Strategies for engaging patients and families in collaborative care programs for depression and anxiety disorders: A systematic review.

Anxiety Collaborative care Depression Patient engagement Primary care Systematic review

Journal

Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073

Informations de publication

Date de publication:
15 02 2020
Historique:
received: 28 08 2019
revised: 23 10 2019
accepted: 02 11 2019
pubmed: 21 11 2019
medline: 16 2 2021
entrez: 21 11 2019
Statut: ppublish

Résumé

Patients and families are often referred to as important partners in collaborative mental health care (CMHC). However, how to meaningfully engage them as partners remains unclear. We aimed to identify strategies for engaging patients and families in CMHC programs for depression and anxiety disorders. We updated a Cochrane review of CMHC programs for depression and anxiety disorders. Searches were conducted in Cochrane CCDAN and CINAHL, complemented by additional database searches, trial registry searches, and cluster searches for 'sibling' articles. Coding and data extraction of engagement strategies was an iterative process guided by a conceptual framework. We used narrative synthesis and descriptive statistics to report on findings. We found 148 unique CMCH programs, described in 578 articles. Most programs (96%) featured at least one strategy for engaging patients or families. Programs adopted 15 different strategies overall, with a median of two strategies per program (range 0-9 strategies). The most common strategies were patient education (87% of programs) and self-management supports (47% of programs). Personalized care planning, shared decision making, and family or peer supports were identified in fewer than one third of programs. Our search strategy was designed to capture programs evaluated in clinical trials and so other innovative programs not studied in trials were likely missed. Most CMHC programs for depression and anxiety disorders adopted a limited number of strategies to engage patients and families in their care. However, this review identifies numerous strategies that can be used to strengthen the patient- and family-centeredness of collaborative care.

Sections du résumé

BACKGROUND
Patients and families are often referred to as important partners in collaborative mental health care (CMHC). However, how to meaningfully engage them as partners remains unclear. We aimed to identify strategies for engaging patients and families in CMHC programs for depression and anxiety disorders.
METHODS
We updated a Cochrane review of CMHC programs for depression and anxiety disorders. Searches were conducted in Cochrane CCDAN and CINAHL, complemented by additional database searches, trial registry searches, and cluster searches for 'sibling' articles. Coding and data extraction of engagement strategies was an iterative process guided by a conceptual framework. We used narrative synthesis and descriptive statistics to report on findings.
FINDINGS
We found 148 unique CMCH programs, described in 578 articles. Most programs (96%) featured at least one strategy for engaging patients or families. Programs adopted 15 different strategies overall, with a median of two strategies per program (range 0-9 strategies). The most common strategies were patient education (87% of programs) and self-management supports (47% of programs). Personalized care planning, shared decision making, and family or peer supports were identified in fewer than one third of programs.
LIMITATIONS
Our search strategy was designed to capture programs evaluated in clinical trials and so other innovative programs not studied in trials were likely missed.
CONCLUSION
Most CMHC programs for depression and anxiety disorders adopted a limited number of strategies to engage patients and families in their care. However, this review identifies numerous strategies that can be used to strengthen the patient- and family-centeredness of collaborative care.

Identifiants

pubmed: 31744737
pii: S0165-0327(19)32311-0
doi: 10.1016/j.jad.2019.11.008
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

528-539

Subventions

Organisme : CIHR
ID : 201505KRS-350972-KRS-CFBA
Pays : Canada

Informations de copyright

Copyright © 2019. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of Competing Interest None.

Auteurs

Matthew Menear (M)

Department of Family Medicine and Emergency Medicine, Laval University, Quebec, Canada; Centre de recherche sur les soins et les services de première ligne de l'Université Laval, Quebec, Canada. Electronic address: matthew.menear.1@ulaval.ca.

Michèle Dugas (M)

Centre de recherche sur les soins et les services de première ligne de l'Université Laval, Quebec, Canada.

Emmanuelle Careau (E)

Centre de recherche sur les soins et les services de première ligne de l'Université Laval, Quebec, Canada; Department of Rehabilitation, Laval University, Quebec, Canada.

Maud-Christine Chouinard (MC)

Department of Health Sciences, Université du Québec à Chicoutimi, Chicoutimi, Canada.

Maman Joyce Dogba (MJ)

Department of Family Medicine and Emergency Medicine, Laval University, Quebec, Canada; Centre de recherche sur les soins et les services de première ligne de l'Université Laval, Quebec, Canada.

Marie-Pierre Gagnon (MP)

Faculty of Nursing, Laval University, Quebec, Canada.

Michel Gervais (M)

Centre intégré universitaire en santé et en services sociaux de la Capitale-Nationale, Quebec, Canada.

Michel Gilbert (M)

National Centre for Excellence in Mental Health, Quebec, Canada.

Janie Houle (J)

Department of Psychology, Université du Québec à Montréal, Montreal, Canada.

Nick Kates (N)

Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada.

Sarah Knowles (S)

NIHR Collaboration for Leadership in Applied Health Research an Care (CLAHRC) Greater Manchester, University of Manchester, Manchester, UK.

Neasa Martin (N)

Neasa Martin and Associates.

Donald E Nease (DE)

Department of Family Medicine, University of Colorado Denver, Denver, US.

Hervé Tchala Vignon Zomahoun (HTV)

Quebec SPOR SUPPORT Unit, Quebec, Canada.

France Légaré (F)

Department of Family Medicine and Emergency Medicine, Laval University, Quebec, Canada; Centre de recherche sur les soins et les services de première ligne de l'Université Laval, Quebec, Canada.

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