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NIHR Signal Case managers improve outcomes for people with dementia and their carers
Using a case manager to coordinate health and social care improves the challenging behaviour of people with dementia and reduces the burden on caregivers. Quality of life of caregivers improves the most when case managers have a professional background in nursing. This NIHR-funded review compared the effectiveness of standard community treatment and interventions with case managers overseeing the interventions for people living with dementia. It considered evidence from 14 trials in a number of...
NIHR Signal The most effective antidepressants for adults revealed in major review
Antidepressants are effective to treat moderate to severe depression in adults. Five antidepressants appear more effective and better tolerated than others. A major review of 522 antidepressant trials found that all of the 21 drugs studied performed better than placebo, in short-term trials measuring response to treatment. However, effectiveness varied widely. Researchers ranked drugs by effectiveness and acceptability after eight weeks of treatment. Several drugs were more effective and were ...
NIHR Signal Self-care support for children with long-term conditions may reduce emergency costs
Helping children and parents to manage long-term conditions like asthma may reduce their need for emergency care, and is unlikely to reduce children’s quality of life. This NIHR review found that structured professional help with self-care, including online support, provision of care plans, case management and face-to-face education, was linked to small increases in quality of life scores and fewer emergency department visits. However, there was no clear evidence that supported self-care ...
NIHR Signal Person-centred care improves quality of life for care home residents with dementia
A person-centred care intervention for people with dementia living in care homes improved their quality of life, reduced agitation and improved interactions with staff. It may also save costs compared with usual care. The WHELD intervention involves training staff in person-centred care, with a focus on improving social interactions and appropriate use of antipsychotic medications. An early study suggested it could halve antipsychotic use. This larger-scale NIHR trial conducted across 69 UK nu...
NIHR Signal Additional therapy helps social recovery from first episode psychosis
Social recovery therapy increases structured activity, such as work, education or sport, by eight hours per week for people with severe social withdrawal following a first episode of psychosis. This cognitive behavioural type of treatment was added to other early interventions and might be particularly useful for those lacking motivation or living with other conditions that prevent them engaging with mental health services. This NIHR-funded trial included 154 young adults with first episode of ...
NIHR Signal Social exclusion heightens risk of death across many health conditions
Socially excluded men have a mortality rate that is nearly eight times higher than the average for other men, and it is almost 12 times higher for excluded women. These health inequities in outcomes exist across a wide range of health conditions, particularly in infectious diseases and mental health. These findings suggest the need for a joined-up approach across sectors to support inclusive services and policies. Populations who experience social exclusion included in the NIHR-supported study ...
NIHR Signal Parental training improves a child’s disruptive behaviours regardless of socio-economic disadvantage or ethnicity
Children from low-income families, or with an unemployed or single parent, benefitted as much as did economically advantaged groups. The Incredible Years programme worked better for children with more severe behaviour problems or a parent with depression. This NIHR-funded review pooled individual-level data for pre-school and primary aged children with persistent disruptive behaviours. The 14 European trials, including eight studies in the UK, took place in diverse settings including schools, c...
NIHR Signal Group-based interventions may help teenagers stop smoking
There is no single clear intervention that helps young people quit smoking in the UK, but this review shows that group counselling is one that may be effective. Interventions included in this review were diverse, for example, computer or text-based, group or individual counselling. Drug treatments such as nicotine patches were included too. Although the review was large, including 41 trials involving more than 13,000 young people, most interventions were not shown to be effective. In contrast, ...
NIHR Signal Staying on antidepressants may prevent a relapse of anxiety
People with anxiety disorders who continued taking antidepressants after successful treatment were less likely to experience a relapse, and relapsed later, than people who stopped taking antidepressants. About 16% of people had a relapse if they remained on antidepressants for on average 44 weeks compared with 36% who stopped after 20 weeks. Anxiety disorders are common and can interfere with people’s everyday work, family and social life. Antidepressants and psychological therapies are t...
NIHR Signal Supported employment helps people with severe mental illness to obtain work
Adults with schizophrenia and other psychosis receiving supported employment were more than twice as likely to obtain a job in the competitive labour market as those receiving pre-job training, sheltered employment or psychiatric care only. Supported employment seemed most effective when augmented with other interventions such as social or cognitive skills training. Many people with severe mental illnesses would like to work, and employment can improve their quality of life. This Cochrane revie...
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