Grant: Knowledge Synthesis Grant

Managing complexity in psychiatric and medical care: a systematic review of the effectiveness of interventions to improve health outcomes in people living with schizophrenia and chronic medical conditions

<html> <body> <p>This research will advance knowledge in an area that is a challenge to the health care system: providing quality psychiatric <em>and</em> medical care to individuals with schizophrenia (SCZ), who are at high risk of poor outcomes in both areas.&nbsp;</p> <p>There are significant gaps in knowledge on interventions and processes of care to manage the complexity of medical and psychiatric comorbidities. This systematic review will synthesize the impact of interventions on the mental and physical health of individuals with SCZ.</p> <p>The demand for this evidence is high among health system stakeholders, who&nbsp;require an evidence base to develop interventions. Since the evidence in this area is small but growing, we will look at broad categories of interventions (behavioural, pharmacological, psychosocial, educational, process of care, and multicomponent interventions) to create as a one-stop knowledge base.</p> <p>SCZ is an ideal condition to study the complexity involved with managing multimorbidity because it is associated with significant medical comorbidity.&nbsp;A SCZ diagnosis is associated with a reduced life span of approximately two decades.&nbsp;The majority of early mortality is caused by medical comorbidity, particularly cardiovascular disease.&nbsp;</p> <p>The main objectives of this review are: to provide a comprehensive synthesis of treatment approaches and models of care to improve the quality of care and health outcomes of individuals with SCZ and any CMC; and to make the results available to key stakeholders through a comprehensive knowledge translation strategy to facilitate the uptake of evidence in organizations with a mandate to improve care for this population.</p> <p>This proposal includes knowledge users who represent the target audiences for this review: clinicians, policy-makers, community agencies and other researchers. Specifically, the Medical Psychiatry Alliance&nbsp;involves four major Ontario institutions and is partially funded by the Ontario Ministry of Health and Long-term Care, whose goal is to improve the quality of lifeand increase life expectancy for those with serious, simultaneous mental and physical illnesses while reducing the burden of illness. The MOHLTC is in the process of developing and implementing an Adult Mental Health Strategy, and has also launched HealthLinks,&nbsp;a province-wide initiative to deliver coordinated and integrated care to people with complex needs (among whom people with SCZ and medical comorbidity are prototypical).</p> <p>In addition to academic publications, a variety of outputs are planned to disseminate findings including: lay summaries for non-research audiences; co-presentations with knowledge users and their organizations; and webinars through provincial and national mental health networks based at CAMH (the Evidence Exchange Network and Portico).</p> </body> </html>