P Bower

..We present preliminary data on the psychometric performance of the PACIC in a large sample of UK patients with long-term conditions...

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..Our objective was to describe patient pathways through stepped care services and the impact of this on patient flow and management...

..This forms the basis of a novel approach to understanding, designing, and implementing new forms of self-management support...

..This study utilises the Normalisation Process Model (NPM) to inform the process of implementation of collaborative care in both a future full-scale trial, and the wider health economy...

..This paper (a) describes the modelling phase used to develop a guided self-help intervention for depression in primary care and (b) reports data from an exploratory randomised trial of the intervention...

..A robust test of recruitment methods involves comparing alternative methods using a randomized trial, 'nested' in an ongoing 'host' trial. There are potential scientific, logistical and ethical obstacles to such studies...

..The potential of telehealth and telecare technology to improve care and reduce costs is limited by a lack of rigorous evidence of actual impact...

..This study therefore reviewed the efficacy of (i) feedback of real patient assessments of interpersonal care skills, (ii) brief training focused on the improvement of interpersonal care (iii) interventions combining both (i) and (ii)..

..In this paper we describe our methodological approach to managing multiple and diverse sources of evidence, within a research programme to increase equity of access to high quality mental health services in primary care...

..In line with current guidance on the development of complex interventions, our aim was to develop and refine the initial intervention using qualitative methods, prior to more formal evaluation...

..This paper describes the development of the GPAQ (with post-consultation and postal versions) and presents a preliminary examination of the psychometric properties of the questionnaire...

..The third such annual survey (2008/9) involved the development of a new survey instrument. We describe the process of that development, and the findings of an extensive pilot survey in UK primary healthcare...

..Primary care professionals often manage patients with multiple long-term health conditions, but managing multimorbidity is challenging given time and resource constraints and interactions between conditions...

..The prevalence of mental health and psychosocial problems in primary care is high. This review examines the clinical and cost-effectiveness of psychological therapies provided in primary care by counsellors...

..Recruitment to health research is known to be problematic. However, evidence concerning ways of improving recruitment is sparse...

..quot;Collaborative care" interventions are effective, but little is known about which aspects of these complex interventions are essential...

..The robustness of these findings is considered within the context of study strengths and weaknesses, and implications for future research are discussed...

..This study sought to examine the association between self-report measures of climate and culture in primary care teams and comprehensive measures of quality of care...

..To examine patients' views on access and continuity in general practice to derive quality standards...

..To determine whether practice structure (for example, list size, number of staff) predicts team processes and whether practice structure and team process in turn predict team outcomes..

..Patients' priorities for these different issues need to be understood, but the optimal methods for assessing priorities are unclear. This study used a discrete choice experiment to assess patients' priorities...

..A randomised controlled trial has demonstrated effectiveness in improving subjective health. However, it is not known whether particular patient characteristics predict the impact of the course...

..Patients may benefit from information and a referral process, which emphasises the centrality of self-efficacy and the patient as 'change agent' prior to referral...

..Each model provides different advantages and disadvantages in terms of the four dimensions of outcome...

..A significant programme of research is required if the potential for child and adolescent mental health services in primary care is to be realized in an effective and efficient way...

..Issues raised during the early stages of implementation may have important implications for the preparation and development of professionals who undertake the role...

..However, to be effective, such interventions must be acceptable to patients...

..Greater conceptual specificity and simplification are required for meaningful, reliable measurement. The implications for research, and for assessing the quality of individual doctors' 'interpersonal' care are discussed...

..Regression indicates that the bias reflects both effects and should be considered when GPAS scores are being interpreted...

..Given that multiple professionals are involved in mental health care in primary care, issues relating to roles are likely to be crucial in the effective implementation of the new PCMHWs...

..However, the available evidence is limited in quantity and quality and more rigorous trials are required to provide more reliable estimates of the clinical and cost-effectiveness of these treatments...

..CONCLUSION: Counselling is associated with modest improvement in short-term outcome compared with usual general practitioner care, and thus may be a useful addition to mental health services in primary care...

..Methods of encouraging work across domains are discussed...

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..This paper is a report of a study to explore practice nurse involvement in facilitation of self-management for long-term conditions...

..There is limited evidence concerning factors associated with enablement in UK general practice...

..This exploratory study aimed to determine what factors predict productivity, intention to continue tutoring, and satisfaction in a sample of volunteer tutors from the Expert Patients Programme...

..e. patient factors that were associated with the impact of the intervention)...

..This review aimed to determine the clinical effectiveness of remotely communicated, therapist-delivered psychotherapy...

..Computerized decision aids have the potential to increase patient involvement in the decision-making process. However, most published evidence concerning the effectiveness of decision aids is from secondary care...

..Responding effectively to patient preferences requires a clear understanding of the way in which patients assess primary care services...

..To examine the feasibility of telephone-delivered cognitive behavioral therapy (T-CBT) in an occupational context, with reference to participant recruitment, treatment adherence, follow-up and effect...

..Assistant psychologists delivered a guided self-help intervention to patients with anxiety and depression who were currently waiting for psychological therapy...

..To understand social processes underpinning support for self-management of long-term conditions in primary care...

..There is a need for appropriate, low-cost, non-medical interventions for many individuals. Befriending is an emotional support intervention commonly offered by the voluntary sector...

..However, the clinical and cost effectiveness of such courses remains unclear...

..The aim of this study was to examine retention and future job intentions of graduate PCMHWs at the end of their one-year training...

..These anxieties are exacerbated in a context where citizenship is increasingly being defined in terms of consumer identities, and making good (health) choices might be seen as distinguishing the civilised from the marginalised...

..However, the design of effective self-help interventions is complex. Qualitative research can help to explore some of this complexity...

..However, changes to the way professionals deliver care is complex, and it is important to understand the key drivers and barriers that may operate in the primary care setting...

..Recruitment requiring GPs to gain patient consent was significantly associated with recruitment problems. The data may be useful in the wider drive to improve recruitment in primary care...

..Two main approaches to measurement are evaluated: self-report instruments and external observation methods. A number of recommendations concerning the measurement of patient-centredness are made...

..The present study sought to investigate the influence of symptom attribution style on the recognition of psychiatric morbidity by general practitioners (GPs)...

..To review the published literature concerning the effects of on-site mental health professionals on general practitioners' management of mental health...

..e. moderators of effect). This study sought to determine whether the content of self-help interventions, the study populations or aspects of study design were the most important moderators...

..To assess the feasibility of overcoming sample size limitations in economic analyses of clinical trials through meta-analysis of data on individual patients from multiple trials...

..Key lessons concerning preferences in this patient population and related issues in trial administration are then discussed...

..The General Practice Assessment Survey (GPAS) is a widely used measure. However, it is important that the measures used are valid and interpretable. Factor analysis is a useful method to assist in validation...

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..Although the current evidence base may be suggestive of a relationship between patient-centred consulting behaviour and patient outcomes, the case has not been made definitively...

..The paper then examines the implications of the model for informed consent and recruitment procedures. Key issues for future research are also outlined...

..Although this technique has significant potential in examining priorities, its use raises practical and conceptual issues. This paper describes the development of a DCE evaluating patient priorities in primary care...

..This systematic review sought to identify psychosocial interventions that could improve both the physical and mental health of patients with diabetes...

..One proposal to overcome this problem is to increase efficiency of provision through the adoption of briefer 'minimal interventions' within stepped care models...

..Decision-makers are likely to need to know whether these interventions are cost-effective in routine primary care settings...

..They reported similar levels of distress at baseline as patients in traditional psychological therapy services, and comparable outcomes. The self-help clinic approach should be evaluated formally within a randomised controlled trial...

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..However, randomly allocating patients to treatments that do not accord with their preferences may influence internal and external validity...

..To summarize current evidence on the effectiveness of different knowledge transfer and change interventions for improving primary and ambulatory anxiety care to provide guidance to professionals and policy-makers in mental health care...

..To examine whether randomized economic evaluations report clinical effectiveness estimates that are unrepresentative of the totality of the research literature...

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