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F252. SERVICE PROVISION FOR ULTRA-HIGH RISK FOR PSYCHOSIS: IMPLEMENTATION OF CLINICAL GUIDELINES IN ENGLAND

BACKGROUND: Evidence from meta-analyses of randomised clinical trials show interventions for young people at ultra high risk (UHR) of developing psychosis are effective both clinically and economically. While research evidence has begun to be integrated into clinical guidelines, there is a lack of r...

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Autores principales: Stain, Helen, Mawn, Lauren, Common, Stephanie, Pilton, Marie, Thompson, Andrew
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5888228/
http://dx.doi.org/10.1093/schbul/sby017.783
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author Stain, Helen
Mawn, Lauren
Common, Stephanie
Pilton, Marie
Thompson, Andrew
author_facet Stain, Helen
Mawn, Lauren
Common, Stephanie
Pilton, Marie
Thompson, Andrew
author_sort Stain, Helen
collection PubMed
description BACKGROUND: Evidence from meta-analyses of randomised clinical trials show interventions for young people at ultra high risk (UHR) of developing psychosis are effective both clinically and economically. While research evidence has begun to be integrated into clinical guidelines, there is a lack of research on the implementation of these guidelines. This paper examines service provision for UHR individuals in accordance with current clinical guidelines within the National Health Service (NHS) in England. METHODS: A self-report online survey was completed by clinical leaders of Early Intervention in Psychosis (EIP) teams (N=50) within the NHS across the UK. RESULTS: Of the 50 EIP teams responding (from 30 NHS Trusts), 53% reported inclusion of the UHR group in their service mandate, with age range predominantly 14–35 years (81%) and service provided for at least 12 months (53%). Provision of services according to NICE clinical guidelines showed 50% of services offered cognitive behavioural therapy (CBT) for psychosis, and 42% offered family intervention. Contrary to guidelines, 50% of services offered antipsychotic medication. Around half of services provided training in assessment by CAARMS, psycho-education, CBT for psychosis, family work and treatment for anxiety and depression. DISCUSSION: Despite clear evidence for the benefit of early intervention in this population, current provision for UHR within EIP services in England does not match clinical guidelines. While some argue this is due to a lack of allocated funding, it is important to note the similar variable adherence to clinical guidelines in the treatment of people with established schizophrenia.
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spelling pubmed-58882282018-04-11 F252. SERVICE PROVISION FOR ULTRA-HIGH RISK FOR PSYCHOSIS: IMPLEMENTATION OF CLINICAL GUIDELINES IN ENGLAND Stain, Helen Mawn, Lauren Common, Stephanie Pilton, Marie Thompson, Andrew Schizophr Bull Abstracts BACKGROUND: Evidence from meta-analyses of randomised clinical trials show interventions for young people at ultra high risk (UHR) of developing psychosis are effective both clinically and economically. While research evidence has begun to be integrated into clinical guidelines, there is a lack of research on the implementation of these guidelines. This paper examines service provision for UHR individuals in accordance with current clinical guidelines within the National Health Service (NHS) in England. METHODS: A self-report online survey was completed by clinical leaders of Early Intervention in Psychosis (EIP) teams (N=50) within the NHS across the UK. RESULTS: Of the 50 EIP teams responding (from 30 NHS Trusts), 53% reported inclusion of the UHR group in their service mandate, with age range predominantly 14–35 years (81%) and service provided for at least 12 months (53%). Provision of services according to NICE clinical guidelines showed 50% of services offered cognitive behavioural therapy (CBT) for psychosis, and 42% offered family intervention. Contrary to guidelines, 50% of services offered antipsychotic medication. Around half of services provided training in assessment by CAARMS, psycho-education, CBT for psychosis, family work and treatment for anxiety and depression. DISCUSSION: Despite clear evidence for the benefit of early intervention in this population, current provision for UHR within EIP services in England does not match clinical guidelines. While some argue this is due to a lack of allocated funding, it is important to note the similar variable adherence to clinical guidelines in the treatment of people with established schizophrenia. Oxford University Press 2018-04 2018-04-01 /pmc/articles/PMC5888228/ http://dx.doi.org/10.1093/schbul/sby017.783 Text en © Maryland Psychiatric Research Center 2018. http://creativecommons.org/licenses/by/4.0/ 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 reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstracts
Stain, Helen
Mawn, Lauren
Common, Stephanie
Pilton, Marie
Thompson, Andrew
F252. SERVICE PROVISION FOR ULTRA-HIGH RISK FOR PSYCHOSIS: IMPLEMENTATION OF CLINICAL GUIDELINES IN ENGLAND
title F252. SERVICE PROVISION FOR ULTRA-HIGH RISK FOR PSYCHOSIS: IMPLEMENTATION OF CLINICAL GUIDELINES IN ENGLAND
title_full F252. SERVICE PROVISION FOR ULTRA-HIGH RISK FOR PSYCHOSIS: IMPLEMENTATION OF CLINICAL GUIDELINES IN ENGLAND
title_fullStr F252. SERVICE PROVISION FOR ULTRA-HIGH RISK FOR PSYCHOSIS: IMPLEMENTATION OF CLINICAL GUIDELINES IN ENGLAND
title_full_unstemmed F252. SERVICE PROVISION FOR ULTRA-HIGH RISK FOR PSYCHOSIS: IMPLEMENTATION OF CLINICAL GUIDELINES IN ENGLAND
title_short F252. SERVICE PROVISION FOR ULTRA-HIGH RISK FOR PSYCHOSIS: IMPLEMENTATION OF CLINICAL GUIDELINES IN ENGLAND
title_sort f252. service provision for ultra-high risk for psychosis: implementation of clinical guidelines in england
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5888228/
http://dx.doi.org/10.1093/schbul/sby017.783
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