Monday, June 20, 2016

Integrated Self-Management Interventions Appear Effective

Integrated self-management strategies are designed to help adults with serious mental illness understand, monitor, and manage both their psychiatric disorder and chronic general medical conditions. While previous studies have demonstrated the effectiveness of psychiatric self-management interventions in improving mental health outcomes for adults with serious mental illness, less is known of the effectiveness of integrated self-management interventions.

A systematic review of 15 studies that assessed nine integrated self-management interventions, recently published in Psychiatric Services in Advance, suggests that these approaches are feasible and have a high potential for clinical effectiveness.

The authors noted that “[s]elf-management interventions usually focus on a combination of three tasks: medical management (for example, teaching people how to follow through on treatment), role management (for example, encouraging healthy behaviors), and emotional management (for example, learning how to monitor symptoms and identify early warning signs of relapse). 

The review revealed that most of the studies established support for the feasibility, acceptability, and preliminary effectiveness of the intervention in regard to enhancing participants’ knowledge of self-management skills, promoting behavioral and attitudinal changes toward managing illnesses, reducing psychiatric symptoms, improving biological indicators of general medical illnesses (such as high blood pressure and weight), and reducing use of acute health services.

The authors cautioned that the impact of the interventions examined “may be limited because of the costly efforts of professional staff and the intensity and duration of these interventions.” They offered several intervention characteristics that may increase the potential for implementation, including greater use of remote technology-based interventions and hiring and training peers to deliver services.

“Our review expands on earlier reviews that focused on general medical self-management only and psychiatric self-management only by focusing on integrated interventions and identifying potential mechanisms to facilitate implementation,” the authors wrote. “Additional efforts are needed to further explore the potential of using emerging technologies to facilitate implementation and delivery of integrated psychiatric and general medical illness self-management programs across the usual clinical settings that serve this population.”

For related information, see the Psychiatric Services article “Organized Self-Management Support Services for Chronic Depressive Symptoms: A Randomized Controlled Trial.”

(Image: Alexander Raths/Shutterstock)

How Will MACRA Impact Your Practice?

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) permanently repealed the old Medicare SGR formula and set in motion entirely new programs for quality reporting and new payment models. What will this mean for your practice? On Wednesday, June 29, from noon to 1 p.m., APA will host a live, free webinar to educate you about several key features of MACRA. Click HERE to register for this event.


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