Authors (including presenting author) :
Chow KL(1), Law HPA(1), Lai KPL(1), Chan PF(1), Fung HT(1), Wong TK(1), Chao DVK(1), Sham KH(2), Yiu GC(2)
Affiliation :
(1)Department of Family Medicine and Primary Health Care, United Christian Hospital and Tseung Kwan O Hospital,(2)Department of Psychiatry, United Christian Hospital
Introduction :
IMHP was launched in General Out-patient clinics (GOPCs) since 2010. The initial reviews conducted in 2012 showed that the programme was effective in serving the gate-keeping role for referrals of patients with CMD to Psychiatry Specialist Out-patient Clinic in KEC. During the past few years, the KEC IMHP team continued to strive to enhance the programme with improved clinical experience through regular liaison meetings with visiting psychiatrist, updated clinical guidelines, enriched modalities of psychological interventions including mindfulness therapy and brief cognitive behavioral therapy performed by occupational therapist, and enhanced communication with community services including the Integrated Family Service Centres and Integrated Community Centre for Mental Wellness.
Objectives :
To review the clinical effectiveness and outcomes of IMHP after programme enhancement in recent 3 years.
Methodology :
All new cases (N= 3339) referred to KEC IMHP from 1st October 2015 to 30th September 2018 were included. Data were retrieved from the IMHP consultation summary reports to assess the change in symptoms severity by Patient Health Questionnaire (PHQ-9) & General Anxiety Disorder Questionnaire (GAD-7) scores after at least 3 months of interventions.
Result & Outcome :
1349 subjects (40.4%) attended IMHP doctor/ keyworker clinic (with or without pharmacotherapy given) while 1990 subjects (59.8%) received key workers' (occupational therapist and psychiatric nurse) interventions only. 73.0% of subjects were female. The mean age was 55.6 years old. The proportion of patients with depressive symptoms score dropped from moderate or above to mild or normal levels was significantly improved from 61.2% in 2012 to 78.4% (p=0.004). The proportion of patients with anxiety symptoms score dropped from moderate or above to mild or normal levels was also significantly improved from 65.0% in 2012 to 79.4% (p<0.001). 75.5% and 77.9% of patients with depressive and anxiety disorders were able to achieve symptom remission solely by non-pharmacological intervention provided by key workers. Conclusion
IMHP was effective in managing CMD in primary care. A multidisciplinary approach in collaboration with the psychiatrists and community services was the key to success of the programme.
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