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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

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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
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
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:
DateEvent
7 January 2019Published
20 December 2018Accepted
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:
Project/Grant IDRIOXX Funder NameFunder ID
RP-PG-0611-20004[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
Collaboration for Leadership in Applied Health Research and Care South West Peninsula [NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
Collaboration for Leadership in Applied Health Research, West Midlands [NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272

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