TY - JOUR
AU - B. Kim
AU - J. K. Benzer
AU - M. K. Afable
AU - T. L. Fletcher
AU - Z. Yusuf
AU - T. L. Smith
A1 - 
AB - BACKGROUND, AIMS AND OBJECTIVES: This scoping review aimed to understand potential barriers and facilitators in transitioning patients from specialty to primary care settings, to inform the implementation of an intervention to promote active consideration of psychiatrically stable patients for transition from the specialty mental health setting back to primary care. METHODS: Guided by Levac and colleagues' six-stage methodological framework for conducting scoping studies, we systematically searched electronic article databases for peer-reviewed literature from January 2000 to May 2016. We included identified articles that discuss findings related to potential barriers and facilitators in transitioning patients from specialty to primary care settings. We performed descriptive and thematic analyses of results to generate emergent codes and their categorizations. RESULTS: Our database search yielded 906 unique articles, 23 of which we included in our scoping review. All but one of the included studies were conducted in North America. Identified potential barriers and facilitators spanned eight emergent themes-(i) primary care accessibility, especially in terms of timely availability of appointments, (ii) clarity in respective roles of specialty care and primary care in managing a patient, (iii) timely exchange of information, (iv) transition process management, (v) perceived ability of primary care providers to manage specialty conditions, (vi) perceived ability of patients to self-manage, (vii) leadership support and (viii) support for implementing initiatives to promote transitions. CONCLUSIONS: Findings from this scoping review enable an increased understanding of current practices and considerations regarding care transitions from specialty to primary care settings. The importance of role clarification, shared clinical information systems, confidence in care competency, and adequate organizational support to promote appropriate transitions were themes most widely reported across the reviewed studies. Few studies specifically examined the transition from specialty mental health to primary care. Future studies should account for mental health-specific symptomatic patterns and recovery trajectories, such as prevalent chronicity and frequency of relapse, in planning and conducting transitions from specialty mental health back to primary care.
AD - U.S. Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.; U.S. Department of Veterans Affairs, Veterans Integrated Service Network 17 Center of Excellence for Research on Returning War Veterans, Central Texas Veterans Healthcare System, Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin, Texas, USA.; UCLA Health, Los Angeles, California, USA.; U.S. Department of Veterans Affairs, South Central Mental Illness Research, Education and Clinical Center, Health Services Research & Development Center for Innovations in Quality, Effectiveness and Safety, Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA.; U.S. Department of Veterans Affairs, Health Services Research & Development Center for Innovations in Quality, Effectiveness and Safety, Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA.; Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA.
AN - 36938857
BT - J Eval Clin Pract
C5 - General Literature
CP - 8
DA - Dec
DO - 10.1111/jep.13832
DP - NLM
ET - 20230320
IS - 8
JF - J Eval Clin Pract
LA - eng
N2 - BACKGROUND, AIMS AND OBJECTIVES: This scoping review aimed to understand potential barriers and facilitators in transitioning patients from specialty to primary care settings, to inform the implementation of an intervention to promote active consideration of psychiatrically stable patients for transition from the specialty mental health setting back to primary care. METHODS: Guided by Levac and colleagues' six-stage methodological framework for conducting scoping studies, we systematically searched electronic article databases for peer-reviewed literature from January 2000 to May 2016. We included identified articles that discuss findings related to potential barriers and facilitators in transitioning patients from specialty to primary care settings. We performed descriptive and thematic analyses of results to generate emergent codes and their categorizations. RESULTS: Our database search yielded 906 unique articles, 23 of which we included in our scoping review. All but one of the included studies were conducted in North America. Identified potential barriers and facilitators spanned eight emergent themes-(i) primary care accessibility, especially in terms of timely availability of appointments, (ii) clarity in respective roles of specialty care and primary care in managing a patient, (iii) timely exchange of information, (iv) transition process management, (v) perceived ability of primary care providers to manage specialty conditions, (vi) perceived ability of patients to self-manage, (vii) leadership support and (viii) support for implementing initiatives to promote transitions. CONCLUSIONS: Findings from this scoping review enable an increased understanding of current practices and considerations regarding care transitions from specialty to primary care settings. The importance of role clarification, shared clinical information systems, confidence in care competency, and adequate organizational support to promote appropriate transitions were themes most widely reported across the reviewed studies. Few studies specifically examined the transition from specialty mental health to primary care. Future studies should account for mental health-specific symptomatic patterns and recovery trajectories, such as prevalent chronicity and frequency of relapse, in planning and conducting transitions from specialty mental health back to primary care.
PY - 2023
SN - 1356-1294
SP - 1338
EP - 1353+
ST - Care transitions from the specialty to the primary care setting: A scoping literature review of potential barriers and facilitators with implications for mental health care
T1 - Care transitions from the specialty to the primary care setting: A scoping literature review of potential barriers and facilitators with implications for mental health care
T2 - J Eval Clin Pract
TI - Care transitions from the specialty to the primary care setting: A scoping literature review of potential barriers and facilitators with implications for mental health care
U1 - General Literature
U3 - 10.1111/jep.13832
VL - 29
VO - 1356-1294
Y1 - 2023
ER -