Search results for ‘Subject term:"comorbidity"’ Sort:
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Community care for people with complex care needs: bridging the gap between health and social care
- Authors:
- KULUSKI Kerry, et al
- Journal article citation:
- International Journal of Integrated Care, 17(4), 2017, Online only
- Publisher:
- International Foundation for Integrated Care
Introduction: A growing number of people are living with complex care needs characterized by multimorbidity, mental health challenges and social deprivation. Required is the integration of health and social care, beyond traditional health care services to address social determinants. This study investigates key care components to support complex patients and their families in the community. Methods: Expert panel focus groups with 24 care providers, working in health and social care sectors across Toronto, Ontario, Canada were conducted. Patient vignettes illustrating significant health and social care needs were presented to participants. The vignettes prompted discussions on i) how best to meet complex care needs in the community and ii) the barriers to delivering care to this population. Results: Categories to support care needs of complex patients and their families included i) relationships as the foundation for care, ii) desired processes and structures of care, and iii) barriers and workarounds for desired care. Discussion and Conclusions: Meeting the needs of the population who require health and social care requires time to develop authentic relationships, broadening the membership of the care team, communicating across sectors, co-locating health and social care, and addressing the barriers that prevent providers from engaging in these required practices. (Publisher abstract)
Service audit pilot report
- Author:
- McCUE Michael
- Publisher:
- Joint Improvement Team
- Publication year:
- 2011
- Pagination:
- 16p.
- Place of publication:
- Edinburgh
The Scottish Government Mental Health Division established the National Co-Morbidity Working Group in 2007. The initial focus of this working group was on the use of in-patient and related services for people with a learning disability with mental health needs. This document provides an overview of efforts to expand the remit of the National Co-Morbidity Working Group to include a re-consideration of the scope of services for people with a learning disability, offending behaviour and autistic spectrum difficulties. A work plan was developed, which included the aim of identifying the most responsive models of service for this client group via a detailed analysis of existing international, national and local service models and key service model characteristics. The outcome of this modelling work was the development of a set of 22 Key Service Model Characteristics (KSMC), which appear to be predictive and reflective of responsive services for individuals with complex support needs. The KSMC was used to evaluate the quality and service governance processes of Turning Point Scotland (TPS). In addition, a workshop event was held with the Risk Management Team of TPS which aimed to evaluate the KSMC as a template for real service review and development.
Substance misuse research: co-morbid mental health and substance misuse in Scotland: summary
- Author:
- SCOTLAND. Scottish Executive
- Publisher:
- Scotland. Scottish Executive
- Publication year:
- 2006
- Pagination:
- 4p.
- Place of publication:
- Edinburgh
The research project investigated the nature, scope and impact of existing service provision in Scotland for people with co-existing mental health and substance misuse problems. The study was commissioned by the Scottish Executive in 2003 to extend current international evidence regarding co-morbidity, address perceived gaps in information on the quality of the provision of care for this client group and help inform the development of the co-morbidity agenda in Scotland. The research fits within the wider strategic context in the UK, complementing other initiatives or strategies. The main aim of the study was to identify the broad range of health and social care needs of people with co-morbid mental health and substance misuse issues in Scotland. Key issues included the quality of current provision and organisation of health, social care and the voluntary and independent sectors in addressing these needs, common factors that might impede this provision, the interrelation of different services and examples of good practice.
Substance misuse research: co-morbid mental health and substance misuse in Scotland
- Authors:
- HODGES Claire-Louise, et al
- Publisher:
- Scotland. Scottish Executive
- Publication year:
- 2006
- Pagination:
- 89p.
- Place of publication:
- Edinburgh
The research project investigated the nature, scope and impact of existing service provision in Scotland for people with co-existing mental health and substance misuse problems. The study was commissioned by the Scottish Executive in 2003 to extend current international evidence regarding co-morbidity, address perceived gaps in information on the quality of the provision of care for this client group and help inform the development of the co-morbidity agenda in Scotland. The research fits within the wider strategic context in the UK, complementing other initiatives or strategies. The main aim of the study was to identify the broad range of health and social care needs of people with co-morbid mental health and substance misuse issues in Scotland. Key issues included the quality of current provision and organisation of health, social care and the voluntary and independent sectors in addressing these needs, common factors that might impede this provision, the interrelation of different services and examples of good practice.
Mazindol augmentation of antipsychotic treatment for schizophrenic patients with comorbid cocaine abuse or dependence: a preliminary double-blind, randomized, placebo-controlled trial
- Authors:
- PERRY Edward B., et al
- Journal article citation:
- Journal of Dual Diagnosis, 1(1), 2004, pp.37-47.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Cocaine abuse has a negative impact on the natural history of schizophrenia. There are no proven treatments for cocaine abuse in schizophrenia patients. The catecholamine reuptake inhibitor, mazindol, has been reported to reduce cocaine abuse in some studies. Here we report the results of a double-blind, randomized, placebocontrolled 6-week pilot study of mazindol augmentation of antipsychotic pharmacotherapy in patients diagnosed with comorbid schizophrenia and cocaine abuse or dependence. Patients diagnosed with schizophrenia or schizoaffective disorder and cocaine abuse or dependence participated in group therapy focused on substance abuse issues and were randomly assigned to mazindol (1 mg tid, increased to 2 mg tid after 1 week) or matched placebo in addition to their current antipsychotic medication for 6 weeks. Twenty-four patients were included in the analysis, with 11 and 13 randomized to the mazindol and placebo groups, respectively. While safe and well-tolerated, mazindol was ineffective in reducing cocaine consumption, cocaine craving, and psychiatric symptoms. Conclusions: These results do not support the efficacy of mazindol in decreasing cocaine craving, cocaine consumption, and psychiatric symptoms in schizophrenic and schizoaffective patients. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580)
Oxleas advanced dementia service: supporting carers and building resilience
- Authors:
- SONOLA Lara, et al
- Publisher:
- King's Fund
- Publication year:
- 2013
- Pagination:
- 32
- Place of publication:
- London
The Oxleas Advanced Dementia Service was formed in November 2012., and brought together two services in south-east London: Greenwich Advanced Dementia Service (GADS) and Bexley Advanced Dementia Care At Home project. The Service is for people with a diagnosis of moderate to severe advanced dementia complicated by complex mental and physical comorbidities who also need social care input and are supported to live at home (by family or paid carers). This report thus describes a model of care that seeks to help patients with advanced dementia to live at home for as long as possible in the last year of life; two individual case studies illustrate the methods used and their effectiveness. The report is part of a research project undertaken by The King’s Fund and funded by Aetna and the Aetna Foundation in the USA, to compare five successful UK-based models of care co-ordination. The aim has been to understand the strategies used to deliver care co-ordination effectively; examine barriers and facilitators to successful care co-ordination; and to identify the techniques that make for success, and the lessons for co-ordinating care in terms of planning, organisation and leadership. Appendices include estimated data on people aged 65 and over predicted to have dementia in Bexley, projected to 2020. (Original abstract)
Comorbidity of substance misuse and mental illness in community mental health and substance misuse services
- Authors:
- WEAVER T., et al
- Journal article citation:
- British Journal of Psychiatry, 183(10), October 2003, pp.304-313.
- Publisher:
- Cambridge University Press
Improved management of mental illness and substance misuse comorbidity is a National Health Service priority, but little is known about its prevalence and current management. This research measures the prevalence of comorbidity among patients of community mental health teams (CMHTs) and substance misuse services, and to assess the potential for joint management. Of CMHT patients, 44% (95% CI 38.1-49.9) reported past-year problem drug use and/or harmful alcohol use; 75% (95% CI 68.2-80.2) of drug service and 85% of alcohol service patients (95% CI 74.2-93.1) had a past-year psychiatric disorder. Most comorbidity patients appear ineligible for cross-referral between services. Large proportions are not identified by services and receive no specialist intervention. Comorbidity is highly prevalent
Depression status, medical comorbidity and resource costs: evidence from an international study of major depression in primary care (LIDO)
- Authors:
- CHISHOLM Daniel, et al
- Journal article citation:
- British Journal of Psychiatry, 183(8), August 2003, pp.121-131.
- Publisher:
- Cambridge University Press
Despite the burden of depression, there remain few data on its economic consequences in an international context. The aim of this article is to explore the relationship between depression status (with and without medical comorbidity), work loss and health care costs, using cross-sectional data from a multi-national study of depression in primary care. Primary care attendees were screened for depression. Those meeting eligibility criteria were categorised according to DSM–IV criteria for major depressive disorder and comorbid status. Unit costs were attached to self-reported days absent from work and uptake of health care services. Medical comorbidity was associated with a 17–46% increase in health care costs in five of the six sites, but a clear positive association between costs and clinical depression status was identified in only one site. The economic consequences of depression are influenced to a greater (and considerable) extent by the presence of medical comorbidity than by symptom severity alone.
MIDAS: a new service for the mentally ill with comorbid drug and alcohol misuse
- Authors:
- BAYNEY R., ST. JOHN-SMITH P., CONHYE A.
- Journal article citation:
- Psychiatric Bulletin, 26(7), July 2002, pp.251-254.
- Publisher:
- Royal College of Psychiatrists
Describe the work and patient characteristics of one of the first combined mental illness and drug and alcohol services (MIDAS) in the UK. Examines MIDAS as an assertive community service, for individuals receiving long-term community care. Results found patients with bipolar affective disorder and personality disorders were more likely to use the service than patients with unipolar disorder or schizophrenia. Despite the use of an assertive service, there was difficulty engaging patients with schizophrenia and comorbid drug use.