Skip to main content

Advertisement

Log in

Integrated Care Pathways for Schizophrenia: A Scoping Review

  • Original Article
  • Published:
Administration and Policy in Mental Health and Mental Health Services Research Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Campbell, H., Hotchkiss, R., Bradshaw, N., & Porteous, M. (1998). Integrated care pathways. British Medical Journal, 316(7125), 133–137.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Drake, R., Bond, G., & Eassock, S. (2009). Implementing evidence-based practices for people with schizophrenia. Schizophrenia Bulletin, 35, 704–713.

    Article  PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • 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.

    Google Scholar 

  • Jones, A. (2000). Implementation of hospital care pathways for patients with schizophrenia. Journal of Nursing Management, 8(4), 215–225.

    Article  CAS  PubMed  Google Scholar 

  • Jones, A. (2001). Hospital care pathways for patients with schizophrenia. Journal of Clinical Nursing, 10(1), 58–69.

    Article  CAS  PubMed  Google Scholar 

  • 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.

    PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Mainz, J. (2003). Defining and classifying clinical indicators for quality improvement. International Journal for Quality in Health Care, 15(6), 523–530.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • McGorry, P. D. (2015). Early intervention in psychosis: Obvious, effective, overdue. The Journal of Nervous and Mental Disease, 203, 310–315.

    Article  PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • Moos, S. (2004). Integrated care pathways for postnatal depression. Journal of Integrated Pathways, 8(2), 70–73.

    Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • 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.

    PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Van Herck, P., Vanhaecht, K., & Sermeus, W. (2004). Effects of clinical pathways: Do they work? Journal of Integrated Care Pathways, 8(3), 95–105.

    Google Scholar 

  • Vanhaecht, K., & Sermeus, W. (2003). The Leuven clinical pathway compass. Journal of Integrated Care Pathways, 7, 2–7.

    Google Scholar 

  • Warner, R. (2004). Recovery from Schizophrenia. New York, NY: Brunner-Routledge.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sean A. Kidd.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10488-015-0696-z

Keywords

Navigation