Slides KingsFundFeb4th 2014
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Item code: PHGB/JHI/1113/0031 Date of Prep: November 2013 Innovation in Mental Health Achieving positive outcomes through innovation in community mental health services February 4 th , 2014 Dr Llew Lewis Consultant Psychiatrist and Deputy Medical Director, South Essex Partnership Foundation University Trust Presentation produced jointly by Janssen Healthcare Innovation and South Essex Partnership University Trust
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Transcript of Slides KingsFundFeb4th 2014
Item code: PHGB/JHI/1113/0031 Date of Prep: November 2013
Innovation in Mental Health
Achieving positive outcomes through innovation in community mental health
services
February 4th, 2014
Dr Llew LewisConsultant Psychiatrist and Deputy Medical Director,
South Essex Partnership Foundation University Trust
Presentation produced jointly by Janssen Healthcare Innovation and South Essex Partnership University Trust
Item code: PHGB/JHI/1113/0031 Date of Prep: November 2013
Challenges to healthcare
How to improve quality of care...
• Increase patient and staff satisfaction
• Free up time to care
• Decrease variability of care
...while addressing pressure on costs:
• Nicholson Challenge
• 4% year-on-year reductions
Item code: PHGB/JHI/1113/0031 Date of Prep: November 2013
The challenge in Psychosis:Treatment is multi-factorial and complex
Service users can be trapped in a vicious cycle
Lack of patient insight into condition
•Low engagement with services•Low medication adherence
symptoms relapse rates
•Poor outcomes•High resource utilisation•High Cost
Pressure on resources
Lack of staff time
Little or no support tools
Lack of structured programmes
1 Schizophrenia Commission. The Abandoned Illness. November 2012. Available at: http://www.rethink.org/media/514093/TSC_main_report_14_nov.pdf Last accessed: October 2013. 2 Andrews A, Knapp M, McCrone P et al. Effective interventions in schizophrenia: The economic case. LSE PSSRU. November 2012.
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Item code: PHGB/JHI/1113/0031 Date of Prep: November 2013
•To partner with Janssen under a Joint Working agreement
•To translate and modify an Adherence model originally developed in Munich to a UK context. Supported by Dr Werner Kissling
•To test the model within SEPT, an innovative mental health Trust in the South-East of England
•To produce an evaluation of the clinical and economic benefits and outcomes
The Maintaining Adherence Programme (MAP)
1. Department of Health Joint working guidelines : http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_082370
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Item code: PHGB/JHI/1113/0031 Date of Prep: November 2013
Why is this approach being considered in the UK?
Despite advances in psychopharmacology and service innovations (UK National Service Framework 1999):
Patients still relapse
• Improve the quality of care and outcomes for people with diagnoses of schizophrenia, schizoaffective and bipolar disorders through a focus on relapse prevention
• Improve productivity: reduce overall resource usage in a climate of radical financial pressures
Aim of the model is to:
Item code: PHGB/JHI/1113/0031 Date of Prep: November 2013
What interventions does the UK model provide?• Dedicated adherence team
• Recovery lounge
• Assessment & regular screening of non-adherence to treatment
• Structured and in-depth psycho-education for service users
• Structured and in-depth psycho-education for families and carers
• Wellbeing activities
• Shared-decision making
• Telephone/text reminder services
• Direct consultant access instead of outpatient clinics
Item code: PHGB/JHI/1113/0031 Date of Prep: November 2013
Interim pilot results: reduction in the mean number of inpatient bed days
1. O’Keefe et al. The Future of Health Poster presented at the Future of Health Conference: 2013: 3-4 October: London.
n=63
58% reduction
Item code: PHGB/JHI/1113/0031 Date of Prep: November 2013
Interim pilot results: better adherence
1. O’Keefe et al. The Future of Health Poster presented at the Future of Health Conference: 2013: 3-4 October: London.
MARS (Medication Adherence Rating Scale = a valid and reliable measure of adherence to medications
DD (Differential Diagnosis) = an questionnaire to evaluate the patient based on the known factors of non adherence
Item code: PHGB/JHI/1113/0031 Date of Prep: November 2013
Interim pilot results: 98% of respondents would recommend the service to a friend
I felt involved in decisions about my treatment (n=49)
I would recommend the service to a friend who had a similar problem (n=48)
“MAP has helped me recognise early warning signs and so I can ask for help before I am in crisis.”
“I am getting my life together and I have tidied my flat and I believe thatthis is because I am coming to MAP.”
1. O’Keefe et al. The Future of Health Poster presented at the Future of Health Conference: 2013: 3-4 October: London.
Questionnaires were completed by 79% (50/63) of patients
Item code: PHGB/JHI/1113/0031 Date of Prep: November 2013
Next Steps
SEPT working with Janssen Healthcare Innovation to roll out version 2.0 - Care4Today™ Mental Health Solutions - across South Essex and further developing the model:- Integration with mainstream community mental health
services- Pathway management system- Patient & carer education website- Physical health modules
Item code: PHGB/JHI/1113/0031 Date of Prep: November 2013
Q&A
