new developments in imparts: integrating mental and physical healthcare: research training and...
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New developments in IMPARTS: Integrating Mental and Physical Healthcare: Research Training and ServicesWebsite: www.kcl.ac.uk/iop/depts/pm/research/imparts
Follow us on Twitter @IMPARTSP
IMPARTS - recap
AIM
To improve detection and management common mental disorders in medical settings
- web-based screening interface- patient-reported mental and physical health
outcome measurement- embedded in routine clinical practice - informs patient care and referral
Page 3
IMPARTS informatics screening system:
http://217.154.233.99/teleomedic2/resource/KCH/SCREENINGDEMO
IMPARTS – the wider context
Improve detection & management of symptom distress
Inform clinical decision-making
& promotes timely
interventionTrack change over time
Routine collection of
patient-reported outcomes Research databaseEvidence
generation
CLINICAL PRACTICE RESEARCH
Transformation of future care
POLICY
Identifying need & informing resource
allocation
Mental health
services in
general hospital
s
Mental health
training for
non- speciali
sts
The IMPARTS package
Implementation
Acceptability of screening
CLINIC Pts approached
Pts declining screening n (%)
Rheumatology 296 15 (5.1)
Limb reconstruction
177 7 (4.0)
Hepatitis C 31 1 (3.2)
Proportion of patients declining screening:
Depression (PHQ-9)
CLINIC Rheumatology n=432
Limb Reconstructionn=169
Hepatitis Cn=26
Probable Major Depression (MDD)
101 (23.4%) 36 (21.3%) 9 (34.6%)
Severe MDD with suicidal ideation
14 (3.2%) 7 (4.1%) 2 (7.7%)
Severe MDD without suicidal ideation
17 (3.9%) 6 (3.6%) 0
Moderate MDD 42 (9.7%) 17 (10.1%) 5 (19.2%)
Mild MDD 28 (6.5%) 6 (3.6%) 3 (11.5%)
Anxiety (GAD-7)
CLINIC Rheumatology n=432
Limb Reconstructionn=169
Hepatitis Cn=26
Probable Generalised Anxiety Disorder (GAD)
107 (24.8%) 33 (21.3%) 6 (23.0%)
Severe GAD 42 (9.7%) 20 (11.8%) 5 (19.2%)
Alcohol (AUDIT) & Drugs
CLINIC Limb Reconstructionn=169
Hepatitis Cn=26
Probable Alcohol Dependence
4 (2.4%) 0
Harmful drinking
0 1 (3.8%
Hazardous drinking
17 (10.1%) 1 (3.8%)
Probable Drug Dependence
4 (2.4%) 3 (11.5%)
Post-traumatic Stress Disorder PTSD (PCL-4)
Probable PTSD10.4%
Some symptoms22.0%
No problem67.6%
Limb Reconstruction (n=169)
IMPARTS Research Database
IMPARTS screening
data
EPR clinical &
demographic data
IMPARTS pseudonymised
Research Database
RESEARCHER
The database will bring together psychological & physical health outcomes into a single, searchable, anonymised data repository.
Limb reconstruction, rheumatology, Hepatitis C…
Research opportunities (1)
Trajectories of depression, anxiety, alcohol misuse in different clinical populations
Research opportunities (2)
Research opportunities (3)Outcomes of mental health problems in physically ill populations over time…
Depressed at T1
Depressed at T2
No depressio
n at T2
Can we predict likelihood of non-remission?
Research opportunities (4)
- Less social support- Unhelpful health beliefs- Unemployed- More pain
Consent for contact
• We have ethical approval to prospectively request consent for contact via the IMPARTS screening interface
“I agree to be contacted by a researcher to offer me the opportunity to take part in relevant research projects if they think
I may be a suitable participant”.
• It would then be possible to deanonymise patient records to allow researchers to contact potential trial participants –when explicit consent has been given
Yes No More information
Teaching programmes and self-help materials
• Claire Doyle• Katie Steel
• More on breathlessness and anxiety later
• Example of Limb Reconstruction service
Teaching programme
• Risk assessment and referral
• Managing anger
• Supporting adjustment
• Scheduling activity
• Increasing adherence
• Working with thought and expectations
Self-help materials
• Learning to control your anger
• Are you on edge?
• Coping and living well
• Depression: are you struggling?
• Keeping active
• Getting on with your life after a trauma
Other bespoke teaching programmes
• Respiratory ward
• Speech and language therapists
• Rheumatology nurses
Materials of general relevance
…and more specific
Emphasis on strengths
http://www.kcl.ac.uk/iop/depts/pm/research/
imparts/Ee-Self-help-materials.aspx
Join the IMPARTS mailing list
Subscribe at:
//mailman.kcl.ac.uk/mailman/listinfo/mentalphysicalhealthcareinterface
Email the group:
For more information on IMPARTS: [email protected]
IMPARTS module in Core Mental Health Skills
Delivered as part of Advanced Practice MSc module Open to all non-mental health specialists interested in
developing their skills Special introductory offer £499 5 interactive taught days with e-learning component (Jan-
Mar) For more info contact: [email protected]
Prof Matthew Hotopf - Project Lead
Email: [email protected]
Dr Lauren Rayner - Project Coordinator
Email: [email protected]
Ms Faith Matcham – Research Assistant
Email: [email protected]
Dr Jane Hutton – Consultant Clinical Psychologist
Email: [email protected]
Dr Rina Dutta – Consultant Psychiatrist
Email: [email protected]
Dr Katie Steel – Clinical Psychologist
Email: [email protected]
Project Team