Blasi Paula R, Mettert Kayne D, Coleman Katie, Lewis Cara, Wagner Edward, Coghill Maria N, Dang Tobias, Richards Julie E
Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
Kaiser Permanente Washington, Renton, WA, USA.
Implement Res Pract. 2021 Sep 14;2:26334895211041294. doi: 10.1177/26334895211041294. eCollection 2021 Jan-Dec.
A lack of access to mental health services is a critical barrier to obtaining evidence-based care. One strategy to improve access is to transition stable patients out of mental health specialty services and into primary care, thus opening availability for new patients and those with acute mental health needs. To support these transitions, organizations might explore a range of new practices and implementation strategies.
We conducted a rapid literature review to summarize descriptions from the research literature about practices for transitioning stable patients from outpatient mental health services to primary care, as well as implementation strategies to enhance the adoption and sustainment of these practices. We searched PsycINFO and Cumulated Index to Nursing and Allied Health Literature (CINAHL) for articles published between January 2000 and August 2019. For articles meeting inclusion criteria, we abstracted data on study characteristics, transition practices, and implementation strategies.
We included 11 articles representing diverse study designs, settings, and health care organizations. Across these articles, we identified six categories of commonly described transition practices, with patient engagement appearing the most frequently (10 articles), followed by shared treatment planning (eight articles), assessment of recovery and stability, care coordination, follow up and support, and medication management (seven articles each). Less frequently, articles included descriptions of implementation strategies, with five articles describing efforts to train and educate stakeholders and four articles describing the use of evaluative and iterative strategies.
We identified descriptions of several common practices to help patients transition from mental health specialty services to primary care, but there are opportunities for an increased focus on implementation strategies to enhance the adoption and sustainment of these transition practices. More research is needed to better understand the effectiveness of specific transition interventions and the feasibility of deploying these interventions in heterogeneous health care settings.
无法获得心理健康服务是获得循证护理的关键障碍。一种改善可及性的策略是将病情稳定的患者从心理健康专科服务中转出，纳入初级保健，从而为新患者和有急性心理健康需求的患者腾出空间。为支持这些过渡，各组织可探索一系列新做法和实施策略。
我们进行了一项快速文献综述，以总结研究文献中关于将病情稳定的患者从门诊心理健康服务过渡到初级保健的做法，以及增强这些做法的采用和维持的实施策略。我们在PsycINFO和护理及联合健康文献累积索引（CINAHL）中搜索了2000年1月至2019年8月发表的文章。对于符合纳入标准的文章，我们提取了关于研究特征、过渡做法和实施策略的数据。
我们纳入了11篇文章，这些文章代表了不同的研究设计、环境和医疗保健组织。在这些文章中，我们确定了六类常见的过渡做法，患者参与出现的频率最高（10篇文章），其次是共享治疗计划（8篇文章）、康复和稳定性评估、护理协调、随访和支持以及药物管理（各7篇文章）。较少有文章包含实施策略的描述，5篇文章描述了培训和教育利益相关者的努力，4篇文章描述了评估和迭代策略的使用。
我们确定了几种帮助患者从心理健康专科服务过渡到初级保健的常见做法的描述，但仍有机会更多地关注实施策略，以增强这些过渡做法的采用和维持。需要更多研究来更好地了解特定过渡干预措施的有效性以及在不同医疗保健环境中部署这些干预措施的可行性。
