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Brown T, May A, Beverley-Stone M. The adaptation and implementation of the Health Improvement Profile to Australian standards in public mental health settings. J Psychiatr Ment Health Nurs 2020; 27:628-639. [PMID: 32037667 DOI: 10.1111/jpm.12616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 02/04/2020] [Accepted: 02/07/2020] [Indexed: 12/24/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: The Health Improvement Profile (HIP) is a one-page form developed in the United Kingdom as a tool for mental health nurses to assess service user's physical health needs. The HIP screens service users' physical health and provides recommendations that clinicians can provide service users with in order to improve their physical health. There was evidence supporting the effectiveness of the HIP; however, the majority of HIP studies to date involve the screening tool being completed by nurses. In Australia, a large proportion of mental health clinicians providing case management to service users in community settings are not nurses. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This paper shows that the HIP can be adjusted to suit the needs of Australian service users and can be utilized by clinicians from a variety of disciplines. It also shows that both clinicians and Australian service users find the HIP helpful and argues for it being made available for all service users. It has clearly shown a need to target flu vaccine programmes at service users. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The HIP has been shown to be a suitable and acceptable screening tool for different clinicians to assess multiple lifestyle risk factors at once, which can be used across different diagnoses and settings. This study, for example, demonstrated a need to focus on promoting the flu vaccine and smoking cessation, as well as encouraging service users to visit eye and dental health services. ABSTRACT: Introduction Health Improvement Profile (HIP) studies to date primarily focused on the screening tool being completed by nurses. This paper explores the HIP in two different settings, with an emphasis on expanding physical health roles for all mental health clinicians. Aim The aim of the present study was to adapt the HIP to Australian standards and implement it at a large mental health service. Method This is an evaluation of the implementation of the HIP over a two-month pilot period. Clinicians and service users were surveyed on their experience of the HIP. Results The community team completed the HIP with 34 (15%) service users. The inpatient unit completed the HIP with 137 (54%) service users. Results from the HIP clearly show priority areas for health interventions. Feedback from clinicians and service users was predominately positive. Discussion We found the HIP to be an acceptable screening tool that encompasses multiple lifestyle risk factors. Implications for practice This study clearly demonstrates the utility of the HIP as a workable and acceptable screening tool with real world applicability. In our pilot, for example, we identified the need for the promotion of influenza vaccinations amongst service users, as well as the ongoing need to target smoking cessation and substance use.
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Affiliation(s)
- Trudy Brown
- Northern Area Mental Health Service, The Northern Hospital, Epping, Vic., Australia.,NorthWestern Mental Health, The Royal Melbourne Hospital, Parkville, Vic., Australia
| | - Alexis May
- NorthWestern Mental Health, The Royal Melbourne Hospital, Parkville, Vic., Australia.,Mid West Area Mental Health Service, Sunshine, Vic., Australia
| | - Matthew Beverley-Stone
- NorthWestern Mental Health, The Royal Melbourne Hospital, Parkville, Vic., Australia.,Mid West Area Mental Health Service, Sunshine, Vic., Australia
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Cameron CM, Cumsille Nazar J, Ehrlich C, Kendall E, Crompton D, Liddy AM, Kisely S. General practitioner management of chronic diseases in adults with severe mental illness: a community intervention trial. AUST HEALTH REV 2019; 41:665-671. [PMID: 27977388 DOI: 10.1071/ah16151] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 11/11/2016] [Indexed: 11/23/2022]
Abstract
Objective The aim of the present study was to assess the effects of a community intervention aimed at general practitioners (GPs) by comparing Medicare claims data from patients with severe mental illness (SMI) of GPs exposed to the intervention and controls that were not. Methods A comparison was made of primary care consultation and pathology data of people with SMI from intervention and control areas. Negative binomial regression models were used to compare the frequency and length of GP consultations, as well as the number and type of pathology examinations. Results Records of 103 people from intervention area and 98 controls were obtained. Intervention and control areas were not different at baseline in terms of age and claims data, but females had higher consultation rates. After adjusting for gender, people from intervention areas had more GP consultations, especially long consultations (adjusted incidence rate ratio 1.56; 95% confidence interval 1.28-1.91). They also had more pathology screening for chronic diseases, in accordance with implemented guideline recommendations. These benefits persisted after the end of the intervention. Conclusion These findings suggest that the ACTIVATE program aimed at training GPs to screen and better manage chronic diseases in adults with SMI had a positive effect up to 6 months after the trial, with demonstrated desired changes in medical management practices by GPs in the intervention area during that time. What is known about the topic? People with an SMI have higher mortality and poorer physical health than the general population. What does this paper add? The community intervention had a significant and sustained effect, with demonstrated desired changes in screening and medical management by GPs for adults with SMI in the intervention area. What are the implications for practitioners? GPs are ideally placed to assist in the prevention and better management of health conditions, thereby reducing avoidable illness and deaths in vulnerable populations, such as adults with SMI. Ongoing professional training and dissemination of clinical guidelines are critical for raising awareness about the physical and oral health care needs of people with SMI.
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Affiliation(s)
- Cate M Cameron
- Menzies Health Institute Queensland, Griffith University, Meadowbrook, Qld 4131, Australia.
| | - Jose Cumsille Nazar
- School of Health Services and Social Work, Griffith University, Meadowbrook, Qld 4131, Australia. Email
| | - Carolyn Ehrlich
- Menzies Health Institute Queensland, Griffith University, Meadowbrook, Qld 4131, Australia.
| | - Elizabeth Kendall
- Menzies Health Institute Queensland, Griffith University, Meadowbrook, Qld 4131, Australia.
| | - David Crompton
- School of Health Services and Social Work, Griffith University, Meadowbrook, Qld 4131, Australia. Email
| | - Ann Maree Liddy
- General Practice Queensland t/a CheckUP Australia, PO Box 3205, South Brisbane, Qld 4101, Australia. Email
| | - Steve Kisely
- School of Medicine, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, Qld 4102, Australia. Email
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Affiliation(s)
- Susanne H Stanley
- School of Psychiatry and Clinical Neurosciences, The University of Western Australia and Fremantle Hospital, Fremantle, WA, Australia
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Abstract
The majority of people who experience mental health issues also have poor physical health resulting in decreased life expectancy. Fortunately, many physical health issues can be identified and rectified by monitoring various health indicators over a time period. The Physical Health Diary is a tool that people can use by themselves and/or with others to track, monitor and improve their physical health over time.
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Affiliation(s)
- Susanne H. Stanley
- Discipline of Psychiatry, UWA Medical School, The University of Western Australia, Perth, WA, Australia
| | - Beenish M. Chaudhry
- Department of Computer Science and Engineering, Interdisciplinary Center for Network Science and Applications, University of Notre Dame, Notre Dame, IN, USA
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Galletly C, Castle D, Dark F, Humberstone V, Jablensky A, Killackey E, Kulkarni J, McGorry P, Nielssen O, Tran N. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders. Aust N Z J Psychiatry 2016; 50:410-72. [PMID: 27106681 DOI: 10.1177/0004867416641195] [Citation(s) in RCA: 513] [Impact Index Per Article: 64.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES This guideline provides recommendations for the clinical management of schizophrenia and related disorders for health professionals working in Australia and New Zealand. It aims to encourage all clinicians to adopt best practice principles. The recommendations represent the consensus of a group of Australian and New Zealand experts in the management of schizophrenia and related disorders. This guideline includes the management of ultra-high risk syndromes, first-episode psychoses and prolonged psychoses, including psychoses associated with substance use. It takes a holistic approach, addressing all aspects of the care of people with schizophrenia and related disorders, not only correct diagnosis and symptom relief but also optimal recovery of social function. METHODS The writing group planned the scope and individual members drafted sections according to their area of interest and expertise, with reference to existing systematic reviews and informal literature reviews undertaken for this guideline. In addition, experts in specific areas contributed to the relevant sections. All members of the writing group reviewed the entire document. The writing group also considered relevant international clinical practice guidelines. Evidence-based recommendations were formulated when the writing group judged that there was sufficient evidence on a topic. Where evidence was weak or lacking, consensus-based recommendations were formulated. Consensus-based recommendations are based on the consensus of a group of experts in the field and are informed by their agreement as a group, according to their collective clinical and research knowledge and experience. Key considerations were selected and reviewed by the writing group. To encourage wide community participation, the Royal Australian and New Zealand College of Psychiatrists invited review by its committees and members, an expert advisory committee and key stakeholders including professional bodies and special interest groups. RESULTS The clinical practice guideline for the management of schizophrenia and related disorders reflects an increasing emphasis on early intervention, physical health, psychosocial treatments, cultural considerations and improving vocational outcomes. The guideline uses a clinical staging model as a framework for recommendations regarding assessment, treatment and ongoing care. This guideline also refers its readers to selected published guidelines or statements directly relevant to Australian and New Zealand practice. CONCLUSIONS This clinical practice guideline for the management of schizophrenia and related disorders aims to improve care for people with these disorders living in Australia and New Zealand. It advocates a respectful, collaborative approach; optimal evidence-based treatment; and consideration of the specific needs of those in adverse circumstances or facing additional challenges.
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Affiliation(s)
- Cherrie Galletly
- Discipline of Psychiatry, School of Medicine, The University of Adelaide, SA, Australia Ramsay Health Care (SA) Mental Health, Adelaide, SA, Australia Northern Adelaide Local Health Network, Adelaide, SA, Australia
| | - David Castle
- Department of Psychiatry, St Vincent's Health and The University of Melbourne, Melbourne, VIC, Australia
| | - Frances Dark
- Rehabilitation Services, Metro South Mental Health Service, Brisbane, QLD, Australia
| | - Verity Humberstone
- Mental Health and Addiction Services, Northland District Health Board, Whangarei, New Zealand
| | - Assen Jablensky
- Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, The University of Western Australia (UWA), Crawley, WA, Australia
| | - Eóin Killackey
- Orygen - The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia The University of Melbourne, Melbourne, VIC, Australia
| | - Jayashri Kulkarni
- The Alfred Hospital and Monash University, Clayton, VIC, Australia Monash Alfred Psychiatry Research Centre, Melbourne, VIC, Australia
| | - Patrick McGorry
- Orygen - The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia The University of Melbourne, Melbourne, VIC, Australia Board of the National Youth Mental Health Foundation (headspace), Parkville, VIC, Australia
| | - Olav Nielssen
- Psychiatry, Northern Clinical School, The University of Sydney, Sydney, NSW, Australia
| | - Nga Tran
- St Vincent's Mental Health, Melbourne, VIC, Australia Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
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Laugharne J, Waterreus AJ, Castle DJ, Dragovic M. Screening for the metabolic syndrome in Australia: a national survey of psychiatrists' attitudes and reported practice in patients prescribed antipsychotic drugs. Australas Psychiatry 2016; 24:62-6. [PMID: 26635377 DOI: 10.1177/1039856215618521] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate current reported psychiatric practice in relation to screening for the metabolic syndrome in patients prescribed antipsychotic drugs within Australia. METHOD A postal survey of all Fellows of the Royal Australian and New Zealand College of Psychiatrists. A 28-item questionnaire inquired into different aspects of screening and monitoring for metabolic syndrome in patients on antipsychotic medication. RESULTS Of 3123 questionnaires sent, 955 were returned. Of respondents, 55% had no established metabolic monitoring protocol or guidelines in their work place, with 13% saying they did not know what to monitor to detect metabolic syndrome. Altogether, 76% reported there was no reliable system in place to remind them when to monitor. Fewer than 50% of respondents routinely check weight, fasting glucose or lipids in their patients on antipsychotics and under than 30% checked blood pressure. Waist circumference was routinely checked in fewer than 7% of patients. Basic monitoring equipment was reported unavailable in more than 50% of clinical settings. However, more than 80% of respondents considered monitoring for metabolic syndrome to be their responsibility and 83% felt they had a medicolegal obligation in this respect. CONCLUSIONS Routine screening for metabolic syndrome in patients on antipsychotic agents, by Australian psychiatrists, is inadequate. Interventions to improve screening rates need to be developed, implemented and evaluated.
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Affiliation(s)
- Jonathan Laugharne
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, WA, Australia
| | - Anna J Waterreus
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, WA, Australia
| | - David J Castle
- St Vincent's Hospital and The University of Melbourne, Melbourne, NSW, Australia
| | - Milan Dragovic
- Clinical Research Centre, North Metropolitan Health Service Mental Health, Perth, WA, Australia
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Galletly CA. Making things better? Aust N Z J Psychiatry 2015; 49:958-9. [PMID: 26450943 DOI: 10.1177/0004867415610204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Cherrie A Galletly
- Ramsay Health Care (SA) Mental Health Services, Ramsay Health Care, Adelaide, SA, Australia Discipline of Psychiatry, School of Medicine, The University of Adelaide, Adelaide, SA, Australia Northern Adelaide Local Health Network, Adelaide, SA, Australia
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Henderson S. What really happens. Aust N Z J Psychiatry 2014; 48:887-8. [PMID: 25258418 DOI: 10.1177/0004867414551668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Scott Henderson
- National Institute for Mental Health Research, The Australian National University, Canberra, Australia
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