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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...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2015
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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 |
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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 |
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