Medication Therapy Management and Collaborative Health Care: Implications for Social Work Practice

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Interventions fostering interdisciplinary and inter-organizational collaboration in health and social care; an integrative literature review

Effects of Depression and Anxiety Improvement on Adherence to Medication and Health Behaviors in Recently Hospitalized Cardiac Patients

To develop a framework for research and evaluation of collaborative mental health care for depression, which includes attributes or domains of care that are important to consumers. A literature review on collaborative mental health care for depression was completed and used to guide discussion at an interactive workshop with pan-Canadian participants comprising people treated for depression with collaborative mental health care, as well as their family members; primary care and mental health practitioners; decision makers; and researchers. Thematic analysis of qualitative data from the workshop identified key attributes of collaborative care that are important to consumers and family members, as well as factors that may contribute to improved consumer experiences. The workshop identified an overarching theme of partnership between consumers and practitioners involved in collaborative care. Eight attributes of collaborative care were considered to be essential or very important to consumers and family members: respectfulness; involvement of consumers in treatment decisions; accessibility; provision of information; coordination; whole-person care; responsiveness to changing needs; and comprehensiveness. Three inter-related groups of factors may affect the consumer experience of collaborative care, namely, organizational aspects of care; consumer characteristics and personal resources; and community resources. A preliminary evaluation framework was developed and is presented here to guide further evaluation and research on consumer-centred collaborative mental health care for depression.

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Effect of pharmacist care on medication adherence and cardiovascular outcomes among patients post-acute coronary syndrome: Asystematic review.

Occupational therapy practitioners use standardized assessments to guide their clinical decision-making, but it is unclear how well performance on standardized assessments translates to performance at home. To understand the concurrent and predictive validity of patient-reported outcomes and performance-based assessments for monitoring performance at home within the context of medication management and adherence. Exploratory study. Participants completed standardized assessments in a lab or at home, which were followed by home-based electronic monitoring of medication adherence. Sixty community-dwelling adults with hypertension or stroke who independently took antihypertensive medications. Participants completed the Hill-Bone Medication Adherence Scale, the Hill-Bone Medication Adherence Reasons Scale, the Performance Assessment of Self-Care Skills Medication Management subtask, and the Executive Function Performance Test-Enhanced Medication Management subtest. Then, they used an electronic pill cap to monitor medication adherence at home for 1 month. Patient-reported outcomes and performance-based assessments in the context of medication management and adherence demonstrated poor concurrent and predictive validity to medication adherence at home. There is a gap between what people think they will do, what they can do on a standardized assessment, and what they actually do at home. Future research is needed to strengthen concurrent and predictive validity to clinically meaningful outcomes. Plain-Language Summary: Occupational therapy practitioners should use caution when using standardized assessments to try to predict client performance at home. They should also continue to use a battery of assessments, clinical reasoning, and client preferences to guide their decision-making for monitoring performance at home within the context of medication management and adherence.

Effectiveness of a nurse practitioner-led collaborative health care model on self-care, functional status, rehospitalization and medical costs in heart failure patients: A randomized controlled trial.

Opportunities and Responsibilities for the Academy in the Medical Home

Effect of Pharmacist Care on Medication Adherence and Cardiovascular Outcomes Among Patients Post-Acute Coronary Syndrome: A Systematic Review

BackgroundAlthough a growing number of collaborative mental health care models have been developed, targeting specific populations, few studies have utilized such interventions among homeless populations. This quasi-experimental study compared the outcomes of two shelter-based collaborative mental health care models for men experiencing homelessness and mental illness: (1) an integrated multidisciplinary collaborative care (IMCC) model and (2) a less resource intensive shifted outpatient collaborative care (SOCC) model.MethodsIn total 142 participants, 70 from IMCC and 72 from SOCC were enrolled and followed for 12 months. Outcome measures included community functioning, residential stability, and health service use. Multivariate regression models were used to compare study arms with respect to change in community functioning, residential stability, and health service use outcomes over time and to identify baseline demographic, clinical or homelessness variables associated with observed changes in these domains.ResultsWe observed improvements in both programs over time on measures of community functioning, residential stability, hospitalizations, emergency department visits and community physician visits, with no significant differences between groups over time on these outcome measures.ConclusionsOur findings suggest that shelter-based collaborative mental health care models may be effective for individuals experiencing homelessness and mental illness. Future studies should seek to confirm these findings and examine the cost effectiveness of collaborative care models for this population.

ObjectiveTo explore how four small towns in rural New South Wales known as the 4Ts are addressing challenges accessing quality care and sustainable health services through a collaborative approach to workforce planning using the collaborative care framework.DesignDescriptive case study approach.SettingThe collaborative care project was developed as a result of ongoing partnerships between 2 rural Local Health Districts, 2 Primary Health Networks and a non‐governmental health workforce organisation. The collaboration works with 5 subregions each comprising 2 or more rural communities. This paper focuses on the 4Ts subregion.ParticipantsStakeholders of the collaborative design including organisations and the community.InterventionA place‐based approach to co‐designing health services with community in one sub‐region of Western New South Wales.Main outcome measuresA synthesis of field observations and experiences of community and jurisdictional partners in implementation of the 4Ts subregional model. Mapping of implementation processes against the collaborative care framework.ResultsThe collaborative care framework is a useful planning and community engagement tool to build health workforce literacy and to impact on system change at the local level. We identify key elements of effectiveness in establishing the 4Ts model, including the need for coordinated health system planning, better integrating existing resources to deliver services, community engagement, building health workforce literacy and town‐based planning.ConclusionThis study adds to the body of knowledge about how to successfully develop a collaborative primary health care workforce model in practice. The findings demonstrate that the implementation of a collaborative primary health care workforce model using the collaborative care framework can improve service access and quality, which in turn might facilitate workforce sustainability.

As health care becomes more complex, health systems have sought to enlist those who can engage patients outside the hospital walls.

Mental health disorders constitute a significant public health concern, with a growing recognition of the need for integrated, comprehensive approaches to their management and treatment. Pharmacists, as essential members of the healthcare team, have a unique opportunity to contribute to the care of patients with mental health conditions. This review critically examines the multifaceted role of pharmacists in mental health treatment, encompassing their involvement in medication management, patient education, and collaborative care models. Pharmacists play a pivotal role in ensuring the safe and effective use of psychotropic medications, offering expertise in drug selection, dosing, monitoring, and assessing medication adherence. Their involvement in medication reconciliation and management of drug interactions can significantly enhance patient safety and optimize treatment outcomes. Moreover, pharmacists can provide valuable education to patients and caregivers regarding medication adherence, potential side effects, and strategies for managing adverse reactions, thereby promoting medication compliance and improving overall treatment efficacy. Furthermore, the integration of pharmacists within collaborative care teams has demonstrated promising outcomes in the delivery of holistic mental health services. Through their interdisciplinary collaboration, pharmacists facilitate effective communication among healthcare providers, enabling comprehensive treatment planning and the identification of potential pharmacotherapeutic interventions. This collaborative approach fosters a patient- centered care model, emphasizing the importance of individualized treatment plans tailored to each patient’s unique needs and preferences. Additionally, the expanding role of pharmacists in mental health screenings, early intervention initiatives, and community-based support programs serves to promote mental health awareness and reduce the stigma associated with mental illness. By actively engaging with patients and communities, pharmacists contribute to the development of accessible mental health services and resources, thereby fostering a more inclusive and supportive healthcare environment.

BackgroundWearable devices (WDs) have evolved beyond simple fitness trackers to sophisticated health monitors capable of measuring vital signs, such as heart rate and blood oxygen levels. Their application in health care, particularly medication management, is an emerging field poised to significantly enhance patient adherence to treatment regimens. Despite their widespread use and increasing incorporation into clinical trials, a comprehensive review of WDs in terms of medication adherence has not been conducted.ObjectiveThis study aimed to conduct a comprehensive scoping review to evaluate the impact of WDs on medication adherence across a variety of diseases, summarizing key research findings, outcomes, and challenges encountered.MethodsAdhering to PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines, a structured search was conducted across MEDLINE, Web of Science, and Embase databases, covering the literature from January 1, 2010, to September 30, 2022. The search strategy was based on terms related to WDs and medication adherence, specifically focusing on empirical studies to ensure the inclusion of original research findings. Studies were selected based on their relevance to medication adherence, usage of WDs in detecting medication-taking actions, and their role in integrated medication management systems.ResultsWe screened 657 articles and identified 18 articles. The identified studies demonstrated the diverse applications of WDs in enhancing medication adherence across diseases such as Parkinson disease, diabetes, and cardiovascular conditions. The geographical distribution and publication years of these studies indicate a growing interest in this research area. The studies were divided into three types: (1) studies reporting a correlation between data from WDs or their usage and medication adherence or drug usage as outcomes, (2) studies using WDs to detect the act of medication-taking itself, and (3) studies proposing an integrated medication management system that uses WDs in managing medication.ConclusionsWDs are increasingly being recognized for their potential to enhance medication management and adherence. This review underscores the need for further empirical research to validate the effectiveness of WDs in real-life settings and explore their use in predicting adherence based on activity rhythms and activities. Despite technological advancements, challenges remain regarding the integration of WDs into routine clinical practice. Future research should focus on leveraging the comprehensive data provided by WDs to develop personalized medication management strategies that can improve patient outcomes.