Literature Collection

INTRODUCTION: Day care services have a long history in the support of older people, both internationally and in England. However, despite their longevity there is no consensus about the aims of day care services and their contribution to integrated care is unrecognised. This paper defines day care as community building-based services that provide care and/or health related services and/or clubs and activities specifically for older people (65+) with care and support needs, which support wellbeing and health, and/or support people to remain living at home and/or enable informal carers to sustain care. METHODS: The paper draws on qualitative data collected in a national study to reimagine day care services for older people in England. Eight sites participated, all from the voluntary sector. RESULTS: Day care services act as both a site of, and facilitator to, integrated care and whilst settings experienced many of the challenges faced by voluntary sector organisations, including a reliance on limited and uncertain funding, they had developed a range of strategies to partially manage them. CONCLUSIONS: Collective forms of day care services have the potential to play a more significant role in the provision of local place based integrated care in England.

OBJECTIVES: This study examines the role of mental health in consumer healthcare choices, using a discrete choice experiment to analyze choices regarding routine primary care visits in Australia. It captures mental health through 3 variables: self-reported current mental health condition and clinically validated measures of depression and anxiety symptoms, the Patient Health Questionnaire-9 capturing depression, and the Generalized Anxiety Disorder 7-item scale capturing anxiety. METHODS: Data were collected during November and December 2021 from a sample (N = 568) representative of the Australian population in age, gender, and location. Participants made hypothetical choices between in-person and telehealth alternatives or a no-visit alternative. Alternatives were described in terms of general practitioner familiarity, out-of-pocket cost, wait time, waiting area size, mask requirements, and modality of telehealth. RESULTS: The results suggest that symptoms of depression and anxiety could affect healthcare choices with opposite direction of effect on uptake and distinct from the presence of a mental health condition. CONCLUSIONS: These findings support the need for more careful consideration of the role of mental health in the analysis of discrete choice experiments, particularly in healthcare, including a better understanding of the mechanisms and time-varying nature of any effect.

This paper is a short report considering the role of occupational therapy in providing mental health services in primary care. Primary care is the first point of contact most people have with the healthcare system. Occupational therapists have a role working with people with mental illness but the role of an occupational therapist working in mental health in a primary care setting is not well understood. Common interventions discussed in the literature included lifestyle approaches, assessment and information gathering, and the teaching of skills for daily living. There was a clear divide in the literature regarding the use of generic or specialist (occupation-focused) roles. Physical health was often prioritized over mental health concerns. Limited research examined both the population group of people with mental health concerns and the practice setting of primary care, identifying the need for further research to articulate the role of occupational therapy in working with mental health in primary care settings.

BACKGROUND: Approximately 50 million individuals across the globe are impacted by epilepsy, leading to fear, discrimination, psychiatric issues, high costs, and social stigma. Proper diagnosis and treatment could allow up to 70% of those affected to live seizure-free. Community pharmacists have significant potential to actively participate in epilepsy patient care, beyond merely dispensing medications. The objective of this study was to systematically review and assess the roles of pharmacists in epilepsy care, focusing on pharmacist-led interventions and services for patients with epilepsy. METHODS: Following PRISMA 2020 guidelines, the review included cross-sectional, retrospective cohort, and qualitative/quantitative studies on pharmacist-led epilepsy interventions in community and outpatient settings. Searches were conducted in Scopus, PubMed Central, and Science Direct for studies published through the end of 2023. Two evaluators independently reviewed and chose studies, and the data was analysed using Microsoft Excel®. Quality assessment was performed using the MMAT tool. RESULTS: Five eligible studies were included, covering 457 participants. Studies originated from the USA (n = 3), Netherlands (n = 1), and Palestine (n = 1). They evaluated pharmacist-led interventions in epilepsy, including medication adherence, quality of life, and pharmacist's integration in epilepsy care. CONCLUSION: This review underscores the possible contributions of pharmacists in epilepsy care, stressing the importance of pharmacist-led interventions to enhance medication adherence and the quality of life for individuals with epilepsy. Future research should evaluate the effectiveness and cost-effectiveness of these services, including disease management and patient education. Increasing awareness among pharmacists and patients about pharmacists' contributions is crucial for improving epilepsy care.