Integrating Psychiatric Services into Comprehensive Dementia Care in the Community

Hiroto Ito^1*, Hideyuki Hattori², Hiroaki Kazui³, Masamoto Taguchi⁴, Manabu Ikeda⁵

¹Department of Social Psychiatry, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
²National Center for Geriatrics and Gerontology, Aichi, Japan.
³Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan.
⁴Ogaki Hospital, Gifu, Japan.
⁵Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.

DOI: 10.4236/ojpsych.2015.52014                

Abstract

Purpose: This study was conducted to clarify the utility of patient-held records as an integrated care approach for patients with dementia in the community. Method: We analyzed the family-held/patient-held records of patients with dementia in the community. The inclusion criteria in the study were as follows: 1) patient-held/family member-held records of patients with dementia in the community; 2) patient-held records designed to share information across different professionals, direct-care staff members, and local government staff; and 3) the continuous participation of psychiatrists in the development and use of the patient-held records. Results: We identified eight sets of family-held/patient-held records in Japanese communities of various sizes, all of which were aimed at integrating information from various services, including information provided by medical and psychiatric professionals to the family and patient. Innovative tools have been available in the areas of the hopes and preferences of the patient, medication and monitoring, sharing information, and the use of information technology. Conclusion and Discussion: Family-held/patient-held records have potential as a tool to enhance the integrated care of people with dementia in the community.

Keywords

Dementia, Integrated Care, Patient-Held Medical Record, Psychiatry

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Reitz, C., Brayne, C. and Mayeux, R. (2011) Epidemiology of Alzheimer Disease. Nature Reviews Neurology, 7, 137-152. http://dx.doi.org/10.1038/nrneurol.2011.2
[2]	Kaneko, R., Ishikawa, A., Ishii, F., Sasai, T., Iwasawa, M., Mita, F., et al. (2008) Population Projections for Japan: 2006-2055 Outline of Results, Methods, and Assumptions. The Japanese Journal of Population, 6, 76-114. http://www.ipss.go.jp/webj-ad/webjournal.files/population/2008_4/05population.pdf.
[3]	Asada, T. (2014) Prevalence of People with Dementia in City Area and Care for Impairment in Daily Living. Final Report of Health and Labor Sciences Research Grant. http://www.tsukuba-psychiatry.com/wp-content/uploads/2013/06/H24Report_Part1.pdf.
[4]	Cheng, G., Huang, C., Deng, H. and Wang, H.. (2012) Diabetes as a Risk Factor for Dementia and Mild Cognitive Impairment: A Meta-Analysis of Longitudinal Studies. Internal Medicine Journal, 42, 484-491. http://dx.doi.org/10.1111/j.1445-5994.2012.02758.x
[5]	Pendlebury, S.T. and Rothwell, P.M. (2009) Prevalence, Incidence, and Factors Associated with Pre-Stroke and Post-Stroke Dementia: A Systematic Review and Meta-Analysis. The Lancet Neurology, 8, 1006-1018. http://dx.doi.org/10.1016/S1474-4422(09)70236-4
[6]	Santangeli, P., Di Biase, L., Bai, R., Mohanty, S., Pump, A., Brantes, M.C., et al. (2012) Atrial Fibrillation and the Risk of Incident Dementia: A Meta-Analysis. Heart Rhythm, 9, 1761-1768. http://dx.doi.org/10.1016/j.hrthm.2012.07.026
[7]	Coleman, E.A., Smith, J.D., Frank, J.C., Min, S.-J., Parry, C. and Kramer, A.M. (2004) Preparing Patients and Caregivers to Participate in Care Delivered across Settings: The Care Transitions Intervention. Journal of the American Geriatrics Society, 52, 1817-1825. http://dx.doi.org/10.1111/j.1532-5415.2004.52504.x
[8]	Elliott, J., Forbes, D., Chesworth, B.M., Ceci, C. and Stolee, P. (2014) Information Sharing with Rural Family Caregivers during Care Transitions of Hip Fracture Patients. International Journal of Integrated Care, 14, e018.
[9]	Ko, H., Turner, T., Jones, C. and Hill, C. (2010) Patient-Held Medical Records for Patients with Chronic Disease: A Systematic Review. Quality and Safety in Health Care, 19, e41. http://www.ncbi.nlm.nih.gov/pubmed/?term=Ko%2C+H.%2C+Turner%2C+T.%2C+Jones%2C+C.+and+Hill %2C+C.+(2010)+Patient-Held+Medical+Records+for+Patients+with+Chronic+Disease%3A+A+Systematic +Review.+Quality+and+Safety+in+Health+Care%2C+19%2C
[10]	Gysels, M., Richardson, A. and Higginson, I.J. (2007) Does the Patient-Held Record Improve Continuity and Related Outcomes in Cancer Care: A Systematic Review. Health Expectations, 10, 75-91. http://dx.doi.org/10.1111/j.1369-7625.2006.00415.x
[11]	Ito, H., Frank, R.G., Nakatani, Y. and Fukuda, Y. (2013) Mental Health Care Reforms in Asia: The Regional Health Care Strategic Plan: The Growing Impact of Mental Disorder in Japan. Psychiatric Services, 64, 617-619. http://dx.doi.org/10.1176/appi.ps.201200518
[12]	Farrelly, S., Brown, G.E., Flach, C., Barley, E., Laugharne, R. and Henderson, C. (2013) User-Held Personalised Information for Routine Care of People with Severe Mental Illness. Cochrane Database of Systematic Reviews, 10, Article ID: CD001711. http://dx.doi.org/10.1002/14651858.CD001711.pub2
[13]	Brunero, S., Lamont, S., Myrtle, L. and Fairbrother, G. (2008) The Blue Card: A Hand-Held Health Record Card for Mental Health Consumers with Comorbid Physical Health Risk. Australasian Psychiatry, 16, 238-243. http://dx.doi.org/10.1080/10398560801979222
[14]	Lester, H., Allan, T., Wilson, S., Jowett, S. and Roberts, L. (2003) A Cluster Randomized Controlled Trial of Patient-Held Medical Records for People with Schizophrenia Receiving Shared Care. British Journal of General Practice, 53, 197-203.
[15]	Stafford, A. and Hannigan, B. (1997) Client-Held Records in Community Mental Health. Nursing Times, 93, 50-51.
[16]	Warner, J.P., King, M., Blizard, R., Mcclenahan, Z. and Tang, S. (2000) Patient-Held Shared Care Records for Individuals with Mental Illness. British Journal of Psychiatry, 177, 319-324. http://dx.doi.org/10.1192/bjp.177.4.319
[17]	Ouwens, M., Wollersheim, H., Hermens, R., Hulscher, M. and Grol, R. (2005) Integrated Care Programmes for Chronically Ill Patients: A Review of Systematic Reviews. International Journal for Quality in Health Care, 17, 141-146. http://dx.doi.org/10.1093/intqhc/mzi016
[18]	Peisah, C., Sorinmad, O.A., Mitchell, L. and Hertogh, C.M.P.M. (2013) Decisional Capacity: Toward an Inclusionary Approach. International Psychogeriatrics, 25, 1571-1579. http://dx.doi.org/10.1017/S1041610213001014
[19]	Campbell, L.A. and Kisely, S.R. (2009) Advance Treatment Directives for People with Severe Mental Illness. Cochrane Database of Systematic Reviews, 1, Article ID: CD005963.
[20]	Folstein, M.F., Folstein, S.E. and McHugh, P.R. (1975) “Mini-Mental State”. A Practical Method for Grading the Cognitive State of Patients for the Clinician. Journal of Psychiatric Research, 12, 189-198. http://dx.doi.org/10.1016/0022-3956(75)90026-6
[21]	Lawton, M.P. and Brody, E.M. (1969) Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily Living. The Gerontologist, 9, 179-186. http://dx.doi.org/10.1093/geront/9.3_Part_1.179
[22]	Cummings, J., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D.A. and Gornbein, J. (1994) The Neuropsychiatric Inventory: Comprehensive Assessment of Psychopathology in Dementia. Neurology, 44, 2308-2314. http://dx.doi.org/10.1212/WNL.44.12.2308
[23]	Ito, H., Sugiura, S., Noda, H. and Higuchi, T. (2013) Creating an Online Patient Follow-Up System. Shakai Hoken Jyunpo, 2531, 10-14. (In Japanese) http://mhcnp.jp/pdf/130513_syakaiHokenJunpo.pdf
[24]	Ito, H., Setoya, Y. and Suzuki, Y. (2012) Lessons Learned in Developing Community Mental Health Care in East and South East Asia. World Psychiatry, 11, 186-190.
[25]	OECD (2010) Health Care Systems: Getting More Value for Money. OECD Economics Department Policy Notes, No. 2. http://www.oecd.org/eco/growth/46508904.pdf
[26]	Nakamura, Y. (2010) Maternal and Child Health Handbook in Japan. JMAJ: Japan Medical Association Journal, 53, 259-265. https://www.med.or.jp/english/journal/pdf/2010_04/259_265.pdf