Patient-held shared care records for individuals with mental illness. Randomised controlled evaluation.
BACKGROUND
Few formalized shared care schemes exist within psychiatry and the evidence base for sharing psychiatric care is weak.


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


METHODS
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% CI 0.86-1.67) and attend clinic (relative risk 0.96, 95% CI 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% CI 0.27-0.99).


CONCLUSIONS
Patient-held records may not be helpful for patients with long-term mental illness.
Warner
J P
JP
Department of Old Age Psychiatry, Imperial College School of Medicine, St Charles Hospital, Exmoor St, London W10 6DZ, UK. j.warner@ic.ac.uk
King
M
M
Blizard
R
R
McClenahan
Z
Z
Tang
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D016000:Cluster Analysis; D005194:Family Practice; D005260:Female; D005568:Forms and Records Control; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008499:Medical Records; D001523:Mental Disorders / Q000523:psychology* / Q000628:therapy; D008875:Middle Aged; D010348:Patient Care Team; D017060:Patient Satisfaction