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A patient-centred referral pathway for mild to moderate lifestyle and mental health problems: does this model work in practice?

作者信息

Calveley Jill, Verhoeven Angela, Hopcroft David

机构信息

Harbour Health and HealthWEST Primary Health Organisation, Auckland, New Zealand.

出版信息

J Prim Health Care. 2009 Mar;1(1):50-6.

PMID:20690487
Abstract

BACKGROUND AND CONTEXT

The Primary Lifestyle Options Programme was an innovative eight-month, patient-centred, early primary care-based pilot aimed at identifying and promptly enabling people with mild to moderate mental health and lifestyle problems to access a range of free interventions as soon as possible.

PROBLEMS

Mild to moderate mental health and lifestyle issues are easily overlooked in primary care. Patients with these problems, once identified, often need support to choose and access treatment providers.

STRATEGIES FOR IMPROVEMENT

During a GP visit a patient requests help by completing a CHAT (Case-finding and Help Assessment Tool) which assesses depression, anxiety, abuse, anger, exercise level, insomnia, and addictions (gambling, tobacco, alcohol and other substances). Patients subsequently have a 30-minute GP consultation where a range of services to address identified problem(s) is offered; this choice is assisted by a comprehensive resource manual. A programme coordinator facilitates access to services by making appointments and liaising between patients and providers. A follow-up GP consult is available.

RESULTS

456 patients (6% Maori) aged from 15 to 84 years requested help via the CHAT for one to seven issues per patient, over an eight-month period. Anxiety, depression and insomnia were the commonest reasons for requesting help. A feedback questionnaire focussed on the usefulness and practicality of the pathway, showing widespread approval from patients, GPs and other treatment providers.

CONCLUSIONS

This programme enables a patient to identify and request help for mental health and lifestyle problems at a mild-moderate stage, and to be supported through an intervention pathway that otherwise is unlikely to be available in a busy primary care environment.

摘要

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