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      Changing practice: assessing attitudes toward a NICE-informed collaborative treatment pathway for bipolar disorder

      research-article
      , , , ,
      BJPsych Open
      Cambridge University Press
      Bipolar affective disorders, qualitative research, e-pathway, care pathway, change management

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          Abstract

          Background

          Bipolar disorder is a chronic mental health condition, which can result in functional impairment despite medication. A large evidence base supports use of psychological therapies and structured care in the treatment of mood disorders, but these are rarely implemented. e-Pathways are digital structures that inform and record patient progress through a healthcare system, although these have not yet been used for bipolar disorder.

          Aims

          To assess the perceived benefits and costs associated with implementing a collaborative NICE-informed e-pathway for bipolar disorder.

          Method

          Healthcare professionals and people with bipolar disorder attended a workshop to share feedback on e-pathways. Data were collected through questionnaires ( n = 26) and transcription of a focus group, analysed qualitatively by a framework analysis.

          Results

          Patients and healthcare professionals welcomed the development of an e-pathway for bipolar disorder. There were five elements to the framework: quality and delivery of care, patient–clinician collaboration, flexibility and adaptability, impact on staff and impact on healthcare services.

          Conclusions

          Identification of benefits and costs ensures that future development of e-pathways addresses concerns of healthcare professionals and people with bipolar disorder, which would be essential for successful implementation. Recommendations for this development include making e-pathways less complicated for patients, ensuring sufficient training and ensuring clinicians do not feel their skills become invalidated. Limitations of the study, and directions for future research, are discussed.

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          Most cited references34

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          Using the framework method for the analysis of qualitative data in multi-disciplinary health research

          Background The Framework Method is becoming an increasingly popular approach to the management and analysis of qualitative data in health research. However, there is confusion about its potential application and limitations. Discussion The article discusses when it is appropriate to adopt the Framework Method and explains the procedure for using it in multi-disciplinary health research teams, or those that involve clinicians, patients and lay people. The stages of the method are illustrated using examples from a published study. Summary Used effectively, with the leadership of an experienced qualitative researcher, the Framework Method is a systematic and flexible approach to analysing qualitative data and is appropriate for use in research teams even where not all members have previous experience of conducting qualitative research.
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            Qualitative data analysis for applied policy research

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              The need for a new medical model: a challenge for biomedicine.

              The dominant model of disease today is biomedical, and it leaves no room within tis framework for the social, psychological, and behavioral dimensions of illness. A biopsychosocial model is proposed that provides a blueprint for research, a framework for teaching, and a design for action in the real world of health care.
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                Author and article information

                Journal
                BJPsych Open
                BJPsych Open
                BJO
                BJPsych Open
                Cambridge University Press (Cambridge, UK )
                2056-4724
                March 2021
                08 March 2021
                : 7
                : 2
                : e64
                Affiliations
                [1]Translational and Clinical Research Institute, Newcastle University , UK
                [2]Translational and Clinical Research Institute, Newcastle University , UK; and North Locality, Central Business Unit, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust , UK
                [3]Translational and Clinical Research Institute, Newcastle University , UK; and North Locality, Central Business Unit, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust , UK
                [4]North Locality, Central Business Unit, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust , UK
                [5]Faculty of Health Sciences and Wellbeing, University of Sunderland , UK
                Author notes
                Correspondence: Stuart Watson. Email: stuart.watson@ 123456ncl.ac.uk
                Author information
                https://orcid.org/0000-0002-2558-3367
                Article
                S2056472421000223
                10.1192/bjo.2021.22
                8058910
                33678215
                7ccff0c8-9e01-4440-9875-67d55466829e
                © The Author(s) 2021

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 06 November 2020
                : 01 February 2021
                : 07 February 2021
                Page count
                Figures: 1, Tables: 1, References: 35, Pages: 7
                Categories
                Mental Health Services
                Papers

                bipolar affective disorders,qualitative research,e-pathway,care pathway,change management

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