Cargando…

The feasibility of implementing recovery, psychosocial and pharmacological interventions for psychosis: comparison study

BACKGROUND: Clinical guidelines for the treatment of people experiencing psychosis have existed for over a decade, but implementation of recommended interventions is limited. Identifying influences on implementation may help to reduce this translational gap. The Structured Assessment of Feasibility...

Descripción completa

Detalles Bibliográficos
Autores principales: van der Krieke, Lian, Bird, Victoria, Leamy, Mary, Bacon, Faye, Dunn, Rebecca, Pesola, Francesca, Janosik, Monika, Le Boutillier, Clair, Williams, Julie, Slade, Mike
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4453226/
https://www.ncbi.nlm.nih.gov/pubmed/26002350
http://dx.doi.org/10.1186/s13012-015-0262-9
_version_ 1782374430413946880
author van der Krieke, Lian
Bird, Victoria
Leamy, Mary
Bacon, Faye
Dunn, Rebecca
Pesola, Francesca
Janosik, Monika
Le Boutillier, Clair
Williams, Julie
Slade, Mike
author_facet van der Krieke, Lian
Bird, Victoria
Leamy, Mary
Bacon, Faye
Dunn, Rebecca
Pesola, Francesca
Janosik, Monika
Le Boutillier, Clair
Williams, Julie
Slade, Mike
author_sort van der Krieke, Lian
collection PubMed
description BACKGROUND: Clinical guidelines for the treatment of people experiencing psychosis have existed for over a decade, but implementation of recommended interventions is limited. Identifying influences on implementation may help to reduce this translational gap. The Structured Assessment of Feasibility (SAFE) measure is a standardised assessment of implementation blocks and enablers. The aim of this study was to characterise and compare the implementation blocks and enablers for recommended psychosis interventions. METHODS: SAFE was used to evaluate and compare three groups of interventions recommended in the 2014 NICE psychosis guideline: pharmacological (43 trials testing 5 interventions), psychosocial (65 trials testing 5 interventions), and recovery (19 trials testing 5 interventions). The 127 trial reports rated with SAFE were supplemented by published intervention manuals, research protocols, trial registrations and design papers. Differences in the number of blocks and enablers across the three interventions were tested statistically, and feasibility profiles were generated. RESULTS: There was no difference between psychosocial and recovery interventions in the number of blocks or enablers to implementation. Pharmacological interventions (a) had fewer blocks than both psychosocial interventions (χ(2)(3) = 133.77, p < 0.001) and recovery interventions (χ(2)(3) = 104.67, p < 0.001) and (b) did not differ in number of enablers from recovery interventions (χ(2)(3) = 0.74, p = 0.863) but had fewer enablers than psychosocial interventions (χ(2)(3) = 28.92, p < 0.001). Potential adverse events associated with the intervention tend to be a block for pharmacological interventions, whereas complexity of the intervention was the most consistent block for recovery and psychosocial interventions. CONCLUSIONS: Feasibility profiles show that pharmacological interventions are relatively easy to implement but can sometimes involve risks. Psychosocial and recovery interventions are relatively complex but tend to be more flexible and more often manualised. SAFE ratings can contribute to tackling the current implementation challenges in mental health services, by providing a reporting guideline structure for researchers to maximise the potential for implementation and by informing prioritisation decisions by clinical guideline developers and service managers.
format Online
Article
Text
id pubmed-4453226
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-44532262015-06-04 The feasibility of implementing recovery, psychosocial and pharmacological interventions for psychosis: comparison study van der Krieke, Lian Bird, Victoria Leamy, Mary Bacon, Faye Dunn, Rebecca Pesola, Francesca Janosik, Monika Le Boutillier, Clair Williams, Julie Slade, Mike Implement Sci Research BACKGROUND: Clinical guidelines for the treatment of people experiencing psychosis have existed for over a decade, but implementation of recommended interventions is limited. Identifying influences on implementation may help to reduce this translational gap. The Structured Assessment of Feasibility (SAFE) measure is a standardised assessment of implementation blocks and enablers. The aim of this study was to characterise and compare the implementation blocks and enablers for recommended psychosis interventions. METHODS: SAFE was used to evaluate and compare three groups of interventions recommended in the 2014 NICE psychosis guideline: pharmacological (43 trials testing 5 interventions), psychosocial (65 trials testing 5 interventions), and recovery (19 trials testing 5 interventions). The 127 trial reports rated with SAFE were supplemented by published intervention manuals, research protocols, trial registrations and design papers. Differences in the number of blocks and enablers across the three interventions were tested statistically, and feasibility profiles were generated. RESULTS: There was no difference between psychosocial and recovery interventions in the number of blocks or enablers to implementation. Pharmacological interventions (a) had fewer blocks than both psychosocial interventions (χ(2)(3) = 133.77, p < 0.001) and recovery interventions (χ(2)(3) = 104.67, p < 0.001) and (b) did not differ in number of enablers from recovery interventions (χ(2)(3) = 0.74, p = 0.863) but had fewer enablers than psychosocial interventions (χ(2)(3) = 28.92, p < 0.001). Potential adverse events associated with the intervention tend to be a block for pharmacological interventions, whereas complexity of the intervention was the most consistent block for recovery and psychosocial interventions. CONCLUSIONS: Feasibility profiles show that pharmacological interventions are relatively easy to implement but can sometimes involve risks. Psychosocial and recovery interventions are relatively complex but tend to be more flexible and more often manualised. SAFE ratings can contribute to tackling the current implementation challenges in mental health services, by providing a reporting guideline structure for researchers to maximise the potential for implementation and by informing prioritisation decisions by clinical guideline developers and service managers. BioMed Central 2015-05-23 /pmc/articles/PMC4453226/ /pubmed/26002350 http://dx.doi.org/10.1186/s13012-015-0262-9 Text en © van der Krieke et al. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
van der Krieke, Lian
Bird, Victoria
Leamy, Mary
Bacon, Faye
Dunn, Rebecca
Pesola, Francesca
Janosik, Monika
Le Boutillier, Clair
Williams, Julie
Slade, Mike
The feasibility of implementing recovery, psychosocial and pharmacological interventions for psychosis: comparison study
title The feasibility of implementing recovery, psychosocial and pharmacological interventions for psychosis: comparison study
title_full The feasibility of implementing recovery, psychosocial and pharmacological interventions for psychosis: comparison study
title_fullStr The feasibility of implementing recovery, psychosocial and pharmacological interventions for psychosis: comparison study
title_full_unstemmed The feasibility of implementing recovery, psychosocial and pharmacological interventions for psychosis: comparison study
title_short The feasibility of implementing recovery, psychosocial and pharmacological interventions for psychosis: comparison study
title_sort feasibility of implementing recovery, psychosocial and pharmacological interventions for psychosis: comparison study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4453226/
https://www.ncbi.nlm.nih.gov/pubmed/26002350
http://dx.doi.org/10.1186/s13012-015-0262-9
work_keys_str_mv AT vanderkriekelian thefeasibilityofimplementingrecoverypsychosocialandpharmacologicalinterventionsforpsychosiscomparisonstudy
AT birdvictoria thefeasibilityofimplementingrecoverypsychosocialandpharmacologicalinterventionsforpsychosiscomparisonstudy
AT leamymary thefeasibilityofimplementingrecoverypsychosocialandpharmacologicalinterventionsforpsychosiscomparisonstudy
AT baconfaye thefeasibilityofimplementingrecoverypsychosocialandpharmacologicalinterventionsforpsychosiscomparisonstudy
AT dunnrebecca thefeasibilityofimplementingrecoverypsychosocialandpharmacologicalinterventionsforpsychosiscomparisonstudy
AT pesolafrancesca thefeasibilityofimplementingrecoverypsychosocialandpharmacologicalinterventionsforpsychosiscomparisonstudy
AT janosikmonika thefeasibilityofimplementingrecoverypsychosocialandpharmacologicalinterventionsforpsychosiscomparisonstudy
AT leboutillierclair thefeasibilityofimplementingrecoverypsychosocialandpharmacologicalinterventionsforpsychosiscomparisonstudy
AT williamsjulie thefeasibilityofimplementingrecoverypsychosocialandpharmacologicalinterventionsforpsychosiscomparisonstudy
AT slademike thefeasibilityofimplementingrecoverypsychosocialandpharmacologicalinterventionsforpsychosiscomparisonstudy
AT vanderkriekelian feasibilityofimplementingrecoverypsychosocialandpharmacologicalinterventionsforpsychosiscomparisonstudy
AT birdvictoria feasibilityofimplementingrecoverypsychosocialandpharmacologicalinterventionsforpsychosiscomparisonstudy
AT leamymary feasibilityofimplementingrecoverypsychosocialandpharmacologicalinterventionsforpsychosiscomparisonstudy
AT baconfaye feasibilityofimplementingrecoverypsychosocialandpharmacologicalinterventionsforpsychosiscomparisonstudy
AT dunnrebecca feasibilityofimplementingrecoverypsychosocialandpharmacologicalinterventionsforpsychosiscomparisonstudy
AT pesolafrancesca feasibilityofimplementingrecoverypsychosocialandpharmacologicalinterventionsforpsychosiscomparisonstudy
AT janosikmonika feasibilityofimplementingrecoverypsychosocialandpharmacologicalinterventionsforpsychosiscomparisonstudy
AT leboutillierclair feasibilityofimplementingrecoverypsychosocialandpharmacologicalinterventionsforpsychosiscomparisonstudy
AT williamsjulie feasibilityofimplementingrecoverypsychosocialandpharmacologicalinterventionsforpsychosiscomparisonstudy
AT slademike feasibilityofimplementingrecoverypsychosocialandpharmacologicalinterventionsforpsychosiscomparisonstudy