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. 2017 May 12:11:919-928.
doi: 10.2147/PPA.S132339. eCollection 2017.

Engagement-focused care during transitions from inpatient and emergency psychiatric facilities

Dawn I Velligan  1 , Megan M Fredrick  1 , Cynthia Sierra  1 , Kiley Hillner  1 , John Kliewer  1 , David L Roberts  1 , Jim Mintz  1
Affiliations

Engagement-focused care during transitions from inpatient and emergency psychiatric facilities

Dawn I Velligan et al. Patient Prefer Adherence. .

Abstract

Objectives: As many as 40% of those with serious mental illness (SMI) do not attend any outpatient visits in the 30 days following discharge. We examined engagement-focused care (EFC) versus treatment as usual in a university-based transitional care clinic (TCC) with a 90-day program serving individuals with SMI discharged from hospitals and emergency rooms. EFC included a unique group intake process (access group) designed to get individuals into care rapidly and a shared decision-making coach.

Methods: Assessments of quality of life, symptomatology, and shared decision-making preferences were conducted at baseline, at 3 months corresponding to the end of TCC treatment and 6 months after TCC discharge. Communication among the patients and providers was assessed at each visit as was service utilization during and after TCC.

Results: Subjective quality of life improved in EFC. Prescribers and patients saw communication more similarly as time went on. Ninety-one percent of patients wanted at least some say in decisions about their treatment.

Conclusions: SDM coaching and improved access improve quality of life. Most people want a say in treatment decisions.

Keywords: community mental health; mental illness; patient education; shared decision making.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Consort diagram. Abbreviations: SDM, shared decision making; TCC, transitional care clinic; LTFU, lost to follow up.
Figure 2
Figure 2
Subjective quality of life over time by treatment group. Abbreviation: SC, standard care.
Figure 3
Figure 3
Shared decision-making preference at baseline.
Figure 4
Figure 4
Matched-Pair Difference score time by treatment group. Abbreviations: EFC, engagement-focused care; SC, standard care.
See this image and copyright information in PMC

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