CG123 Common mental health disorders - National Institute for ...

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Systems for organising and developing local care pathwaysTable 40: Clinical review protocol for the review of care pathwaysComponent DescriptionReview question In adults (18 years and older) with depression (includingsubthreshold disorders) or an anxiety disorder*, what arethe aspects of a clinical care pathway that are associatedwith better individual or organisations outcomes?ObjectivesTo perform a narrative synthesis of systematic reviewsaddressing care pathwaysPopulationAdults (18 years and older) identified with depression(including subthreshold disorders) or an anxiety disorder*Intervention(s) Care pathwaysComparison Standard management strategyCritical outcomes AnyElectronic databases CINAHL, DARE, EMBASE, MEDLINE, PsycINFO,Date searched 1 January 1995 to 14 June 2010Study design Systematic review*Including GAD, panic disorder, social anxiety disorder, OCD, specific phobias and PTSD.GILBODY2006 (Gilbody et al., 2006), GUNN2006 (Gunn et al., 2006), NEUMEYER-GROMEN2004 (Neumeyer-Gromen et al., 2004) and SMOLDERS2008 (Smolderset al., 2008) looked at collaborative care and case management as specific models ofcare. One further study, CALLAGHAN2003 (Callaghan et al., 2003), looked at liaisonmental health services as a model of care. Two studies, HEIDEMAN2005 (Heidemanet al., 2005) and AGARWAL2008 (Agarwal & Crooks, 2008), also investigated continuityof care, but for anxiety disorders rather than depression. One study, ADLER2010(Adler et al., 2010), looked at continuity of care; the aforementioned AGARWAL2008(Agarwal et al., 2008) looked ways of improving informational continuity andGILBODY2003 (Gilbody et al., 2003) investigated the effect of educational interventionson depression outcomes.The characteristics of the studies included in this review can be found in Table 41.Further information about both included and excluded studies can be found inAppendix 14.7.2.3 Clinical evidenceOn the basis of an initial review of the references identified by the literature search, theGDG was able to group the included studies under a number of headings. These191
Systems for organising and developing local care pathwaysTable 41: Study information table for systematic reviews of care pathwaysStudy ID ADLER2010 ADLI2006 AGARWAL2008 BADAMGARAV2003 BOWER2006Method used to Narrative Narrative Narrative Meta-analysis Meta-analysissynthesise evidence and meta-regressionDesign of included Various Various Various RCTs RCTsstudiesSearch strategy CINAHL and MEDLINE MEDLINE (no dates CINAHL, EMBASE, Cochrane Library, CINAHL, the Cochranewere searched to 2007 given) MEDLINE, PsycINFO HealthSTAR, MEDLINE Library, DARE, EMBASE,and Web of Science were searched to 2001 MEDLINE and PsycINFOwere searched to 2006 were searched to 2005No. of included studies 12 Not given 34 19 72Review quality Adequate Poor Adequate Adequate AdequateInterventions Continuity of care Algorithms Informational continuity Disease management Collaborative careOutcomes Patient satisfaction Recovery, quality of Accuracy Improvements in Antidepressant use andlife, patient satisfaction, symptoms, physical symptom improvementremission or response functioning, socialto treatment, treatment and health status andadherence, symptom patient satisfaction,reduction, suicidal impact on healthcareideation, side-effect utilisation,burden and functional hospitalisations,impairment healthcare costs,depression detection,referral rates, prescribingadequacy and adherenceParticipant diagnoses Various medical concerns Depression Various mental and Depression Depression or depressivenon-mental health symptomsconditions192
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Commonmental healthdisordersTHE NIC
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© The British Psychological Societ
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Contents6 FURTHER ASSESSMENT OF RIS
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Guideline development group members
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Preface1 PREFACEThis guideline has
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Prefacecollaborative manner using t
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PrefaceThe experience of people wit
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Common mental health disorders2.2 T
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Common mental health disordersto ho
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Common mental health disordersManua
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Common mental health disordershighe
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Common mental health disordersNegat
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Common mental health disorderscours
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Common mental health disordersover
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Common mental health disorders2.2.6
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Common mental health disordersTable
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Common mental health disorders1996)
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Common mental health disordersSumma
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Common mental health disordersTable
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Common mental health disordersappli
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Common mental health disorderspatie
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Methods used to develop this guidel
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Access to healthcare4. ACCESS TO HE
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Access to healthcareunder the Menta
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Access to healthcare4.2.3 Studies c
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Access to healthcareIndividual-leve
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Access to healthcareJUNG2003 review
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Access to healthcareSCHEPPERS2006).
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Access to healthcare70Table 8: Clin
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Access to healthcareTable 9: Study
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Access to healthcareCHAPMAN2004 inc
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Access to healthcare4.4 SERVICE DEV
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Access to healthcareBEACH2006 [Beac
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Access to healthcareTable 12: Summa
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Access to healthcareAll studies wer
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Access to healthcarepractitioners h
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Access to healthcareIndividual-leve
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Access to healthcarefrom such popul
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Access to healthcarestructure and d
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Case identification and formal asse
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Further assessment of risk and need
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Further assessment of risk and need
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Page 219 and 220: Summary of recommendationsFigure 12
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Page 231 and 232: Appendices9 APPENDICESAppendix 1: S
Page 233 and 234: Appendix 1of a depressive disorder
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Page 239 and 240: Appendix 2Mr Mike BessantEmployment
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Appendix 2Actions takenMr Rupert Su
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Appendix 2Personal family interestN
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Appendix 3APPENDIX 3:STAKEHOLDERS A
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Appendix 4ClinicalpopulationPeople
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Appendix 4Case identificationNo. Pr
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Appendix 5APPENDIX 5:REVIEW PROTOCO
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Appendix 7APPENDIX 7:METHODOLOGY CH
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Appendix 9APPENDIX 9:METHODOLOGY CH
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Appendix 92.10 Are all important pa
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Appendix 9case also excludes costs
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Appendix 9For consistency, the EQ-5
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Appendix 9Answer ‘yes’ if the a
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Appendix 9Answer ‘yes’ if the e
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Appendix 9Answer ‘yes’ if appro
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Appendix 10APPENDIX 10: EVIDENCE TA
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Appendix 11APPENDIX 11:HIGH PRIORIT
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Appendix 11discussion of options bu
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Appendix 13APPENDIX 13:GENERALIZED
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ReferencesAndlin-Sobocki, P., Jöns
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ReferencesBower, P., Gilbody, S., R
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ReferencesCooper, S., Smiley, E., M
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ReferencesEhlers A., Gene-Cos N. &
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ReferencesGiles, D. E., Jarrett, R.
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ReferencesHorowitz, M. J., Wilner,
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ReferencesKnapp, M. & Ilson, S. (20
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ReferencesMarks, J., Goldberg, D. P
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ReferencesNCCMH (forthcoming) Self-
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ReferencesOzer, E. J., Best, S. R.,
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ReferencesSartorius, N. (2002) Eine
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ReferencesTiemens, B. G., Ormel, J.
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ReferencesWilkinson, M. J. B. & Bar
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Glossarybeliefs and interpretations
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Glossaryto learn to become more awa
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Abbreviations12 ABBREVIATIONSADDADS
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AbbreviationsOASISOCDONSORPHQ (-A,
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