary care teams, the use of coaching, and supervision. Barriers and facilitators identified were related to service commitment, care partner skills, supervisor understanding and service user motivation. An implementation support strategy was developed, with researcher facilitation of communication and supervision and additional training for practitioners. Some components of the intervention were not experienced as intended; this appeared to reflect difficulties with operationalising the intervention. Analysis of data relating to the intended outcomes of the intervention indicated that the mechanisms proposed in the programme theory had operated as expected.
Conclusions
Additional implementation support is likely to be required for the PARTNERS model to be delivered; the effectiveness of such support may be affected by practitioner and service user readiness to change. There is also a need to test the programme theory more fully. These issues will be addressed in the process evaluation of our full trial.
Trial registration: ISRCTN95702682 , 26 October 2017
| Item Type: | Journal Article | ||||||||||||
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| Subjects: | R Medicine > RC Internal medicine | ||||||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| SWORD Depositor: | Library Publications Router | ||||||||||||
| Library of Congress Subject Headings (LCSH): | Manic-depressive illness -- Patients -- Treatment, Schizophrenia -- Patients -- Treatment, Psychoses -- Patients -- Treatment | ||||||||||||
| Journal or Publication Title: | BMC Psychiatry | ||||||||||||
| Publisher: | BioMed Central Ltd. | ||||||||||||
| ISSN: | 1471-244X | ||||||||||||
| Official Date: | 7 January 2019 | ||||||||||||
| Dates: |
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| Volume: | 19 | ||||||||||||
| Number: | 1 | ||||||||||||
| Article Number: | 7 | ||||||||||||
| DOI: | 10.1186/s12888-018-1997-z | ||||||||||||
| Status: | Peer Reviewed | ||||||||||||
| Publication Status: | Published | ||||||||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||||||||
| Date of first compliant deposit: | 24 January 2019 | ||||||||||||
| Date of first compliant Open Access: | 24 January 2019 | ||||||||||||
| RIOXX Funder/Project Grant: |
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