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Tahan HM, Lamb G, Fink-Samnick E, Morley C, Moreo K. Preparing for New Primary Care Models: The Role of Professional Case Management. Prof Case Manag 2025:01269241-990000000-00035. [PMID: 40261187 DOI: 10.1097/ncm.0000000000000813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/24/2025]
Abstract
PURPOSE AND OBJECTIVES This paper aims to raise awareness of the case management community about innovative primary care models, like the Making Care Primary (MCP) which has potential to become the foundation for future primary care reform. It provides professional case managers (PCMs), case management leaders, and primary care providers with examples of evidence-based best practices to apply in primary care settings and programs. PRIMARY PRACTICE SETTINGS Primary care practices and organizations, ambulatory clinics, community-based primary care. FINDINGS/CONCLUSIONS The authors share examples of findings from case management research published over the last 10 years as they pertain to the 3 main domains of MCP-care management, care integration, and community connections-to show the impact case management interventions may have on key outcomes in value-based primary care. The systematic, narrative, and scoping reviews summarized in this paper suggest a set of important case management structures, processes and outcomes relevant to care management, care integration, and community connections that help manage the diverse needs of patients. This evidence is also important in identifying essential case management interventions that ensure person-centered and holistic care and improve patient outcomes especially as they pertain to personal health and wellbeing. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE The authors of this paper draw attention to the importance of PCMs and their roles in evolving primary care models in the context of teams and effective teamwork. The contributions of PCMs on primary care teams can be extensive and critical to the successful achievement of desirable primary care outcomes for individuals with complex chronic illness and health-related social needs and thus to the overall success of value-based models of primary care. The evidence the authors summarize provide important guidance on best case management practices in primary care that contribute to better health outcomes.
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Affiliation(s)
- Hussein M Tahan
- Hussein M. Tahan, PhD, RN, FAAN, FCM, serves as the system vice president and chief nursing officer for nursing professional development, workforce management, and academic affairs for MedStar Health, Columbia, MD. He is also a case management consultant, expert, author, researcher, and awards winner. Dr. Tahan has over 30 years of experience in hospital management and operations and professional case management practice. He is widely published with 3 textbooks and numerous peer reviewed articles on case management. He is an inaugural editorial advisory board member of the Professional Case Management journal, and past commissioner and commission chair of the Commission for Case Manager Certification. Dr. Tahan was honored with the 2016 Case Management Society of America Lifetime Achievement Award and Case Management Fellow designation in 2022
- Gerri Lamb, PhD, RN, FAAN, is Professor Emerita and Founding Director of the Center for Advancing Interprofessional Practice, Education, and Research at Arizona State University. Dr. Lamb has served as an expert consultant on case management performance measurement, standards of practice, and research for national professional and service organizations. She has been principal investigator on several funded projects on case management and care coordination and author and editor of several well-known publications on case management and care coordination
- Ellen Fink-Samnick, DBH, MSW, LCSW, ACSW, CCM, CCTP, CRP, FCM, is the Principal of EFS Supervision Strategies, LLC and an award-winning industry entrepreneur whose focus is on competency-based case management, interprofessional ethics, health equity, patient-inclusive care, quality, and trauma-informed leadership. She is a content developer professional speaker, author, and educator with academic appointments at Cummings Graduate Institute of Behavioral Health Studies and George Mason University. Dr. Fink-Samnick served in national leadership and consultant roles across the industry
- Colleen Morley, DNP, RN, CCM, CMAC, CMCN, CMGT-BC, ACM-RN, FCM, FAACM, is the Associate Chief Clinical Operations Officer, Care Continuum for University of Illinois Health System and the current Immediate Past President of the Case Management Society of America National Board of Directors. Dr. Morley is the recipient of the ANA Illinois Nurse Influencer of the Year Award (2024), the CMSA Foundation Practice Improvement Award (2020) and ANA Illinois Practice Improvement Award (2020). She also received the AAMCN Managed Care Nurse Leader of the Year in 2010 and the CMSA Fellow of Case Management designation in 2022. Her first book, "A Practical Guide to Acute Care Case Management," published by Blue Bayou Press was released in February 2022 and her second book, "A Practical Guide to Hospital Readmission Reduction" in February 2024
- Kathleen Moreo, BSN, BHSA, RN, CMGT-BC, CCM, CDMS, FCM, is an educator and researcher who has published extensively in peer-reviewed journals and has co-authored 2 books on case management for the American Nurses Association. She was inducted into the Class of 2023 Fellows of Case Management by the Case Management Society of America (CMSA) and is a past recipient of the CMSA Case Manager of the Year award as well as a CMSA past president. Moreo currently serves on the Professional Case Management editorial board, advisory boards, and for environmental causes
| | - Gerri Lamb
- Hussein M. Tahan, PhD, RN, FAAN, FCM, serves as the system vice president and chief nursing officer for nursing professional development, workforce management, and academic affairs for MedStar Health, Columbia, MD. He is also a case management consultant, expert, author, researcher, and awards winner. Dr. Tahan has over 30 years of experience in hospital management and operations and professional case management practice. He is widely published with 3 textbooks and numerous peer reviewed articles on case management. He is an inaugural editorial advisory board member of the Professional Case Management journal, and past commissioner and commission chair of the Commission for Case Manager Certification. Dr. Tahan was honored with the 2016 Case Management Society of America Lifetime Achievement Award and Case Management Fellow designation in 2022
- Gerri Lamb, PhD, RN, FAAN, is Professor Emerita and Founding Director of the Center for Advancing Interprofessional Practice, Education, and Research at Arizona State University. Dr. Lamb has served as an expert consultant on case management performance measurement, standards of practice, and research for national professional and service organizations. She has been principal investigator on several funded projects on case management and care coordination and author and editor of several well-known publications on case management and care coordination
- Ellen Fink-Samnick, DBH, MSW, LCSW, ACSW, CCM, CCTP, CRP, FCM, is the Principal of EFS Supervision Strategies, LLC and an award-winning industry entrepreneur whose focus is on competency-based case management, interprofessional ethics, health equity, patient-inclusive care, quality, and trauma-informed leadership. She is a content developer professional speaker, author, and educator with academic appointments at Cummings Graduate Institute of Behavioral Health Studies and George Mason University. Dr. Fink-Samnick served in national leadership and consultant roles across the industry
- Colleen Morley, DNP, RN, CCM, CMAC, CMCN, CMGT-BC, ACM-RN, FCM, FAACM, is the Associate Chief Clinical Operations Officer, Care Continuum for University of Illinois Health System and the current Immediate Past President of the Case Management Society of America National Board of Directors. Dr. Morley is the recipient of the ANA Illinois Nurse Influencer of the Year Award (2024), the CMSA Foundation Practice Improvement Award (2020) and ANA Illinois Practice Improvement Award (2020). She also received the AAMCN Managed Care Nurse Leader of the Year in 2010 and the CMSA Fellow of Case Management designation in 2022. Her first book, "A Practical Guide to Acute Care Case Management," published by Blue Bayou Press was released in February 2022 and her second book, "A Practical Guide to Hospital Readmission Reduction" in February 2024
- Kathleen Moreo, BSN, BHSA, RN, CMGT-BC, CCM, CDMS, FCM, is an educator and researcher who has published extensively in peer-reviewed journals and has co-authored 2 books on case management for the American Nurses Association. She was inducted into the Class of 2023 Fellows of Case Management by the Case Management Society of America (CMSA) and is a past recipient of the CMSA Case Manager of the Year award as well as a CMSA past president. Moreo currently serves on the Professional Case Management editorial board, advisory boards, and for environmental causes
| | - Ellen Fink-Samnick
- Hussein M. Tahan, PhD, RN, FAAN, FCM, serves as the system vice president and chief nursing officer for nursing professional development, workforce management, and academic affairs for MedStar Health, Columbia, MD. He is also a case management consultant, expert, author, researcher, and awards winner. Dr. Tahan has over 30 years of experience in hospital management and operations and professional case management practice. He is widely published with 3 textbooks and numerous peer reviewed articles on case management. He is an inaugural editorial advisory board member of the Professional Case Management journal, and past commissioner and commission chair of the Commission for Case Manager Certification. Dr. Tahan was honored with the 2016 Case Management Society of America Lifetime Achievement Award and Case Management Fellow designation in 2022
- Gerri Lamb, PhD, RN, FAAN, is Professor Emerita and Founding Director of the Center for Advancing Interprofessional Practice, Education, and Research at Arizona State University. Dr. Lamb has served as an expert consultant on case management performance measurement, standards of practice, and research for national professional and service organizations. She has been principal investigator on several funded projects on case management and care coordination and author and editor of several well-known publications on case management and care coordination
- Ellen Fink-Samnick, DBH, MSW, LCSW, ACSW, CCM, CCTP, CRP, FCM, is the Principal of EFS Supervision Strategies, LLC and an award-winning industry entrepreneur whose focus is on competency-based case management, interprofessional ethics, health equity, patient-inclusive care, quality, and trauma-informed leadership. She is a content developer professional speaker, author, and educator with academic appointments at Cummings Graduate Institute of Behavioral Health Studies and George Mason University. Dr. Fink-Samnick served in national leadership and consultant roles across the industry
- Colleen Morley, DNP, RN, CCM, CMAC, CMCN, CMGT-BC, ACM-RN, FCM, FAACM, is the Associate Chief Clinical Operations Officer, Care Continuum for University of Illinois Health System and the current Immediate Past President of the Case Management Society of America National Board of Directors. Dr. Morley is the recipient of the ANA Illinois Nurse Influencer of the Year Award (2024), the CMSA Foundation Practice Improvement Award (2020) and ANA Illinois Practice Improvement Award (2020). She also received the AAMCN Managed Care Nurse Leader of the Year in 2010 and the CMSA Fellow of Case Management designation in 2022. Her first book, "A Practical Guide to Acute Care Case Management," published by Blue Bayou Press was released in February 2022 and her second book, "A Practical Guide to Hospital Readmission Reduction" in February 2024
- Kathleen Moreo, BSN, BHSA, RN, CMGT-BC, CCM, CDMS, FCM, is an educator and researcher who has published extensively in peer-reviewed journals and has co-authored 2 books on case management for the American Nurses Association. She was inducted into the Class of 2023 Fellows of Case Management by the Case Management Society of America (CMSA) and is a past recipient of the CMSA Case Manager of the Year award as well as a CMSA past president. Moreo currently serves on the Professional Case Management editorial board, advisory boards, and for environmental causes
| | - Colleen Morley
- Hussein M. Tahan, PhD, RN, FAAN, FCM, serves as the system vice president and chief nursing officer for nursing professional development, workforce management, and academic affairs for MedStar Health, Columbia, MD. He is also a case management consultant, expert, author, researcher, and awards winner. Dr. Tahan has over 30 years of experience in hospital management and operations and professional case management practice. He is widely published with 3 textbooks and numerous peer reviewed articles on case management. He is an inaugural editorial advisory board member of the Professional Case Management journal, and past commissioner and commission chair of the Commission for Case Manager Certification. Dr. Tahan was honored with the 2016 Case Management Society of America Lifetime Achievement Award and Case Management Fellow designation in 2022
- Gerri Lamb, PhD, RN, FAAN, is Professor Emerita and Founding Director of the Center for Advancing Interprofessional Practice, Education, and Research at Arizona State University. Dr. Lamb has served as an expert consultant on case management performance measurement, standards of practice, and research for national professional and service organizations. She has been principal investigator on several funded projects on case management and care coordination and author and editor of several well-known publications on case management and care coordination
- Ellen Fink-Samnick, DBH, MSW, LCSW, ACSW, CCM, CCTP, CRP, FCM, is the Principal of EFS Supervision Strategies, LLC and an award-winning industry entrepreneur whose focus is on competency-based case management, interprofessional ethics, health equity, patient-inclusive care, quality, and trauma-informed leadership. She is a content developer professional speaker, author, and educator with academic appointments at Cummings Graduate Institute of Behavioral Health Studies and George Mason University. Dr. Fink-Samnick served in national leadership and consultant roles across the industry
- Colleen Morley, DNP, RN, CCM, CMAC, CMCN, CMGT-BC, ACM-RN, FCM, FAACM, is the Associate Chief Clinical Operations Officer, Care Continuum for University of Illinois Health System and the current Immediate Past President of the Case Management Society of America National Board of Directors. Dr. Morley is the recipient of the ANA Illinois Nurse Influencer of the Year Award (2024), the CMSA Foundation Practice Improvement Award (2020) and ANA Illinois Practice Improvement Award (2020). She also received the AAMCN Managed Care Nurse Leader of the Year in 2010 and the CMSA Fellow of Case Management designation in 2022. Her first book, "A Practical Guide to Acute Care Case Management," published by Blue Bayou Press was released in February 2022 and her second book, "A Practical Guide to Hospital Readmission Reduction" in February 2024
- Kathleen Moreo, BSN, BHSA, RN, CMGT-BC, CCM, CDMS, FCM, is an educator and researcher who has published extensively in peer-reviewed journals and has co-authored 2 books on case management for the American Nurses Association. She was inducted into the Class of 2023 Fellows of Case Management by the Case Management Society of America (CMSA) and is a past recipient of the CMSA Case Manager of the Year award as well as a CMSA past president. Moreo currently serves on the Professional Case Management editorial board, advisory boards, and for environmental causes
| | - Kathleen Moreo
- Hussein M. Tahan, PhD, RN, FAAN, FCM, serves as the system vice president and chief nursing officer for nursing professional development, workforce management, and academic affairs for MedStar Health, Columbia, MD. He is also a case management consultant, expert, author, researcher, and awards winner. Dr. Tahan has over 30 years of experience in hospital management and operations and professional case management practice. He is widely published with 3 textbooks and numerous peer reviewed articles on case management. He is an inaugural editorial advisory board member of the Professional Case Management journal, and past commissioner and commission chair of the Commission for Case Manager Certification. Dr. Tahan was honored with the 2016 Case Management Society of America Lifetime Achievement Award and Case Management Fellow designation in 2022
- Gerri Lamb, PhD, RN, FAAN, is Professor Emerita and Founding Director of the Center for Advancing Interprofessional Practice, Education, and Research at Arizona State University. Dr. Lamb has served as an expert consultant on case management performance measurement, standards of practice, and research for national professional and service organizations. She has been principal investigator on several funded projects on case management and care coordination and author and editor of several well-known publications on case management and care coordination
- Ellen Fink-Samnick, DBH, MSW, LCSW, ACSW, CCM, CCTP, CRP, FCM, is the Principal of EFS Supervision Strategies, LLC and an award-winning industry entrepreneur whose focus is on competency-based case management, interprofessional ethics, health equity, patient-inclusive care, quality, and trauma-informed leadership. She is a content developer professional speaker, author, and educator with academic appointments at Cummings Graduate Institute of Behavioral Health Studies and George Mason University. Dr. Fink-Samnick served in national leadership and consultant roles across the industry
- Colleen Morley, DNP, RN, CCM, CMAC, CMCN, CMGT-BC, ACM-RN, FCM, FAACM, is the Associate Chief Clinical Operations Officer, Care Continuum for University of Illinois Health System and the current Immediate Past President of the Case Management Society of America National Board of Directors. Dr. Morley is the recipient of the ANA Illinois Nurse Influencer of the Year Award (2024), the CMSA Foundation Practice Improvement Award (2020) and ANA Illinois Practice Improvement Award (2020). She also received the AAMCN Managed Care Nurse Leader of the Year in 2010 and the CMSA Fellow of Case Management designation in 2022. Her first book, "A Practical Guide to Acute Care Case Management," published by Blue Bayou Press was released in February 2022 and her second book, "A Practical Guide to Hospital Readmission Reduction" in February 2024
- Kathleen Moreo, BSN, BHSA, RN, CMGT-BC, CCM, CDMS, FCM, is an educator and researcher who has published extensively in peer-reviewed journals and has co-authored 2 books on case management for the American Nurses Association. She was inducted into the Class of 2023 Fellows of Case Management by the Case Management Society of America (CMSA) and is a past recipient of the CMSA Case Manager of the Year award as well as a CMSA past president. Moreo currently serves on the Professional Case Management editorial board, advisory boards, and for environmental causes
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Hogue A, Satcher MF, Drazdowski TK, Hagaman A, Hibbard PF, Sheidow AJ, Coetzer-Liversage A, Mitchell SG, Watson DP, Wilson KJ, Muench F, Fishman M, Wenzel K, de Martell SC, Stein LAR. Linkage facilitation services for opioid use disorder: Taxonomy of facilitation practitioners, goals, and activities. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 157:209217. [PMID: 37981242 PMCID: PMC10922806 DOI: 10.1016/j.josat.2023.209217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/14/2023] [Accepted: 11/13/2023] [Indexed: 11/21/2023]
Abstract
INTRODUCTION This article proposes a taxonomy of linkage facilitation services used to help persons with opioid use disorder access treatment and recovery resources. Linkage facilitation may be especially valuable for persons receiving medication for opioid use disorder (MOUD) given the considerable barriers to treatment access and initiation that have been identified. The science of linkage facilitation currently lacks both consistent communication about linkage facilitation practices and a conceptual framework for guiding research. METHODS To address this gap, this article presents a taxonomy derived from expert consensus that organizes the array of practitioners, goals, and activities associated with linkage services for OUD and related needs. Expert panelists first independently reviewed research reports and policy guidelines summarizing the science and practice of linkage facilitation for substance use disorders generally and OUD specifically, then met several times to vet the conceptual scheme and content of the taxonomy until they reached a final consensus. RESULTS The derived taxonomy contains eight domains: facilitator identity, facilitator lived experience, linkage client, facilitator-client relationship, linkage activity, linkage method, linkage connectivity, and linkage goal. For each domain, the article defines basic domain categories, highlights research and practice themes in substance use and OUD care, and introduces innovations in linkage facilitation being tested in one of two NIDA-funded research networks: Justice Community Opioid Innovation Network (JCOIN) or Consortium on Addiction Recovery Science (CoARS). CONCLUSIONS To accelerate consistent application of this taxonomy to diverse research and practice settings, the article concludes by naming several considerations for linkage facilitation workforce training and implementation.
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Affiliation(s)
- Aaron Hogue
- Partnership to End Addiction, 711 Third Avenue, 5th floor, New York, NY 10017, United States of America.
| | - Milan F Satcher
- Dartmouth Health and Geisel School of Medicine at Dartmouth College, United States of America
| | | | - Angela Hagaman
- East Tennessee State University, United States of America
| | | | | | | | | | | | | | - Frederick Muench
- Partnership to End Addiction, 711 Third Avenue, 5th floor, New York, NY 10017, United States of America
| | - Marc Fishman
- Maryland Treatment Centers, United States of America
| | - Kevin Wenzel
- Maryland Treatment Centers, United States of America
| | | | - L A R Stein
- Department of Psychology, University of Rhode Island, United States of America; Department of Behavioral & Social Sciences, Brown University, United States of America; Department of Behavioral Healthcare, Developmental Disabilities & Hospitals, RI, United States of America
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May PA, Marais AS, Kalberg WO, de Vries MM, Buckley D, Hasken JM, Snell CL, Barnard Röhrs R, Hedrick DM, Bezuidenhout H, Anthonissen L, Bröcker E, Robinson LK, Manning MA, Hoyme HE, Seedat S, Parry CDH. Multifaceted case management during pregnancy is associated with better child outcomes and less fetal alcohol syndrome. Ann Med 2023; 55:926-945. [PMID: 36919586 PMCID: PMC10026770 DOI: 10.1080/07853890.2023.2185808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Pregnant women participated in multifaceted case management (MCM) to prevent Fetal Alcohol Spectrum Disorders (FASD). METHODS Women recruited from antenatal clinics for a longitudinal child development study were screened for alcohol use. Forty-four pregnant women were defined as high-risk drinkers on the Alcohol Use Disorder Identification Test (AUDIT) by an AUDIT score ≥8 and participated in 18 months of MCM to facilitate reduction or cessation of alcohol consumption. Forty-one women completed MCM. Fifty-five equally high-risk women who received standard antenatal care comprised the comparison/control group. Development in offspring was evaluated by a blinded interdisciplinary team of examiners through 5 years of age. RESULTS At five years of age, more children (34%) of MCM participating women did not meet the criteria for FASD vs. non-MCM offspring (22%). Furthermore, a statistically significant (p = .01) lower proportion of MCM offspring (24%) was diagnosed with fetal alcohol syndrome (FAS) compared to controls (49%). Children of MCM participants had significantly (p < .05) better physical outcomes: lower total dysmorphology scores, larger head circumferences, longer palpebral fissures, and higher midfacial measurements. Neurodevelopment results showed mixed outcomes. While Bayley developmental scores indicated that MCM offspring were performing significantly worse on most domains through 18 months, group scores equalized and were not significantly different on Kaufman Assessment Battery neurobehavioral measures by five years. Regression analyses indicated that offspring of women who received standard antenatal care were associated with significantly more negative outcomes than MCM offspring: a diagnosis of FAS (OR = 3.2; 95% CI: 1.093-9.081), microcephaly (OR = 5.3; 95% CI: 2.1-13.5), head circumference ≤10th centile (OR = 4.3; 95%CI: 1.8-10.4), and short palpebral fissures (OR = 2.5; 95% CI: 1.0-5.8). CONCLUSION At age five, proportionally fewer children of MCM participants qualified for a diagnosis of FAS, and proportionally more had physical outcomes indicating better prenatal brain development. Neurobehavioral indicators were not significantly different from controls by age five.KEY MESSAGESMultifaceted Case Management (MCM) was designed and employed for 18 months during the prenatal and immediate postpartum period to successfully meet multiple needs of women who had proven to be very high risk for birthing children with fetal alcohol spectrum disorders (FASD).Offspring of the women who participated in MCM were followed up through age five years and were found to have significantly better physical outcomes on multiple variables associated with fetal alcohol syndrome (FAS) and FASD, such as larger head circumferences and fewer minor anomalies, than those children born to equally at-risk women not receiving MCM.Fewer children of women receiving MCM were diagnosed with FASD than the offspring of equally-at-risk controls, and significantly (p = .01) fewer MCM offspring had FAS, the most severe FASD diagnosis.
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Affiliation(s)
- Philip A May
- Nutrition Research Institute, The University of North Carolina at Chapel Hill, Kannapolis, NC, USA
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Center on Alcohol, Substance Abuse and Addictions, The University of New Mexico, Albuquerque, NM, USA
| | - Anna-Susan Marais
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Wendy O Kalberg
- Center on Alcohol, Substance Abuse and Addictions, The University of New Mexico, Albuquerque, NM, USA
| | - Marlene M de Vries
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - David Buckley
- Center on Alcohol, Substance Abuse and Addictions, The University of New Mexico, Albuquerque, NM, USA
| | - Julie M Hasken
- Nutrition Research Institute, The University of North Carolina at Chapel Hill, Kannapolis, NC, USA
| | - Cudore L Snell
- School of Social Work, Howard University, Washington, DC, USA
| | - Ronel Barnard Röhrs
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Dixie M Hedrick
- Nutrition Research Institute, The University of North Carolina at Chapel Hill, Kannapolis, NC, USA
| | - Heidre Bezuidenhout
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Lise Anthonissen
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Erine Bröcker
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Luther K Robinson
- Department of Pediatrics, State University of New York, Buffalo, NY, USA
| | - Melanie A Manning
- Department of Pathology and Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - H Eugene Hoyme
- Sanford Children's Genomic Medicine Consortium, Sanford Health, Sioux Falls, SD, USA
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Charles D H Parry
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa
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Isaacs KR, Bajracharya E, Taylor S, Chang K, Washio Y, Parker T, Paul DA, Ma TX. Usability and acceptability testing of a Plan of Safe Care in a mobile health platform. Front Psychiatry 2023; 14:1182630. [PMID: 37304428 PMCID: PMC10248520 DOI: 10.3389/fpsyt.2023.1182630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/09/2023] [Indexed: 06/13/2023] Open
Abstract
Purpose Women who are pregnant or parenting while recovering from substance use disorder (SUD) are at risk for insufficient recovery support. With the federal mandate, implementation has been left to each state for the Plan of Safe Care (POSC), leading to challenges in providing comprehensive care coordination and meeting federal reporting requirements. Methods This research tests the usability and acceptability of a POSC platform, called SAFE4BOTH, which combines a mobile health (mHealth) app for use by mothers with substance use disorder (MSUD) with a web-based case management system for use by stakeholders to reduce the issue of fragmented postnatal maternal and infant care. The platform was designed to enable access to services, improve reporting task workflow, and assist in improving interactions between mothers and service providers.After applying a user-centered design approach, the usability and acceptability of the SAFE4BOTH platform were evaluated using focus groups, interviews, and a System Usability Scale (SUS). The evaluation involved four staff members from a Medication for Addiction Treatment clinic (comprising of three case management workers and one peer counselor), four state employees of the Delaware Division of Family Services, and 20 mothers with MSUD who had delivered infants in need of a POSC.Features tested in the SAFE4BOTH platform included a secure, web-based POSC, a contingency management-based reward system, a micro-learning library, a resources locator, a chat messaging and videoconferencing system, a directory for contact management, a QR code reader, use of an appointment compliance system engaging geofencing, and an enhanced calendar. Family services and treatment center staff accessed SAFE4BOTH from their laptops or tablets, and MSUD accessed SAFE4BOTH from their phones. Results Family services staff, treatment center staff, and MSUD participants rated SAFE4BOTH as usable and acceptable with average System Usability Scale scores of 68.1 (SD 8.5), 92.5 (SD 11.73), and 78.4 (SD 12.5) (respectively). Conclusion The platform was judged both usable and acceptable by all three target populations (family services staff, treatment center staff, and MSUD). Further studies are planned to explore the efficacy of longitudinally supporting the mother's recovery and the infant's healthy development.
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Affiliation(s)
| | | | - Shantae Taylor
- ChristianaCare – Department of Pediatrics, Wilmington, DE, United States
- Substance Use, Gender and Applied Research, RTI International, Research Triangle Park, Durham, NC, United States
| | - Katie Chang
- Benten Technologies, Manassas, VA, United States
| | - Yukiko Washio
- Substance Use, Gender and Applied Research, RTI International, Research Triangle Park, Durham, NC, United States
- Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University Lewis Katz School of Medicine, Philadelphia, PA, United States
| | - Trenee Parker
- Delaware Division of Family Services, Department of Services for Children, Youth and Their Families, Wilmington, DE, United States
| | - David A. Paul
- ChristianaCare – Department of Pediatrics, Wilmington, DE, United States
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, United States
| | - Tony X. Ma
- Benten Technologies, Manassas, VA, United States
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Hempel S, Ganz D, Saluja S, Bolshakova M, Kim T, Turvey C, Cordasco K, Basu A, Page T, Mahmood R, Motala A, Barnard J, Wong M, Fu N, Miake-Lye IM. Care coordination across healthcare systems: development of a research agenda, implications for practice, and recommendations for policy based on a modified Delphi panel. BMJ Open 2023; 13:e060232. [PMID: 37197809 DOI: 10.1136/bmjopen-2021-060232] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/19/2023] Open
Abstract
OBJECTIVE For large, integrated healthcare delivery systems, coordinating patient care across delivery systems with providers external to the system presents challenges. We explored the domains and requirements for care coordination by professionals across healthcare systems and developed an agenda for research, practice and policy. DESIGN The modified Delphi approach convened a 2-day stakeholder panel with moderated virtual discussions, preceded and followed by online surveys. SETTING The work addresses care coordination across healthcare systems. We introduced common care scenarios and differentiated recommendations for a large (main) healthcare organisation and external healthcare professionals that contribute additional care. PARTICIPANTS The panel composition included health service providers, decision makers, patients and care community, and researchers. Discussions were informed by a rapid review of tested approaches to fostering collaboration, facilitating care coordination and improving communication across healthcare systems. OUTCOME MEASURES The study planned to formulate a research agenda, implications for practice and recommendations for policy. RESULTS For research recommendations, we found consensus for developing measures of shared care, exploring healthcare professionals' needs in different care scenarios and evaluating patient experiences. Agreed practice recommendations included educating external professionals about issues specific to the patients in the main healthcare system, educating professionals within the main healthcare system about the roles and responsibilities of all involved parties, and helping patients better understand the pros and cons of within-system and out-of-system care. Policy recommendations included supporting time for professionals with high overlap in patients to engage regularly and sustaining support for care coordination for high-need patients. CONCLUSIONS Recommendations from the stakeholder panel created an agenda to foster further research, practice and policy innovations in cross-system care coordination.
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Affiliation(s)
- Susanne Hempel
- Southern California Evidence Review Center, University of Southern California, Los Angeles, California, USA
| | - David Ganz
- Geriatrics Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
- Department of Medicine, David Geffen School of Medicine at the University of California at Los Angeles, Los Angeles, California, USA
| | - Sonali Saluja
- Gehr Family Center for Health Systems Science and Innovation, University of Southern California, Los Angeles, California, USA
| | - Maria Bolshakova
- Southern California Evidence Review Center, University of Southern California, Los Angeles, California, USA
| | - Timothy Kim
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Carolyn Turvey
- Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Healthcare System, Iowa City, Iowa, USA
- Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine at the University of Iowa, Iowa City, Iowa, USA
- Rural Health Resource Center, Iowa City Veterans Affairs Healthcare System, Iowa City, Iowa, USA
| | - Kristina Cordasco
- VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Aashna Basu
- Department of Medicine, David Geffen School of Medicine at the University of California at Los Angeles, Los Angeles, California, USA
- Care in the Community Service, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Tonya Page
- Office of Community, Clinical Integration & Field Support, Veteran Affairs Central Office, Kentucky City, Kentucky, USA
| | - Reshma Mahmood
- Santa Maria and San Luis Obispo Community Outpatient Clinics, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Aneesa Motala
- Southern California Evidence Review Center, University of Southern California, Los Angeles, California, USA
| | - Jenny Barnard
- VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Michelle Wong
- VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Ning Fu
- Southern California Evidence Review Center, University of Southern California, Los Angeles, California, USA
- School of Public Administration and Emergency Management, Jinan University, Guangzhou, Guangdong, China
| | - Isomi M Miake-Lye
- VA West Los Angeles Evidence-based Synthesis Program, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
- Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California, USA
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6
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Bartkeviciute B, Riklikiene O, Kregzdyte R, Lesauskaite V. Individualized care for older adults with diabetes and its relationship with communication, psychosocial self-efficacy, resources and support for self-management and socio-demographics. Nurs Open 2023; 10:2560-2571. [PMID: 36479931 PMCID: PMC10006652 DOI: 10.1002/nop2.1515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 11/04/2022] [Accepted: 11/20/2022] [Indexed: 12/13/2022] Open
Abstract
AIM To examine the relationship between patient-provider communication, psychosocial patient self-efficacy, resources and support for self-management and socio-demographics within individualized care of older adults with diabetes. DESIGN A quantitative study with a cross-sectional survey design. METHODS Data were collected from September 2019 to January 2021 using: Individualized Care Scale, The Communication Assessment Tool, The Diabetes Empowerment Scale and The Resources and Support for Self-Management Scale. Patients with either Type 1 or Type 2 diabetes mellitus that were 65 years old and over (N = 145) participated in the study. RESULTS The most positive aspects of patient-provider communication were respect and creating a comfortable environment for the patient. A significant relationship was observed between patients' perceptions and support of individualized care and diabetes-related measures. Effective communication was the main factor associated with support for individualizing care, and together with education level, empowerment and access to resources, explained 23% of the variance.
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Affiliation(s)
- Birute Bartkeviciute
- Clinical Department of Geriatrics, Faculty of NursingLithuanian University of Health SciencesKaunasLithuania
| | - Olga Riklikiene
- Department of Nursing, Faculty of NursingLithuanian University of Health SciencesKaunasLithuania
| | - Rima Kregzdyte
- Department of Preventive Medicine, Faculty of Public HealthLithuanian University of Health SciencesKaunasLithuania
| | - Vita Lesauskaite
- Clinical Department of Geriatrics, Faculty of NursingLithuanian University of Health SciencesKaunasLithuania
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Wang N, Chen J, Chen W, Shi Z, Yang H, Liu P, Wei X, Dong X, Wang C, Mao L, Li X. The effectiveness of case management for cancer patients: an umbrella review. BMC Health Serv Res 2022; 22:1247. [PMID: 36242021 PMCID: PMC9562054 DOI: 10.1186/s12913-022-08610-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 09/21/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Case management (CM) is widely utilized to improve health outcomes of cancer patients, enhance their experience of health care, and reduce the cost of care. While numbers of systematic reviews are available on the effectiveness of CM for cancer patients, they often arrive at discordant conclusions that may confuse or mislead the future case management development for cancer patients and relevant policy making. We aimed to summarize the existing systematic reviews on the effectiveness of CM in health-related outcomes and health care utilization outcomes for cancer patient care, and highlight the consistent and contradictory findings. METHODS An umbrella review was conducted followed the Joanna Briggs Institute (JBI) Umbrella Review methodology. We searched MEDLINE (Ovid), EMBASE (Ovid), PsycINFO, CINAHL, and Scopus for reviews published up to July 8th, 2022. Quality of each review was appraised with the JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. A narrative synthesis was performed, the corrected covered area was calculated as a measure of overlap for the primary studies in each review. The results were reported followed the Preferred reporting items for overviews of systematic reviews checklist. RESULTS Eight systematic reviews were included. Average quality of the reviews was high. Overall, primary studies had a slight overlap across the eight reviews (corrected covered area = 4.5%). No universal tools were used to measure the effect of CM on each outcome. Summarized results revealed that CM were more likely to improve symptom management, cognitive function, hospital (re)admission, treatment received compliance, and provision of timely treatment for cancer patients. Overall equivocal effect was reported on cancer patients' quality of life, self-efficacy, survivor status, and satisfaction. Rare significant effect was reported on cost and length of stay. CONCLUSIONS CM showed mixed effects in cancer patient care. Future research should use standard guidelines to clearly describe details of CM intervention and its implementation. More primary studies are needed using high-quality well-powered designs to provide solid evidence on the effectiveness of CM. Case managers should consider applying validated and reliable tools to evaluate effect of CM in multifaced outcomes of cancer patient care.
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Affiliation(s)
- Nina Wang
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Jia Chen
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Wenjun Chen
- School of Nursing, University of Ottawa, Ottawa, Canada.
- Center for Research on Health and Nursing, University of Ottawa, Ottawa, Canada.
| | - Zhengkun Shi
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Huaping Yang
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Peng Liu
- Intensive Care Unit of Cardiovascular Surgery Department, Xiangya Hospital, Central South University, Changsha, China
| | - Xiao Wei
- The 956th Army Hospital, Linzhi, China
| | - Xiangling Dong
- Intensive Care Unit of Cardiovascular Surgery Department, Xiangya Hospital, Central South University, Changsha, China
| | - Chen Wang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Ling Mao
- School of Nursing, Changsha Medical University, Changsha, China
| | - Xianhong Li
- Xiangya School of Nursing, Central South University, Changsha, China
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8
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Cupp JA, Byrne KA, Herbert K, Roth PJ. Acute Care Utilization After Recovery Coaching Linkage During Substance-Related Inpatient Admission: Results of Two Randomized Controlled Trials. J Gen Intern Med 2022; 37:2768-2776. [PMID: 35296984 PMCID: PMC8926086 DOI: 10.1007/s11606-021-07360-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 12/16/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND For patients with substance use disorder (SUD), a peer recovery coach (PRC) intervention increases engagement in recovery services; effective support services interventions have occasionally demonstrated cost savings through decreased acute care utilization. OBJECTIVE Examine effect of PRCs on acute care utilization. DESIGN Combined results of 2 parallel 1:1 randomized controlled trials. PARTICIPANTS Inpatient adults with substance use disorder INTERVENTIONS: Inpatient PRC linkage and follow-up contact for 6 months vs usual care (providing contact information for SUD resources and PRCs) MAIN MEASURES: Acute care encounters (emergency and inpatient) 6 months before and after enrollment; encounter type by primary diagnosis code category (mental/behavioral vs medical); 30-day readmissions with Lace+ readmission risk scores. KEY RESULTS A total of 193 patients were randomized: 95 PRC; 98 control. In the PRC intervention, 66 patients had a pre-enrollment acute care encounter and 56 had an encounter post-enrollment, compared to the control group with 59 pre- and 62 post-enrollment (odds ratio [OR] = -0.79, P = 0.11); there was no significant effect for sub-groups by encounter location (emergency vs inpatient). There was a significant decrease in mental/behavioral ED visits (PRC: pre-enrollment 17 vs post-enrollment 10; control: pre-enrollment 13 vs post-enrollment 16 (OR = -2.62, P = 0.02)) but not mental/behavioral inpatient encounters or medical emergency or inpatient encounters. There was no significant difference in 30-day readmissions corrected for Lace+ scores (15.8% PRC vs 17.3% control, OR = 0.19, P = 0.65). CONCLUSIONS PRCs did not decrease overall acute care utilization but may decrease emergency encounters related to substance use. TRIAL REGISTRATION ClinicalTrials.gov (NCT04098601, NCT04098614).
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Affiliation(s)
| | | | - Kristin Herbert
- University of South Carolina School of Medicine-Greenville, Greenville, USA
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Colombani F, Encrenaz G, Sibé M, Quintard B, Ravaud A, Saillour-Glénisson F. Development of an evidence-based reference framework for care coordination with a focus on the micro level of integrated care: A mixed method design study combining scoping review of reviews and nominal group technique. Health Policy 2022; 126:245-261. [PMID: 35063324 DOI: 10.1016/j.healthpol.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Because of the limits in conceptualisation of care coordination linked to a large array of care coordination models and definitions available, a care coordination framework is needed with a particular focus on the micro level. OBJECTIVE To develop an evidence-based reference framework for person-centred care coordination interventions based on international validated definitions. METHODS This two-step mixed-methods study included first, a scoping review of reviews focus on the impact of care coordination interventions and then, a nominal group technique. The scoping review aimed at identifying the components of the four dimensions of the framework (contexts, activities, actors and tools, and effects). The nominal group technique was to select the relevant components of the dimension 'activities' of the reference framework. RESULTS The scoping review selected 52 articles from the 1407 retrieved at first. The nominal group selected the 66 most relevant activities from the 159 retrieved in the literature (28 activities of care organisation, 24 activities of care, and 14 activities of facilitation). CONCLUSION This operational framework focused on care coordination at the micro level, is a useful and innovative tool, applicable in any clinical condition, and in any health care system for describing, implementing and evaluating care coordination programmes.
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Affiliation(s)
- Françoise Colombani
- CHU Bordeaux, Centre de Coordination en Cancérologie (3C), Groupe hospitalier Saint André, 1 rue Jean Burguet, 33075, Bordeaux F-33000, France; INSERM, Centre INSERM U1219-Bordeaux Population Health, EMOS (Economie et Management des Organisations de Santé), Bordeaux F-33000, France.
| | - Gaëlle Encrenaz
- CHU Bordeaux, Centre de Coordination en Cancérologie (3C), Groupe hospitalier Saint André, 1 rue Jean Burguet, 33075, Bordeaux F-33000, France.
| | - Matthieu Sibé
- INSERM, Centre INSERM U1219-Bordeaux Population Health, EMOS (Economie et Management des Organisations de Santé), Bordeaux F-33000, France; ISPED (Bordeaux School of Public Health), University Bordeaux, Bordeaux F-33000, France.
| | - Bruno Quintard
- INSERM, Centre INSERM U1219-Bordeaux Population Health, HACS (Equipe Handicap, Activité, Cognition, Santé), Bordeaux F-33000, France; University Bordeaux, Bordeaux F-33000, France.
| | - Alain Ravaud
- CHU Bordeaux, Centre de Coordination en Cancérologie (3C), Groupe hospitalier Saint André, 1 rue Jean Burguet, 33075, Bordeaux F-33000, France; CHU Bordeaux, Service d'oncologie médicale, Pôle de Cancérologie, Bordeaux F-33000, France; University Bordeaux, Bordeaux F-33000, France.
| | - Florence Saillour-Glénisson
- INSERM, Centre INSERM U1219-Bordeaux Population Health, EMOS (Economie et Management des Organisations de Santé), Bordeaux F-33000, France; CHU Bordeaux, Unité Méthodes Évaluation en Santé (UMES), Service d'Information Médicale, Pôle de santé publique, Bordeaux F-33000, France.
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Individualized Health Care for Older Diabetes Patients from the Perspective of Health Professionals and Service Consumers. J Pers Med 2021; 11:jpm11070608. [PMID: 34199022 PMCID: PMC8306441 DOI: 10.3390/jpm11070608] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 06/17/2021] [Accepted: 06/25/2021] [Indexed: 12/26/2022] Open
Abstract
Background: Individualized nursing care as a form of person-centered care delivery is a well-known approach in the health care context and is accepted as best practice by organizations and professionals, yet its implementation in everyday practice creates serious challenges. The aim was to assess and compare the perceptions of health professionals and older diabetes patients on their individual care in regard to the patient’s clinical situation, personal life situation, and decisional control. Methods: The quantitative study with a cross-sectional survey design was conducted from March 2019 until January 2021. The Individualized Care Scale was applied for the data collection. Health professionals (nurses and physicians, n = 70) and older diabetes patients (n = 145) participated in the study. The average duration of diabetes was 15.8 years (SD = 10.0) and type 2 diabetes was the most common (89.0%). The current glucose-lowering therapy for 51.0% of the patients was oral medications, 37.9% used injected insulin, and 11.1% were treated by combined therapy. Results: The highest-rated aspects of individualized care on both dimensions of the scale from the health professionals’ perspective related to the clinical situation, and the scores for provision were significantly higher than those for support. The highest means of patients’ ratings on the support dimension related to the clinical situation and the decisions over care sub-scale; for the care provision dimension, the highest individuality in care was assigned to the decisions over care sub-scale. The lowest ratings of individualized care, both in the health professionals’ and patients’ samples, related to the personal life situation sub-scale. Conclusions: Health professionals are more positive in regard to individualized care support and provisions for older diabetes patients than the patients themselves. Patient characteristics, such as the type of glucose-lowering therapy, education, and nutritional status, make a difference in patients’ understanding and experience of individuality in care.
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Tran MTN, Luong QH, Le Minh G, Dunne MP, Baker P. Psychosocial Interventions for Amphetamine Type Stimulant Use Disorder: An Overview of Systematic Reviews. Front Psychiatry 2021; 12:512076. [PMID: 34220557 PMCID: PMC8245759 DOI: 10.3389/fpsyt.2021.512076] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 05/06/2021] [Indexed: 12/28/2022] Open
Abstract
Introduction: Amphetamine-type stimulants (ATS) use is a global concern due to increased usage and the harm to physical, mental, and social well-being. The objective of this overview of systematic reviews is to summarise trial results of psychosocial interventions and describe their efficacy and safety. Methods: We searched seven bibliographic databases to November 2020 for systematic reviews examining ATS misuse treatment by psychosocial interventions. Given the apparent incompleteness of the included reviews, we undertook a supplemental meta-analysis of all eligible primary studies. Results: We included 11 systematic reviews of moderate to high quality and 39 primary studies which assessed the outcomes of psychosocial interventions on people who use ATS. The key findings include: (1) There were conflicting results about the effectiveness of psychosocial interventions among reviews, which may confuse decision-makers in selecting treatment. (2) In the supplemental meta-analysis, relative to usual care (only counselling or self-help materials), membership of a psychological intervention group was associated with an important reduction in drug usage [risk ratio (RR) 0.80, 95% CI: 0.75 to 0.85]. Patients in psychological interventions used injectables substantially less [odds ratio (OR) 0.35, 95% CI: 0.24 to 0.49]. The risk of unsafe sex in the psychosocial intervention group was lower than in the control group (RR 0.49, 95% CI: 0.34 to 0.71). The combination of therapies reduced 1.51 day using drugs in the preceding 30 days (95% CI: -2.36 to -0.67) compared to cognitive behavioural therapy intervention alone. (3) Compared to usual care, cognitive behavioural therapy was less likely to be retained at follow-up (RR 0.89, 95% CI: 0.82 to 0.97; high-quality evidence). However, the additional of contingency management strategy can make an important improvement upon retention (RR 1.42, 95%CI: 1.25 to 1.62). Authors' Conclusions: Integrated models are more effective than a single-treatment strategy. Comprehensive and sustained psychosocial interventions can help to reduce use of ATS and other drugs, risk behaviours and mental disorders, and significantly improve treatment adherence.
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Affiliation(s)
- Mai Thi Ngoc Tran
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Center for Training and Research on Substance Abuse-HIV, Hanoi Medical University, Hanoi, Vietnam
- Nursing and Midwifery Faculty, Hanoi Medical University, Hanoi, Vietnam
| | - Quang Hung Luong
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Giang Le Minh
- Center for Training and Research on Substance Abuse-HIV, Hanoi Medical University, Hanoi, Vietnam
| | - Michael P. Dunne
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Faculty of Law, Australian Centre of Health Law Research, Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Institute for Community Health Research, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Philip Baker
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology (QUT), Brisbane, QLD, Australia
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Doménech-Briz V, Gómez Romero R, de Miguel-Montoya I, Juárez-Vela R, Martínez-Riera JR, Mármol-López MI, Verdeguer-Gómez MV, Sánchez-Rodríguez Á, Gea-Caballero V. Results of Nurse Case Management in Primary Heath Care: Bibliographic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9541. [PMID: 33419267 PMCID: PMC7766905 DOI: 10.3390/ijerph17249541] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/14/2020] [Accepted: 12/17/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND The new characteristics of today's population, together with the presence of chronic diseases in the elderly, require a new approach to care, promoting coordination between different levels of care. In this sense, we find the figure of the nurse case manager (NCM) in primary health care mainly responsible for ensuring continuity of care in complex patients with chronic diseases. OBJECTIVE to describe the role of the NCM in care management, determining its effectiveness in addressing chronic disease (health outcomes and quality of life) and its efficiency in the health system. METHODS Bibliographic review of scientific evidence on case management applied to nursing. Between March and April 2020 a bibliographic search was carried out in the Dialnet, Scielo, Scopus and Pubmed databases. INCLUSION CRITERIA articles written in the last 5 years, which analyze how this nursing rol influences the care and health of patients. RESULTS A total of 16 articles were selected. The NCM reduced the use of the emergency department, hospital admissions, readmissions, and the duration of these in the patients studied. CONCLUSION The NCM is effective and efficient for both patients and health institutions, and a common practice model is needed that includes standardized protocols and evidence-based practices.
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Affiliation(s)
- Vicente Doménech-Briz
- Hospital Universitario de la Ribera, km 1, Ctra. Corbera, 46600 Alzira, Spain; (V.D.-B.); (Á.S.-R.)
| | - Rosario Gómez Romero
- Nursing School La Fe, adscript center of Universidad de Valencia, 46026 Valencia, Spain; (I.d.M.-M.); (M.I.M.-L.); (V.G.-C.)
- Research Group GREIACC, Health Research Institute La Fe, Avda. Fernando Abril Martorell, 106. Pabellón docente Torre H, Hospital La Fe, 46016 Valencia, Spain
| | - Isabel de Miguel-Montoya
- Nursing School La Fe, adscript center of Universidad de Valencia, 46026 Valencia, Spain; (I.d.M.-M.); (M.I.M.-L.); (V.G.-C.)
- Research Group GREIACC, Health Research Institute La Fe, Avda. Fernando Abril Martorell, 106. Pabellón docente Torre H, Hospital La Fe, 46016 Valencia, Spain
| | - Raúl Juárez-Vela
- Department of Nursing, University of La Rioja, 26006 Logroño, La Rioja, Spain
- Research Group BMP Idi-Paz. Hospital La- Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain
| | - José Ramón Martínez-Riera
- Departamento Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia, Universidad de Alicante, E-03080 Alicante, Spain;
| | - María Isabel Mármol-López
- Nursing School La Fe, adscript center of Universidad de Valencia, 46026 Valencia, Spain; (I.d.M.-M.); (M.I.M.-L.); (V.G.-C.)
- Research Group GREIACC, Health Research Institute La Fe, Avda. Fernando Abril Martorell, 106. Pabellón docente Torre H, Hospital La Fe, 46016 Valencia, Spain
| | - María Virtudes Verdeguer-Gómez
- Dirección Atención Primaria, Departamento de Salud de Alzira, Alzira, Valencia, Spain. km 1, Ctra. Corbera, 46600 Alzira, Valencia;
| | - Álvaro Sánchez-Rodríguez
- Hospital Universitario de la Ribera, km 1, Ctra. Corbera, 46600 Alzira, Spain; (V.D.-B.); (Á.S.-R.)
| | - Vicente Gea-Caballero
- Nursing School La Fe, adscript center of Universidad de Valencia, 46026 Valencia, Spain; (I.d.M.-M.); (M.I.M.-L.); (V.G.-C.)
- Research Group GREIACC, Health Research Institute La Fe, Avda. Fernando Abril Martorell, 106. Pabellón docente Torre H, Hospital La Fe, 46016 Valencia, Spain
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13
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Matsuda Y, Kim YJ, Salani DA, McCabe BE, Mitrani VB. Predictors of parenting self-agency among mothers receiving substance abuse or mental health treatment. Int J Ment Health Nurs 2019; 28:1132-1141. [PMID: 31199073 PMCID: PMC6736753 DOI: 10.1111/inm.12624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/26/2019] [Indexed: 11/28/2022]
Abstract
Mothers' mental health or substance use disorders impact the behaviours of their children both short-term and long-term. There is increased concern for mothers with mental health or substance use disorders to effectively handle parenting challenges. Children of these mothers are at risk for emotional and behavioural adjustment problems as well as poor academic performances. Parenting self-agency refers to parents' perceptions of their confidence and ability to overcome barriers and manage issues in parenting. Examining the factors that predict parenting self-agency aids in understanding how nurses can assist mothers and families. The purpose of this study was to explore predictors of parenting self-agency among mothers who are impacted by mental health or substance use disorders. A secondary analysis was conducted using the baseline assessment data of a randomized trial that examined the efficacy of a nurse-led family-strengthening home-health intervention. The data were obtained from 172 mothers who were receiving outpatient treatment for substance use or other mental health disorders and had children under 18. A multivariate linear regression analysis was conducted to find predictors of parenting self-agency among participating mothers. The authors found that increased children's externalizing problems and intensity of hassle predicted lower parenting self-agency, and family cohesion predicted higher parenting self-agency. The authors conclude that treatments need to address family as a whole to increase mothers' parenting self-agency, thus assisting these mothers in raising their children in the best possible environment.
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Affiliation(s)
- Yui Matsuda
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
| | - Young-Ju Kim
- College of Nursing, Sungshin Women's University, Seoul, South Korea
| | - Deborah A Salani
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
| | - Brian E McCabe
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
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Vanderplasschen W, Rapp RC, De Maeyer J, Van Den Noortgate W. A Meta-Analysis of the Efficacy of Case Management for Substance Use Disorders: A Recovery Perspective. Front Psychiatry 2019; 10:186. [PMID: 31057432 PMCID: PMC6477913 DOI: 10.3389/fpsyt.2019.00186] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 03/14/2019] [Indexed: 11/21/2022] Open
Abstract
Background: Case management is a client-centered approach to improve the coordination and continuity of service delivery, especially for persons with substance use disorders (SUD) and multiple and complex support needs. This intervention supports individuals by helping them identify needed services, facilitate linkage with services, and promote participation and retention in services. However, it is questionable whether case management is equally effective in promoting recovery and aspects of personal functioning. The objective was to conduct an updated meta-analysis and to assess whether case management was more effective than treatment as usual (TAU) among persons with SUD for improving treatment-related (e.g., successful linkage with and retention in treatment) as well as personal functioning outcomes (e.g., substance use). Methods: This meta-analysis focuses on randomized controlled trials (RCTs) that included persons with alcohol or drug use disorders and compared case management with TAU. To be eligible, interventions had to meet core case management functions as defined in the literature. We conducted searches of the following databases to May 2017: the Cochrane Drugs and Alcohol Specialized Register, CENTRAL, PubMed, Embase, CINAHL, and Web of Science. Also, reference lists of retrieved publications were scanned for relevant (un)published studies. Results: The overall effect size for case management compared to TAU across all outcome categories and moments was small and positive (SMD = 0.18, 95% CI 0.07-0.28), but statistically significant. Effects were considerably larger for treatment tasks (SMD = 0.33, 95% CI 0.18-0.48) than for personal functioning outcomes (SMD = 0.06, 95% CI -0.02 to 0.15). The largest effect sizes were found for retention in substance abuse treatment and linkage with substance abuse services. Moderator effects of case management models and conditions were assessed, but no significant differences were observed. Conclusions: The primary results from earlier meta-analyses were supported: case management is more effective than TAU conditions for improving outcomes, but this effect is significantly larger for treatment-related tasks than for personal functioning outcomes. Case management can be an important supplement to available services for improving linkage and retention, although further research is needed to assess its potential for supporting recovery from a longitudinal perspective.
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Affiliation(s)
| | - Richard C Rapp
- Boonshoft School of Medicine, Wright State University, Dayton, OH, United States
| | - Jessica De Maeyer
- Centre of Expertise on Quality of Life, University College Ghent, Ghent, Belgium
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Joo JY, Huber DL. Case Management Effectiveness on Health Care Utilization Outcomes: A Systematic Review of Reviews. West J Nurs Res 2019; 41:111-133. [PMID: 29542405 DOI: 10.1177/0193945918762135] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Case management is a cost-effective strategy for coordinating chronic illness care. However, research showing how case management affects health care is mixed. This study systematically synthesizes and critically evaluates evidence in systematic reviews of health care utilization outcomes from case management interventions for the care of chronic illnesses. Results are synthesized from seven English language systematic reviews published between January 1990 and June 2017. Hospital readmissions, length of hospital stay, institutionalization, emergency department visits, and hospitals/primary care visits were all identified as health care utilization outcomes of case management interventions. There was evidence that these interventions positively reduced health care utilization; however, results were mixed. These results and the implications of this review of reviews may be valuable for clinical practitioners, health care researchers, and policymakers.
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Myers B, Williams PP, Govender R, Manderscheid R, Koch JR. Substance abuse treatment engagement, completion and short-term outcomes in the Western Cape province, South Africa: Findings from the Service Quality Measures Initiative. Drug Alcohol Depend 2018; 185:278-284. [PMID: 29482052 DOI: 10.1016/j.drugalcdep.2017.12.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 12/02/2017] [Accepted: 12/27/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Optimizing the effectiveness of substance use disorder (SUD) treatment is critical in low-and middle-income countries (LMICs) with limited opportunities for SUD treatment. This is the first study to identify targets for interventions to improve the quality of SUD treatment in a LMIC. METHOD We explored correlates of three indicators of treatment quality (treatment engagement, completion and abstinence at treatment exit) using data from a SUD performance measurement system implemented in the Western Cape Province of South Africa. The sample included data from 1094 adult treatment episodes representing 53% of the treatment episodes in 2016. Using multivariate logistic regression analyses, we modeled socio-demographic, substance use and program correlates of treatment engagement, completion, and abstinence at treatment exit. RESULTS Overall, 59% of patients completed treatment (48% of patients from outpatient services). Treatment completion was associated with greater likelihood of abstinence at treatment exit. Patients were more likely to complete treatment if they engaged in treatment, were older, and had more severe drug problems (characterized by daily drug use and heroin problems) and attended programs of shorter duration. Residential treatment was associated with greater likelihood of treatment engagement, completion, and abstinence at treatment exit. CONCLUSION Improving rates of outpatient treatment completion will enhance the effectiveness of South Africa's SUD treatment system. Interventions that promote engagement in treatment, particularly among younger patients; reduce program length through referral to step-down continuing care; and ensure better matching of drug problem to treatment level and type could improve rates of treatment completion.
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Affiliation(s)
- Bronwyn Myers
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Department of Psychiatry, Stellenbosch University, Cape Town, South Africa.
| | - Petal Petersen Williams
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Rajen Govender
- Department of Sociology, University of Cape Town, Cape Town, South Africa; Violence Prevention Research Unit, South African Medical Research Council, Cape Town, South Africa; Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Ron Manderscheid
- National Association of County Behavioral Health and Developmental Disability Directors, Washington DC, USA; Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - J Randy Koch
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA; Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
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17
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Joo J, Liu M. Experiences of case management with chronic illnesses: a qualitative systematic review. Int Nurs Rev 2018; 65:102-113. [DOI: 10.1111/inr.12429] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J.Y. Joo
- College of Nursing Gachon University Incheon Korea
| | - M.F. Liu
- College of Nursing School of Gerontology Health Management Taipei Medical University Taipei Taiwan
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18
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Joo JY, Huber DL. Barriers in Case Managers’ Roles: A Qualitative Systematic Review. West J Nurs Res 2017; 40:1522-1542. [DOI: 10.1177/0193945917728689] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The challenges faced by case managers when implementing case management have received little focus. Several qualitative studies have been published that may be able to shed light on those challenges. This study is a systematic review of qualitative literature to identify barriers case managers have when implementing case management. Five electronic bibliographic databases were systematically searched, and 10 qualitative studies were identified for inclusion in the review which were published from 2007 to 2016. Through thematic synthesis of findings, five themes were identified as barriers to case management implementation: unclear scope of practice, diverse and complex case management activities, insufficient training, poor collaboration with other health-care providers, and client relationship challenges. This review study suggested that standardized evidence-based practical protocols and certification programs may help overcome case managers’ barriers and improve case management practices. Health policymakers, case management associations, and health-care management researchers should develop educational and practical supports for case managers.
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Penzenstadler L, Machado A, Thorens G, Zullino D, Khazaal Y. Effect of Case Management Interventions for Patients with Substance Use Disorders: A Systematic Review. Front Psychiatry 2017; 8:51. [PMID: 28428761 PMCID: PMC5382199 DOI: 10.3389/fpsyt.2017.00051] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 03/20/2017] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Substance use disorder (SUD) is an important health problem that requires a complex range of care because of the chronic nature of the disorder and the multiple psychosocial problems involved. Current outpatient programs often have difficulties in delivering and coordinating ongoing care and access to different health-care providers. Various case management (CM) models have been developed, first for patients in other psychiatric domains and then for patients with SUD, in order to improve treatment outcomes. AIM This paper aims to assess the effectiveness of CM for patients with SUD. METHODS We performed a systematic review of CM interventions for patients with SUD by analyzing randomized controlled studies published on the subject between 1996 and 2016 found on the electronic database PubMed. RESULTS AND CONCLUSION Fourteen studies were included in the analysis. Differences between studies in outcome measures, populations included, and intervention characteristics made it difficult to compare results. Most of these studies reported improvement in some of the chosen outcomes. Treatment adherence mostly improved, but substance use was reported to decrease in only a third of the studies. Overall functioning improved in about half of the studies. The heterogeneity of the results might be linked to these differences between studies. Further research is needed in the field.
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Affiliation(s)
| | | | - Gabriel Thorens
- Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, Geneva University, Geneva, Switzerland
| | - Daniele Zullino
- Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, Geneva University, Geneva, Switzerland
| | - Yasser Khazaal
- Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, Geneva University, Geneva, Switzerland.,Research Center, Montreal University Institute of Mental Health, Montreal, QC, Canada
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20
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Joo JY, Liu MF. Case management effectiveness in reducing hospital use: a systematic review. Int Nurs Rev 2016; 64:296-308. [PMID: 27861853 DOI: 10.1111/inr.12335] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
AIM This systematic review synthesizes recent evidence of the effectiveness of case management in reducing hospital use by individuals with chronic illnesses. BACKGROUND Hospital use by individuals with chronic illnesses accounts for 66% of healthcare costs in the United States. its has been cited as care coordination that can reduce healthcare costs; however, its effectiveness in improving hospital use outcomes is contradictory, and no review has yet synthesized recent studies of case management with respect to hospital use outcomes. METHODS This systematic review followed the Cochrane processes and was guided by use of PRISMA statements. Five electronic databases were searched to obtain randomized controlled trials published within the last 10 years that evaluated case management hospital use as a primary outcome by individuals with chronic illnesses. RESULTS Ten studies published between 2007 and 2015 were retrieved and assessed for risk of methodological bias. All studies used case management as an intervention, focused on transitional care services and reported hospital use, including readmissions and emergency department and hospital visits, as a primary outcome. Analysis of the studies showed that case management greatly reduced hospital readmissions and emergency department visits. LIMITATIONS Only studies published in English were searched, and retrieved studies tended to report positive results. CONCLUSIONS There was strong evidence of significant reductions in hospital use with case management as an intervention. However, other results about the efffectiveness of case management remain mixed; more rigorously designed studies with case management interventions are needed. IMPLICATIONS FOR NURSING AND HEALTH POLICY The complexity and cost of chronic illnesses means that case management should be considered as a tool to improve quality of care and lower healthcare costs.
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Affiliation(s)
- J Y Joo
- College of Nursing, Gachon University, Incheon, Korea
| | - M F Liu
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
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