Psychological intervention

About: Psychological intervention is a research topic. Over the lifetime, 82654 publications have been published within this topic receiving 2608356 citations.

Hospital-based medication reconciliation practices: a systematic review

Abstract: Background Medication discrepancies at care transitions are common and lead to patient harm. Medication reconciliation is a strategy to reduce this risk. Objectives To summarize available evidence on medication reconciliation interventions in the hospital setting and to identify the most effective practices. Data Sources MEDLINE (1966 through February 2012) and a manual search of article bibliographies. Study Selection Twenty-six controlled studies. Data Extraction Data were extracted on study design, setting, participants, inclusion/exclusion criteria, intervention components, timing, comparison group, outcome measures, and results. Data Synthesis Studies were grouped by type of medication reconciliation intervention—pharmacist related, information technology (IT), or other—and were assigned quality ratings using US Preventive Services Task Force criteria. Results Fifteen of 26 studies reported pharmacist-related interventions, 6 evaluated IT interventions, and 5 studied other interventions. Six studies were classified as good quality. The comparison group for all the studies was usual care; no studies compared different types of interventions. Studies consistently demonstrated a reduction in medication discrepancies (17 of 17 studies), potential adverse drug events (5 of 6 studies), and adverse drug events (2 of 2 studies) but showed an inconsistent reduction in postdischarge health care utilization (improvement in 2 of 8 studies). Key aspects of successful interventions included intensive pharmacy staff involvement and targeting the intervention to a high-risk patient population. Conclusions Rigorously designed studies comparing different inpatient medication reconciliation practices and their effects on clinical outcomes are scarce. Available evidence supports medication reconciliation interventions that heavily use pharmacy staff and focus on patients at high risk for adverse events. Higher-quality studies are needed to determine the most effective approaches to inpatient medication reconciliation.

Parenting Stress Reduces the Effectiveness of Early Teaching Interventions for Autistic Spectrum Disorders.

Abstract: This community-based study examined the influence of early teaching interventions on children diagnosed with Autistic Spectrum Disorders, and the dynamics between the time intensity of the interventions and parenting stress, on child outcomes. Intellectual, educational, and adaptive behavior and social functioning were all measured. Sixty-five children were divided into four groups, based on the levels of time intensity of their intervention, and on their parents' stress levels. There were gains in intellectual, educational, and adaptive behavioral and social skills, and there was a positive relationship between the time intensity of the early teaching interventions and child outcome gains. More importantly, however, high levels of parenting stress counteracted the effectiveness of the early teaching interventions.

Practice parameter for the assessment and treatment of children and adolescents with anxiety disorders.

Abstract: This revised practice parameter reviews the evidence from research and clinical experience and highlights significant advancements in the assessment and treatment of anxiety disorders since the previous parameter was published. It highlights the importance of early assessment and intervention, gathering information from various sources, assessment of comorbid disorders, and evaluation of severity and impairment. It presents evidence to support treatment with psychotherapy, medications, and a combination of interventions in a multimodal approach.

Implementing clinical guidelines: current evidence and future implications.

Abstract: One of the most common findings from health services research is a failure to routinely translate research findings into daily practice. Previous systematic reviews of strategies to promote the uptake of research findings suffered from a range of methodologic problems that have been addressed in a more recent systematic review of guideline dissemination and implementation strategies. Changes in practitioner behavior; in the desired direction, were reported in 86% of the comparisons made. The median effect size overall was approximately 10% improvement in absolute terms. The review suggests that interventions that were previously thought to be ineffective (e.g., dissemination of educational materials) may have modest but worthwhile benefits. Also, multifaceted interventions, previously thought to be more effective than single interventions, were found to be no more effective than single interventions. Overall, there is an imperfect evidence base for decision makers to work from. Many studies had methodologic weaknesses, and reporting of this kind of research is generally poor, making the generalizability of study findings frequently uncertain. A better theoretical underpinning of studies would make this body of research more useful.