Dataset Information

Collaborative Care for Psychiatric Disorders in Older Adults: A Systematic Review.

ABSTRACT:

Objective

To evaluate the mode of implementation, clinical outcomes, cost-effectiveness, and the factors influencing uptake and sustainability of collaborative care for psychiatric disorders in older adults.

Design

Systematic review.

Setting

Primary care, home health care, seniors' residence, medical inpatient and outpatient.

Participants

Studies with a mean sample age of 60 years and older.

Intervention

Collaborative care for psychiatric disorders.

Methods

PubMed, MEDLINE, Embase, and Cochrane databases were searched up until October 2016. Individual randomized controlled trials and cohort, case-control, and health service evaluation studies were selected, and relevant data were extracted for qualitative synthesis.

Results

Of the 552 records identified, 53 records (from 29 studies) were included. Very few studies evaluated psychiatric disorders other than depression. The mode of implementation differed based on the setting, with beneficial use of telemedicine. Clinical outcomes for depression were significantly better compared with usual care across settings. In depression, there is some evidence for cost-effectiveness. There is limited evidence for improved dementia care and outcomes using collaborative care. There is a lack of evidence for benefit in disorders other than depression or in settings such as home health care and general acute inpatients. Attitudes and skill of primary care staff, availability of resources, and organizational support are some of the factors influencing uptake and implementation.

Conclusions

Collaborative care for depressive disorders is feasible and beneficial among older adults in diverse settings. There is a paucity of studies on collaborative care in conditions other than depression or in settings other than primary care, indicating the need for further evaluation.

SUBMITTER: Dham P

PROVIDER: S-EPMC5697628 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Collaborative Care for Psychiatric Disorders in Older Adults: A Systematic Review.

Dham Pallavi P Colman Sarah S Saperson Karen K McAiney Carrie C Lourenco Lillian L Kates Nick N Rajji Tarek K TK

Canadian journal of psychiatry. Revue canadienne de psychiatrie 20170718 11

<h4>Objective</h4>To evaluate the mode of implementation, clinical outcomes, cost-effectiveness, and the factors influencing uptake and sustainability of collaborative care for psychiatric disorders in older adults.<h4>Design</h4>Systematic review.<h4>Setting</h4>Primary care, home health care, seniors' residence, medical inpatient and outpatient.<h4>Participants</h4>Studies with a mean sample age of 60 years and older.<h4>Intervention</h4>Collaborative care for psychiatric disorders.<h4>Methods ...[more]

PMID: 28718325

Similar Datasets

Project description:BackgroundCollaborative care is an evidence-based approach to improving outcomes for common mental disorders in primary care. Efforts are underway to broadly implement the collaborative care model, yet the extent to which this model promotes person-centered mental health care has been little studied. The aim of this study was to describe practices related to two patient and family engagement strategies-personalized care planning and shared decision making-within collaborative care programs for depression and anxiety disorders in primary care.MethodsWe conducted an update of a 2012 Cochrane review, which involved searches in Cochrane CCDAN and CINAHL databases, complemented by additional database, trial registry, and cluster searches. We included programs evaluated in a clinical trials targeting adults or youth diagnosed with depressive or anxiety disorders, as well as sibling reports related to these trials. Pairs of reviewers working independently selected the studies and data extraction for engagement strategies was guided by a codebook. We used narrative synthesis to report on findings.ResultsIn total, 150 collaborative care programs were analyzed. The synthesis showed that personalized care planning or shared decision making were practiced in fewer than half of programs. Practices related to personalized care planning, and to a lesser extent shared decision making, involved multiple members of the collaborative care team, with care managers playing a pivotal role in supporting patient and family engagement. Opportunities for quality improvement were identified, including fostering greater patient involvement in collaborative goal setting and integrating training and decision aids to promote shared decision making.ConclusionThis review suggests that personalized care planning and shared decision making could be more fully integrated within collaborative care programs for depression and anxiety disorders. Their absence in some programs is a missed opportunity to spread person-centered mental health practices in primary care.

Dataset Information

Collaborative Care for Psychiatric Disorders in Older Adults: A Systematic Review.

Objective

Design

Setting

Participants

Intervention

Methods

Results

Conclusions

Publications

Collaborative Care for Psychiatric Disorders in Older Adults: A Systematic Review.

Similar Datasets

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