Understanding the barriers affecting psychologists’ adherence to evidence-based treatment guidelines from a stakeholder standpoint

2019 ◽  
Vol 25 (2) ◽  
pp. 47-62
Author(s):  
Tahira Haider ◽  
Debra Dunstan
Keyword(s):  
Treatment Guidelines ◽  
New South ◽  
Musculoskeletal Injuries ◽  
Psychological Services ◽  
Psychological Injury ◽  
Evidence Based ◽  
Evidence Based Treatment ◽  
South Wales ◽  
Evidence Based Guidelines ◽  
Injured Patients

AbstractPsychologists’ adherence with evidence-based guidelines based on the biopsychosocial premise in the management of musculoskeletal injuries is influenced by the actions by General Practitioners (GPs), insurers, and injured patients’ actions. For data collection, we interviewed GPs (n = 6), insurers (n = 6), and injured people (n = 15) from the two personal injury compensation schemes in New South Wales. Thematic analysis yielded the following: GPs were reticent to access psychological services that represented a poor fit between their practice and treatment guidelines, insurers lacked trust in the validity of “secondary psychological injury” claims’. Injured peoples’ willingness to engage with treatment was impaired by a poor fit between the treatment guidelines and their experience of insurers’ and psychologists’ practices.

scholarly journals Understanding processes of criminalisation: Insights from an Australian study of criminal law-making

2019 ◽  
pp. 174889581986851 ◽  
Author(s):  
Luke McNamara ◽  
Julia Quilter ◽  
Russell Hogg ◽  
Arlie Loughnan ◽  
Heather Douglas ◽  
...  
Keyword(s):  
Pilot Study ◽  
Criminal Law ◽  
Analytical Approach ◽  
New South ◽  
Democratic Participation ◽  
Evidence Based ◽  
Australian Study ◽  
South Wales ◽  
Methodological Tool ◽  
Law Making

Criminalisation theory scholars have examined important questions regarding what behaviours should be criminalised and why. More recently, greater attention has been paid to linking normative accounts with empirical and historicised analyses of criminalisation practices. Building on recent work on modalities of criminalisation as a methodological tool for contextual criminalisation research, this article introduces a second analytical approach for better understanding how criminal laws are made: processes of criminalisation. We discuss the findings of a pilot study of 143 criminal law statutes enacted in three Australian jurisdictions (New South Wales, Queensland, Victoria) from 2012–2017. We conclude that a processes approach supports a nuanced appreciation of the conditions under which criminal law statutes are produced, and facilitates scrutiny of whether legislative enactments are evidence-based and a product of meaningful consultation and genuine democratic participation in law-making.

Treatment of interictal psychiatric disorder in epilepsy. I. Affective and anxiety disorders

2002 ◽  
Vol 14 (1) ◽  
pp. 39-43 ◽  
Author(s):  
Cm van der Feltz-Cornelis
Keyword(s):  
Anxiety Disorders ◽  
Psychiatric Disorder ◽  
Affective Disorders ◽  
Treatment Guidelines ◽  
Systematic Research ◽  
Evidence Based ◽  
Evidence Based Treatment ◽  
General Psychiatry ◽  
Dsm Iv ◽  
Patients With Epilepsy

Background:Interictal affective disorders are common in patients with epilepsy and there is a need for evidence-based treatment guidelines.Objective:This paper gives an overview of research concerning treatment of interictal affective disorders and interictal anxiety disorders in epilepsy.Methods:Literature review supplemented by clinical experience.Results:Interictal psychiatric disorder can be characterized as intermittent pleomorphic psychopathology. The most common manifestations are interictal dysphoric disorder (IDD) and depression. There is a lack of randomized control trials (RCTs) concerning effectiveness and side-effects of antidepressants in epilepsy patients.Conclusion:Treatment implications of the concept of IDD and other interictal disorders are an optimized dosage of anti-epileptics in combination with antidepressants. This coincides with recent guidelines concerning combinations of psychotropic medication, such as for depression and bipolar disorder, in general psychiatry. Systematic research involving the DSM-IV categories of generalized anxiety disorder, panic disorder and agoraphobia and depression is not yet available. Prevalence and treatment of interictal anxiety disorders and depressive disorder in epilepsy should be the subject of further research, in order to enable development of evidence-based treatment guidelines for these disorders in epilepsy patients.

The importance of quality transition processes for students with disabilities across settings: Learning from the current situation in New South Wales

2014 ◽  
Vol 58 (3) ◽  
pp. 318-336 ◽  
Author(s):  
Iva Strnadová ◽  
Therese M Cumming
Keyword(s):  
Developmental Disabilities ◽  
Secondary School ◽  
Students With Disabilities ◽  
New South ◽  
New South Wales ◽  
Transition Process ◽  
Evidence Based ◽  
School Life ◽  
Transition Processes ◽  
South Wales

This article examines the current state of the transition process for students with developmental disabilities in New South Wales, Australia. Teachers from 75 schools were surveyed about current practices for students with developmental disabilities transitioning from primary to secondary school and from secondary school to post-school life. Teachers' responses to the open-ended survey questions were analysed using inductive content analysis. The results of the analysis revealed that although many schools had transition processes in place, such as school visits and orientation programs, many key evidence-based practices were missing. Key themes that emerged included school-specific transition practices at each level and the importance of home–school collaboration. Overall results indicated a need for a mandated, student-centred planning and support process, guided by evidence-based practice.

PTSD Treatment of African American Adults in Primary Care: The Gap Between Current Practice and Evidence-Based Treatment Guidelines

2011 ◽  
Vol 103 (7) ◽  
pp. 585-593 ◽  
Author(s):  
Ruth Elaine Graves ◽  
John R. Freedy ◽  
Notalelomwan U. Aigbogun ◽  
William B. Lawson ◽  
Thomas A. Mellman ◽  
...  
Keyword(s):  
Primary Care ◽  
African American ◽  
Current Practice ◽  
Treatment Guidelines ◽  
Evidence Based ◽  
Evidence Based Treatment ◽  
Ptsd Treatment ◽  
African American Adults

Anticoagulant Use in Real Time

2012 ◽  
Vol 26 (3) ◽  
pp. 270-279 ◽  
Author(s):  
Divyamani Srinivasan ◽  
Bree Watzak
Keyword(s):  
Treatment Guidelines ◽  
Trauma Surgery ◽  
The United States ◽  
Pharmacy Education ◽  
Bleeding Complications ◽  
Clinical Aspects ◽  
Evidence Based ◽  
Inherited Disorders ◽  
Reversal Agents ◽  
Evidence Based Guidelines

Venous thromboembolism (VTE) encompasses deep vein thrombosis (DVT) and pulmonary embolism (PE). Each year, VTE affects about 300 000 to 600 000 people in the United States, and death is the first manifestation in one-fourth of this population.1{Beckman, 2010 #79} Moreover, approximately 10% of the US population has genetic factors that increase their risk for developing thrombosis.1 In addition to inherited disorders, factors that contribute to VTE include prolonged immobilization, trauma, surgery, cancer, and critically ill patients.2 Routine assessment and prophylaxis are recommended in these groups to avoid DVT-related complications.2 Anticoagulants are the mainstay of drugs used in DVT/PE prevention and treatment. Despite the availability of evidence-based guidelines for anticoagulant therapy, there is suboptimal implementation of DVT prophylaxis in hospitalized patients.3 All anticoagulants are “high-alert” drugs, and judicious use is mandatory to prevent bleeding complications.4 This review discusses treatment guidelines, monitoring, side effects, and reversal agents available for some anticoagulant drugs approved for VTE. Dissemination of the knowledge via pharmacy education programs significantly improves the adherence to VTE prophylaxis.5 Understanding the clinical aspects of anticoagulant dispensing as presented in this review is hoped to facilitate implementation of the theoretical knowledge as well as evidence-based guidelines in order to maximize patient benefit.

Psychosocial Factors and Diabetes Mellitus: Evidence-Based Treatment Guidelines

2005 ◽  
Vol 1 (3) ◽  
pp. 255-270 ◽  
Author(s):  
Frank Petrak ◽  
Stephan Herpertz ◽  
Christian Albus ◽  
Axel Hirsch ◽  
Bernhard Kulzer ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Psychosocial Factors ◽  
Treatment Guidelines ◽  
Evidence Based ◽  
Evidence Based Treatment

scholarly journals Primary Care Clinician perspectives on ADHD care and suggestions for improvement initiatives

2020 ◽  
Author(s):  
Sean O'Dell ◽  
Matthew J. Gormley ◽  
Victoria Schlieder ◽  
Tracey Klinger ◽  
Kathy DeHart ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Systems ◽  
Treatment Guidelines ◽  
Behavioral Health Care ◽  
Screening Tools ◽  
Care Process ◽  
Future Research ◽  
Evidence Based ◽  
Evidence Based Guidelines ◽  
Current Practices

Abstract Background and Objectives: Despite efficacious treatments and evidence-based guidelines, youth coping with attention deficit hyperactivity disorder (ADHD) receive suboptimal care. Primary care clinicians (PCCs) are frontline providers of ADHD care; however, little is known about PCC perspectives regarding this care gap and how to effectively address it within health systems. We investigated PCC perspectives on determinants of pediatric ADHD care and considerations for improving adherence to evidence-based guidelines. Methods: Semi-structured qualitative interviews were conducted with 26 PCCs representing clinics within a health system on improving adherence to treatment guidelines for pediatric ADHD. Interview guides were based on the Pragmatic Robust Implementation and Sustainability Model (PRISM) to elicit PCC views regarding determinants of current practices and suggestions to guide improvement efforts. We used thematic analysis to identify patterns of responding that were common across participants.Results: We identified 12 themes categorized into two broad domains: Status Quo of Pediatric ADHD Care and Supporting and Constraining Factors for Improvement Initiatives. PCCs identified several internal and external contextual factors as determinants of current practices. Of note, PCCs reported they face challenges at multiple steps in the care process, including mental health stigma, coordinating care across settings, clinical productivity pressures, access to behavioral health care, and insurance mandates regarding medications. PCCs recommended efficient continuing education trainings accompanied by improvements to the electronic health record to include validated screening tools and documentation templates.Conclusions: Future research triangulating these findings may help to more efficiently improve the quality of pediatric ADHD care in health systems.

scholarly journals Better access to psychology services in primary mental health care: an evaluation

2006 ◽  
Vol 30 (2) ◽  
pp. 195 ◽  
Author(s):  
Sanjyot Vagholkar ◽  
Lesley Hare ◽  
Iqbal Hasan ◽  
Nicholas Zwar ◽  
David Perkins
Keyword(s):  
Mental Health ◽  
Health Care ◽  
General Practice ◽  
Mental Health Care ◽  
Patient Outcomes ◽  
New South ◽  
Psychological Services ◽  
South Wales ◽  
The University ◽  
Program Data

Introduction: The Access to Allied Psychological Services program was introduced as part of the Better Outcomes in Mental Health Care initiative in 2001?2002. Divisions of General Practice are funded to establish programs that allow GPs to refer patients for psychological treatments. The University of New South Wales evaluated programs run by the Southern Highlands and Illawarra Divisions of General Practice. This paper presents the findings of these evaluations. Method: Both evaluations analysed process and patient outcomes. This was obtained from a combination of program data and qualitative satisfaction data. Results: The two program models differed in the mechanism of retention of the psychologists and the method of referral of patients. Anxiety and depression were the main reasons for referral, and clinical data showed there was improvement in patient outcomes. Patients, GPs and psychologists expressed satisfaction with the programs. Discussion: The Access to Allied Psychological Services programs in both Divisions have proven popular. Flexibility in the program structure allows Divisions to develop a model which suits their local circumstances. There is support for ongoing Commonwealth funding and the challenge is to find the most effective and financially sustainable model of delivery for psychological services in primary care.

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