Implementation of Guidelines on Family Involvement for Persons with Psychotic Disorders (IFIP): A Cluster Randomised Controlled Trial.

Autor: Hestmark L; Centre for Medical Ethics, University of Oslo, Postbox 1130, Blindern, 0318, Oslo, Norway. lars.hestmark@medisin.uio.no., Romøren M; Centre for Medical Ethics, University of Oslo, Postbox 1130, Blindern, 0318, Oslo, Norway., Heiervang KS; Centre for Medical Ethics, University of Oslo, Postbox 1130, Blindern, 0318, Oslo, Norway.; Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway.; Center for Mental Health and Substance Abuse, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway., Hansson KM; Centre for Medical Ethics, University of Oslo, Postbox 1130, Blindern, 0318, Oslo, Norway., Ruud T; Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway.; Institute of Clinical Medicine, University of Oslo, Oslo, Norway., Šaltytė Benth J; Institute of Clinical Medicine, Campus Ahus, University of Oslo , Oslo, Norway.; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway., Norheim I; Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Lier, Norway., Weimand B; Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway.; Center for Mental Health and Substance Abuse, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway.; Faculty of Health Sciences, OsloMet Oslo Metropolitan University, Oslo, Norway., Pedersen R; Centre for Medical Ethics, University of Oslo, Postbox 1130, Blindern, 0318, Oslo, Norway.
Jazyk: angličtina
Zdroj: Administration and policy in mental health [Adm Policy Ment Health] 2023 May; Vol. 50 (3), pp. 520-533. Date of Electronic Publication: 2023 Feb 16.
DOI: 10.1007/s10488-023-01255-0
Abstrakt: Family involvement is part of the evidence-based treatment for persons with psychotic disorders, yet is under-implemented despite guideline recommendations. This study assessed whether an implementation support programme increased the adherence to guidelines on family involvement, compared to guideline/manual only. In a cluster randomised design, community mental health centre units in South-East Norway went through stratified allocation to the experimental (n = 7) or control (n = 7) arm. Experimental clusters received an implementation support programme including clinical training and supervision, appointing a family coordinator and an implementation team, a toolkit, and fidelity measurements at baseline, 12, 18, and 24 months with on-site feedback and supervision. Control clusters received no such support and had fidelity measurements at baseline and 24 months without feedback. During fidelity measurements, adherence to the guidelines was measured with the basic family involvement and support scale, the general organizational index, and the family psychoeducation fidelity scale, the latter being the primary outcome. The scales consist of 12-14 items rated from 1 to 5. Data was analysed with an independent samples t-test, linear mixed models, and a tobit regression model. At 24 months, the mean scores were 4.00 or higher on all scales in the experimental arm, and the increase in adherence to the guidelines was significantly greater than in the control arm with p-values < 0.001. Large-scale implementation of guidelines on family involvement for persons with psychotic disorders in community mental health centres may be accomplished, with substantial implementation support.Trial Registration: ClinicalTrials.gov Identifier NCT03869177. Registered 11.03.19.
(© 2023. The Author(s).)
Databáze: MEDLINE
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