Cargando…

How should we implement collaborative care for older people with depression? A qualitative study using normalisation process theory within the CASPER plus trial

BACKGROUND: Depression in older people may have a prevalence as high as 20%, and is associated with physical co-morbidities, loss, and loneliness. It is associated with poorer health outcomes and reduced quality of life, and is under-diagnosed and under-treated. Older people may find it difficult to...

Descripción completa

Detalles Bibliográficos
Autores principales: Taylor, Anna Kathryn, Gilbody, Simon, Bosanquet, Katharine, Overend, Karen, Bailey, Della, Foster, Deborah, Lewis, Helen, Chew-Graham, Carolyn Anne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6052715/
https://www.ncbi.nlm.nih.gov/pubmed/30021506
http://dx.doi.org/10.1186/s12875-018-0813-7
_version_ 1783340716581191680
author Taylor, Anna Kathryn
Gilbody, Simon
Bosanquet, Katharine
Overend, Karen
Bailey, Della
Foster, Deborah
Lewis, Helen
Chew-Graham, Carolyn Anne
author_facet Taylor, Anna Kathryn
Gilbody, Simon
Bosanquet, Katharine
Overend, Karen
Bailey, Della
Foster, Deborah
Lewis, Helen
Chew-Graham, Carolyn Anne
author_sort Taylor, Anna Kathryn
collection PubMed
description BACKGROUND: Depression in older people may have a prevalence as high as 20%, and is associated with physical co-morbidities, loss, and loneliness. It is associated with poorer health outcomes and reduced quality of life, and is under-diagnosed and under-treated. Older people may find it difficult to speak to their GPs about low mood, and GPs may avoid identifying depression due to limited consultation time and referral options for older patients. METHODS: A qualitative study nested within a randomised controlled trial for older people with moderate to severe depression: the CASPER plus Trial (Care for Screen Positive Elders). We interviewed patient participants, GPs, and case managers (CM) to explore patients’ and professionals’ views on collaborative care developed for older people, and how this model could be implemented at scale. Transcripts were analysed thematically using normalization process theory. RESULTS: Thirty-three interviews were conducted. Across the three data-sets, four main themes were identified based on the main principles of the Normalization Process Theory: understanding of collaborative care, interaction between patients and professionals, liaison between GPs and case managers, and the potential for implementation. CONCLUSIONS: A telephone-delivered intervention, incorporating behavioural activation, is acceptable to older people with depression, and is deliverable by case managers. The collaborative care framework makes sense to case managers and has the potential to optimize patient outcomes, but implementation requires integration in day to day general practice. Increasing GPs’ understanding of collaborative care might improve liaison and collaboration with case managers, and facilitate the intervention through better support of patients. The CASPER plus model, delivering therapy to older adults with depression by telephone, offers the potential for implementation in a resource-poor health service.
format Online
Article
Text
id pubmed-6052715
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-60527152018-07-23 How should we implement collaborative care for older people with depression? A qualitative study using normalisation process theory within the CASPER plus trial Taylor, Anna Kathryn Gilbody, Simon Bosanquet, Katharine Overend, Karen Bailey, Della Foster, Deborah Lewis, Helen Chew-Graham, Carolyn Anne BMC Fam Pract Research Article BACKGROUND: Depression in older people may have a prevalence as high as 20%, and is associated with physical co-morbidities, loss, and loneliness. It is associated with poorer health outcomes and reduced quality of life, and is under-diagnosed and under-treated. Older people may find it difficult to speak to their GPs about low mood, and GPs may avoid identifying depression due to limited consultation time and referral options for older patients. METHODS: A qualitative study nested within a randomised controlled trial for older people with moderate to severe depression: the CASPER plus Trial (Care for Screen Positive Elders). We interviewed patient participants, GPs, and case managers (CM) to explore patients’ and professionals’ views on collaborative care developed for older people, and how this model could be implemented at scale. Transcripts were analysed thematically using normalization process theory. RESULTS: Thirty-three interviews were conducted. Across the three data-sets, four main themes were identified based on the main principles of the Normalization Process Theory: understanding of collaborative care, interaction between patients and professionals, liaison between GPs and case managers, and the potential for implementation. CONCLUSIONS: A telephone-delivered intervention, incorporating behavioural activation, is acceptable to older people with depression, and is deliverable by case managers. The collaborative care framework makes sense to case managers and has the potential to optimize patient outcomes, but implementation requires integration in day to day general practice. Increasing GPs’ understanding of collaborative care might improve liaison and collaboration with case managers, and facilitate the intervention through better support of patients. The CASPER plus model, delivering therapy to older adults with depression by telephone, offers the potential for implementation in a resource-poor health service. BioMed Central 2018-07-18 /pmc/articles/PMC6052715/ /pubmed/30021506 http://dx.doi.org/10.1186/s12875-018-0813-7 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. 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 Article
Taylor, Anna Kathryn
Gilbody, Simon
Bosanquet, Katharine
Overend, Karen
Bailey, Della
Foster, Deborah
Lewis, Helen
Chew-Graham, Carolyn Anne
How should we implement collaborative care for older people with depression? A qualitative study using normalisation process theory within the CASPER plus trial
title How should we implement collaborative care for older people with depression? A qualitative study using normalisation process theory within the CASPER plus trial
title_full How should we implement collaborative care for older people with depression? A qualitative study using normalisation process theory within the CASPER plus trial
title_fullStr How should we implement collaborative care for older people with depression? A qualitative study using normalisation process theory within the CASPER plus trial
title_full_unstemmed How should we implement collaborative care for older people with depression? A qualitative study using normalisation process theory within the CASPER plus trial
title_short How should we implement collaborative care for older people with depression? A qualitative study using normalisation process theory within the CASPER plus trial
title_sort how should we implement collaborative care for older people with depression? a qualitative study using normalisation process theory within the casper plus trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6052715/
https://www.ncbi.nlm.nih.gov/pubmed/30021506
http://dx.doi.org/10.1186/s12875-018-0813-7
work_keys_str_mv AT taylorannakathryn howshouldweimplementcollaborativecareforolderpeoplewithdepressionaqualitativestudyusingnormalisationprocesstheorywithinthecasperplustrial
AT gilbodysimon howshouldweimplementcollaborativecareforolderpeoplewithdepressionaqualitativestudyusingnormalisationprocesstheorywithinthecasperplustrial
AT bosanquetkatharine howshouldweimplementcollaborativecareforolderpeoplewithdepressionaqualitativestudyusingnormalisationprocesstheorywithinthecasperplustrial
AT overendkaren howshouldweimplementcollaborativecareforolderpeoplewithdepressionaqualitativestudyusingnormalisationprocesstheorywithinthecasperplustrial
AT baileydella howshouldweimplementcollaborativecareforolderpeoplewithdepressionaqualitativestudyusingnormalisationprocesstheorywithinthecasperplustrial
AT fosterdeborah howshouldweimplementcollaborativecareforolderpeoplewithdepressionaqualitativestudyusingnormalisationprocesstheorywithinthecasperplustrial
AT lewishelen howshouldweimplementcollaborativecareforolderpeoplewithdepressionaqualitativestudyusingnormalisationprocesstheorywithinthecasperplustrial
AT chewgrahamcarolynanne howshouldweimplementcollaborativecareforolderpeoplewithdepressionaqualitativestudyusingnormalisationprocesstheorywithinthecasperplustrial