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The British Journal of Psychiatry (2000) 177: 319-324
© 2000 The Royal College of Psychiatrists

Patient-held shared care records for individuals with mental illness

Randomised controlled evaluation

JAMES P. WARNER, MD

Department of Old Age Psychiatry, Imperial College School of Medicine, London

MICHAEL KING, PhD, ROBERT BLIZARD, MSc, ZARA McCLENAHAN, MB and SYLVIA TANG, MB

Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, London

Correspondence: Dr James Warner, Department of Old Age Psychiatry, Imperial College School of Medicine, St Charles Hospital, Exmoor St, London W10 6DZ, UK. Tel: 020 8962 4105; e-mail: j.warner{at}ic.ac.uk

Declaration of interest None.

Background Few formalised shared care schemes exist within psychiatry and the evidence base for sharing psychiatric care is weak.

Aims To evaluate the utility of patient-held shared care records for individuals with long-term mental illness.

Method Cluster-randomised controlled parallel-group 12-month trial involving 90 patients with long-term mental illness drawn from 28 general practices.

Results Carrying a shared care record had no significant effect on mental state or satisfaction with psychiatric services. Compared with controls, patients in the shared care group were no more likely to be admitted (relative risk 1.2, 95% Cl 0.86-1.67) and attend clinic (relative risk 0.96, 95% Cl 0.67-1.36) over the study period. Uptake of the shared care scheme was low by patients and professionals alike. Subjects with psychotic illness were significantly less likely to use their records (relative risk 0.51, 95% Cl 0.27-0.99).

Conclusions Patient-held records may not be helpful for patients with long-term mental illness.




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