How digital therapies can help treat anxiety and depression

NICE is to start assessing new digital therapies that will help treat more people with anxiety and depression.

Guided self-help, which can track people’s mood or advise on breathing exercises for example, is recommended by NICE guidance to help treat mild to moderate anxiety and depression.

As part of NHS England’s Improving Access to Psychological Therapies (IAPT) programme, NICE has been asked to assess digital applications or computer programmes, which will sit alongside face-to-face, phone and online therapy.

Developers of therapy applications are being invited to submit their product to NICE to see if it meets the criteria to be entered into the new programme.

An eligible product will be assessed by NICE for its content, how effective it is at treating anxiety and depression, how cost effective it is and whether it complies with technical NHS standards.

NICE will then produce an IAPT assessment briefing (IAB) on the product which will be looked at by an expert panel, made up of mental health clinicians, statisticians, an economist and a patient representative.

They will look at NICE’s briefing and make a decision on whether the product can be recommended for real-life testing in selected IAPT services, where further evidence can be collected on its effectiveness.

Read more via NICE

Learning from technological innovation in the vanguards

Helen Arthur, Harnessing Technology Lead, New Care Models Programme at NHS England, talks about how the vanguards are applying technology, and how other areas can learn from their challenges and successes. | via The Kings Fund

Related event: Digital Health and Care Congress 2017: Embedding technology in health and social care

Related publication: A digital NHS? An introduction to the digital agenda and plans for implementation

 

IT intervention to support medicine optimisation in primary care

Jeffries, M. et al. (2017) Understanding the implementation and adoption of an information technology intervention to support medicine optimisation in primary care: qualitative study using strong structuration theory. BMJ Open. 7:e014810

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Objectives: Using strong structuration theory, we aimed to understand the adoption and implementation of an electronic clinical audit and feedback tool to support medicine optimisation for patients in primary care.

Conclusions: Successful implementation of information technology interventions for medicine optimisation will depend on a combination of the infrastructure within primary care, social structures embedded in the technology and the conventions, norms and dispositions of those utilising it. Future interventions, using electronic audit and feedback tools to improve medication safety, should consider the complexity of the social and organisational contexts and how internal and external structures can affect the use of the technology in order to support effective implementation.

Read the full article here

Towards evidence-based emergency medicine

Horner, D. (2017) Emergency Medicine Journal. 34(5) pp. 331-334.

BestBETS

Image source: BEstBETS

Best Evidence Topic reports (BETs) summarise the evidence pertaining to particular clinical questions. They are not systematic reviews, but rather contain the best (highest level) evidence that can be practically obtained by busy practicing clinicians. The search strategies used to find the best evidence are reported in detail to allow clinicians to update searches whenever necessary. Each BET is based on a clinical scenario and ends with a clinical bottom line which indicates, in the light of the evidence found, what the reporting clinician would do if faced with the same scenario again.

The BETs published below were first reported at the Critical Appraisal Journal Club at the Manchester Royal Infirmary or placed on the BestBETs website. Each BET has been constructed in the four stages that have been described elsewhere. The BETs shown here together with those published previously and those currently under construction can be seen at http://www.bestbets.org. Two BETs are included in this issue of the journal.

Read the full abstract here

Mental health patients to benefit from new digital services

Seven areas across England are set to trail-blaze digital services for mental health patients, which will include innovative apps to improve care and online access to ‘real-time’ patient records. | NHS England

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NHS England has announced funding for seven mental health trusts to enable them to pioneer digital services for mental health patients.  It is intended that all key professionals involved in a patient’s care have access to real-time records – from triage and initial assessment, through to admissions or referrals, as well as transfer between services and follow up care.

The trusts will also develop remote, mobile and assistive technologies to empower patients to manage their conditions and enable family and carers to provide the best possible support.

The trusts will have up to £70m to invest in digital services – consisting £35m with additional match funding from themselves of £35m – in order to become ‘Global Digital Exemplars for Mental Health’ helping the organisations become world-leading in the use of IT, providing knowledge and expertise to the wider NHS in order to reduce time and costs for others.

This is all part of the NHS’ plan to harness technology to improve services and become more efficient.

Information and Digital Technologies: Clinical Requirements 2020

Breakthroughs in the use of data and technology are changing the way we live our lives. Adaptation of these changes has been relatively slow in healthcare, but there is now an increasing focus on learning how to use these technologies to improve the way we deliver care for our patients | Academy of Royal Medical Colleges

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Image source: AoMRC

Policy developments in the digital agenda at a national level have been supported by the Academy of Medical Royal Colleges setting out its vision for NHS information systems in 2013 and the National Information strategy for a digital NHS in 2014.

The aim of this document is to ensure that clinical priorities are met and reflected at a national level. It is the list of clinical requirements setting out what information and communication technologies clinicians would expect in 2020 in the work environment. These standards have been designed to establish a level of detail that will inform decision-making and enable accountability.

As 2020 approaches Clinicians should see the tangible areas of improvement in data and technology and use it to modernise and improve the quality of care we are able to deliver for our patients.

Read the full report here

Telecare is more than just technology – it has the power to create care networks for older people

Telecare is a range of remote care technologies and associated services that have been developed to accommodate an ageing population while helping people to stay in their homes | The Conversation

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Image source: Moyan Brenn – Flickr // CC BY 2.0

Over the next 25 years, the percentage of people aged over 85 is set to more than double, with one in four in this age group already counting as “frail”. In the over 65s, this is estimated at one in ten. At the same time, the number of people, such as family, who might be caregivers is reducing due to different patterns of marriage and parenting, people living apart at greater distances and more women in paid employment.

Traditionally, elderly people who need care in their own homes rely on paid or unpaid carers. Telecare can be thought of as a form of care at a distance, which can allow older and frailer people to live independently. While some might see a risk of decreasing social contact, it can provide safety and security to those people who because of mobility problems and other health issues are housebound. Telecare should be considered as an aid, not a solution to growing demands for care.

Telecare can provide some care on a personal level through attachments that can develop between users and telephone operators, who regularly check in with the telephone operators for weekly test calls.

Read the full blog post here