Abstract
This paper summarizes the existing evidence for integrated care pathways (ICPs) for the treatment of schizophrenia. Scoping review methods following PRISMA guidelines were employed due to the variable nature of the evidence in this area. The review identified 13 papers. Of these papers, 7 focused on describing ICP content and process-related data and 6 examined clinical outcomes. Of the 6 studies providing outcome data, 2 reported improved outcomes associated with ICPs. Conceptually, ICPs hold great promise for improving the quality of schizophrenia care. However, in contrast with other specialty healthcare domains, the schizophrenia ICP evidence base is very limited and has not fulsomely begun to address ICPs for effectiveness.
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Allen, D., Gillen, E., & Rixson, L. (2009). Systematic review of the effectiveness of integrated care pathways: What works, for whom, in which circumstances? International Journal of Evidence Based Healthcare, 7(2), 61–74.
Anders, R. L., Tomai, J. S., Clute, R. M., & Olson, T. (1997). Development of a scientifically valid coordinated care path. Journal of Nursing Administration, 27(5), 45–52.
Bentall, R. (2006). Madness explained: Why we must reject the Kraeplinian paradigm and replace it with a ‘complaint oriented’ approach to understanding mental illness. Medical Hypotheses, 66, 220–233.
Campbell, H., Hotchkiss, R., Bradshaw, N., & Porteous, M. (1998). Integrated care pathways. British Medical Journal, 316(7125), 133–137.
Chan, S. W., & Wong, K. F. (1999). The use of critical pathways in caring for schizophrenic patients in a mental hospital. Archives of Psychiatric Nursing, 13(3), 145–153.
Cheng, K. M., Chan, C., Wong, R., Leung, K., Mui, J., Chui, W., & Cheung, E. (2012). Integrated care pathway for the personalized care programme for patients with severe mental illness. Hong Kong International Journal of Care Pathways, 16, 72–75.
Costantini, M., Romoli, V., Di Leo, S., Beccaro, M., Bono, L., Pilastri, P., et al. (2014). Liverpool care pathway for patients with cancer in hospital. The Lancet, 383, 226–237.
Drake, R., Bond, G., & Eassock, S. (2009). Implementing evidence-based practices for people with schizophrenia. Schizophrenia Bulletin, 35, 704–713.
El-Ghorr, A., Cameron, R., Fleming, M., McKechnie, L., Thomson, D., & Doherty, S. (2010). Scotland’s national approach to improving mental health services: Integrated care pathways as tools for redesign and continuous quality improvement. International Journal of Care Pathways, 14(2), 57–64.
Emmerson, B., Frost, A., Fawcett, L., Ballantyne, E., Ward, W., & Catts, S. (2006). Do clinical pathways really improve clinical performance in mental health settings? Australasian Psychiatry, 14(4), 395–398.
Gaughan, A. (2007). Development of a multidisciplinary support pathway for people with learning disabilities with complex needs and/or whose behaviour challenges services. Journal of Care Services Management, 2(1), 54–78.
Gerlinger, G., Hauser, M., de Hert, M., Lacluyse, K., Wampers, M., & Correll, C. (2013). Personal stigma in schizophrenia spectrum disorders: A systematic review of prevalence rates, correlates, impact and interventions. World Psychiatry, 12, 155–164.
Gustavsson, A., Svensson, M., Jacobi, F., Allgulander, C., Alonso, J., Beghi, E., et al. (2011). Cost of disorders of the brain in Europe 2010. European Neuropsychopharmacology, 21(10), 718–779.
Hall, J. E. (2004). Mental health integrated care pathways in the UK: A review of their content. Journal of Integrated Care Pathways, 8, 14–18.
Jones, A. (2000). Implementation of hospital care pathways for patients with schizophrenia. Journal of Nursing Management, 8(4), 215–225.
Jones, A. (2001). Hospital care pathways for patients with schizophrenia. Journal of Clinical Nursing, 10(1), 58–69.
Jones, C., Hacker, D., Cormac, I., Meaden, A., & Irving, C. B. (2012). Cognitive behaviour therapy versus other psychosocial treatments for schizophrenia. Cochrane Database of Systematic Reviews, 4, CD008712.
Jones, A., & Kamath, P. D. (1998). Issues for the development of care pathways in mental health services. Journal of Nursing Management, 6(2), 87–95.
Kerkemeyer, L., Mostardt, S., Biermann, J., Wasem, J., Neumann, A., Walendzik, A., et al. (2014). Evaluation of an integrated care program for schizophrenia: Concept and study design. European Archives of Psychiatry and Clinical Neuroscience, 265(2), 155–162.
Kidd, S. A., Virdee, G., & McKenzie, K. J. (2014). Mental health reform at a systems level: Broadening the lens on recovery oriented care. Canadian Journal of Psychiatry, 59, 243–249.
King, R. (2006). Intensive case management: A critical re-appraisal of the scientific evidence for effectiveness. Administration and Policy in Mental Health and Mental Health Services Research, 33(5), 529–535.
Lock, J. (1999). How clinical pathways can be useful: An example of a clinical pathway for the treatment of anorexia nervosa in adolescents. Clinical Child Psychology and Psychiatry, 4(3), 331–340.
Mainz, J. (2003). Defining and classifying clinical indicators for quality improvement. International Journal for Quality in Health Care, 15(6), 523–530.
Marchisio, S., Vanetti, M., Valsesia, R., Carnevale, L., & Panella, M. (2009). Effect of introducing a care pathway to standardize treatment and nursing of schizophrenia. Community Mental Health Journal, 45(4), 255–259.
McGorry, P. D. (2015). Early intervention in psychosis: Obvious, effective, overdue. The Journal of Nervous and Mental Disease, 203, 310–315.
Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA Statement. PLoS Medicine, 6, e1000097.
Moos, S. (2004). Integrated care pathways for postnatal depression. Journal of Integrated Pathways, 8(2), 70–73.
Mynors-Wallis, L., Rastogi, S., Virgo, N., Kosky, N., Howard, A., & Brake, G. (2004). Controlled evaluation of a care pathway for an acute episode of schizophrenia. Journal of Integrated Pathways, 8(3), 106–113.
Nakanishi, M., Sawamura, K., Sato, S., Setoya, Y., & Anzai, N. (2010). Development of a clinical pathway for long-term inpatients with schizophrenia. Psychiatry and Clinical Neurosciences, 64(1), 99–103.
National Institute for Health and Care Excellence. (2014). Schizophrenia and psychosis in adults: Treatment and management. (Clinical guideline 178). http://www.nice.org.uk/guidance/cg178/chapter/1-recommendations. Accessed June 19, 2015.
NHS. (2004). Quality improvement Scotland. National overview: Schizophrenia. Retrieved June 3, 2015 from www.nhshealthquality.org.
Pearson, S. D., Kleefield, S. F., Soukop, J. R., Cook, E. F., & Lee, T. H. (2001). Critical pathways intervention to reduce length of hospital stay. American Journal of Medicine, 110(3), 175–180.
Rotter, T., Kinsman, L., James, E., Machotta, A., Gothe, H., Willis, J., et al. (2010). Clinical pathways: Effects on professional practice, patient outcomes, length of stay and hospital costs. Cochrane Database of Systematic Reviews, 3, CD006632.
Schmidt-Kraepelin, C., Janssen, B., & Gaebel, W. (2009). Prevention of rehospitalization in schizophrenia: Results of an integrated care project in Germany. European Archives of Psychiatry and Clinical Neuroscience, 259(Suppl 2), S205–S212.
Steinacher, B., Mausolff, L., & Gusy, B. (2012). The effects of a clinical care pathway for schizophrenia: A before and after study in 114 patients. Deutsches Arzteblatt International, 109(46), 788–794.
Swartz, M. S., Perkins, D. O., Stroup, T. S., Davis, S. M., Capuano, G., Rosenheck, R. A., et al. (2007). Effects of antipsychotic medications on psychosocial functioning in patients with chronic schizophrenia: Findings from the NIMH CATIE Study. American Journal of Psychiatry, 164, 428–436.
Turner-Stokes, L., Hassan, N., Pierce, K., & Clegg, F. (2002). Managing depression in brain injury rehabilitation: The use of an integrated care pathway and preliminary report of response to sertraline. Clinical Rehabilitation, 16(3), 261–268.
Van Herck, P., Vanhaecht, K., & Sermeus, W. (2004). Effects of clinical pathways: Do they work? Journal of Integrated Care Pathways, 8(3), 95–105.
Vanhaecht, K., & Sermeus, W. (2003). The Leuven clinical pathway compass. Journal of Integrated Care Pathways, 7, 2–7.
Warner, R. (2004). Recovery from Schizophrenia. New York, NY: Brunner-Routledge.
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Chen, S., Awan, S., Rajji, T. et al. Integrated Care Pathways for Schizophrenia: A Scoping Review. Adm Policy Ment Health 43, 760–767 (2016). https://doi.org/10.1007/s10488-015-0696-z
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DOI: https://doi.org/10.1007/s10488-015-0696-z