Individuella vårdplaner

Denna publikation publicerades för mer än två år sedan. Kunskapsläget kan ha förändrats.

Enligt nya bestämmelser i hälso- och sjukvårdslagen samt socialtjänstlagen som trädde i kraft år 2010 ska patienter med psykisk funktionsnedsättning ha rätt till upprättande av en samordnad individuell vårdplan. Den samordnade individuella vårdplanen ska klargöra vilka insatser som den enskilde behöver och vem som ska samordna och ansvara för de olika insatserna. Det kan vara insatser från flera verksamheter och yrkesföreträdare.

Fråga till SBU:s Upplysningstjänst

Vad finns det för studier som utvärderar samordnade individuella vårdplaner för personer med psykisk funktionsnedsättning*?

Sammanfattning av Upplysningstjänstens svar

Generellt är det svårt att hitta studier där interventionen är tillräckligt likvärdig den motsvarande svenska. Därför har vi i stället fokuserat sökningen till studier som undersöker effekten av individanpassad vård. Många av de studier vi har identifierat har varit okontrollerade studier och/eller studier där utfallsmått skattas genom enkätundersökningar till patienter, anhöriga och/eller vårdare, vilket gör att tillförlitligheten i resultaten minskar. Vi har därför valt att enbart redovisa kontrollerade studier alternativt svenska studier på ämnet utförligt i svaret.

Upplysningstjänsten har identifierat en svensk okontrollerad studie som undersöker effekten av samordnad individuell vårdplan. Vidare har vi identifierat en systematisk översikt och en randomiserad kontrollerad studie (RCT) där effekten av personnära vård/planering undersöks. Slutligen har vi funnit en Cochrane-rapport som sammanställer studier där effekten av olika insatser kring organisation av vård för förståndshandikappade undersöks.

Sammantaget finns det få kontrollerade studier på området. Baserat på de studier vi har identifierat är det oklart vilka effekter som ett införande av samordnade individuella vårdplaner har.

SBU arbetar för närvarade med att ta fram tre rapporter som berör patienter med schizofreni, ADHD eller autismspektrumtillstånd. I rapporterna undersöks bland annat hur patienterna upplever sin delaktighet i vården samt organisation kring vården. Rapporterna förväntas färdigställas under hösten 2012.

SBU har även publicerat en rapport ”Implementeringsstöd för psykiatrisk evidens i primärvården”, som undersöker åtgärder som förbättrar följsamhet till riktlinjer.

* Vi har baserat sökningen avseende psykisk funktionsnedsättning på den breda termen "mental disorder", detta inkluderar bland annat personer med demens, inlärningssvårigheter samt förståndshandikapp.

Detta är SBU:s Upplysningstjänsts svar på en avgränsad medicinsk fråga. Observera att det kan ha tillkommit nya studier efter litteratursökningsdatum: 2012-09-25.

Identifierad litteratur

Studier från Sverige 

Piuva K, Blom R, Sandström U. En utvärdering av Gemensam individuell vårdplan, Socialtjänsten, beroendevården och öppna psykiatriska mottagningen i Sollentuna. In: FoU Nordväst, editor.; 2008.

Inkluderade studier och översikter som undersöker personnära vård/planering

Chenoweth L, King MT, Jeon Y-H, Brodaty H, Stein-Parbury J, Norman R, et al. Caring for Aged Dementia Care Resident Study (CADRES) of person-centred care, dementia-care mapping, and usual care in dementia: A cluster-randomised trial. The Lancet Neurology 2009;8:317-325.

Rudkin A, Rowe D. A systematic review of the evidence base for lifestyle planning in adults with learning disabilities: implications for other disabled populations (Structured abstract). In: Clinical Rehabilitation; 1999. p 363-372.

Inkluderade översikter som undersöker effekten av samarbete och organisation kring vård

Robert B, Helene OK, Laurie B, Yona L, Angela C. Organising health care services for persons with an intellectual disability. In: Cochrane Database of Systematic Reviews. John Wiley & Sons, Ltd; 2008.


Frågeställare

Socialdepartementet

Datum

2012-10-01

Programchef

Jan Liliemark

Projektledare

Christel Hellberg hellberg@sbu.se

Övriga medarbetare

Jessica Dagerhamn

Ladda ner rapport

SBU:s upplysningstjänst Systematisk litteratursökning som besvarar fråga från vården eller socialtjänsten om vilka relevanta översikter och studier som finns. Svaret utformas av medarbetare på SBU, vid behov med stöd av ämnessakkunnig. Systematisk kvalitetsgranskning görs inte.

Publicerad: 2012-11-08
Kontakta SBU: registrator@sbu.se
http://www.sbu.se/vardplaner

Publikationer inom samma område

Litteratursökning

Litteratursökning till och med 2012-09-25.

Databaser
PubMed, PsycINFO via EBSCO, The Cochrane Library, SweMed+

Söktermer

PubMed 19 September 2012
Title: Personalized care plans for patient with mental disorders
  Search terms Items found
Population
1. (("Dementia"[Mesh]) OR "Bipolar Disorder"[Mesh:NoExp]) OR "Schizophrenia and Disorders with Psychotic Features"[Mesh] (DE "Mental Disorders" OR DE "Adjustment Disorders" OR DE "Affective Disorders" OR DE "Alexithymia" OR DE "Anxiety Disorders" OR DE "Autism" OR DE "Chronic Mental Illness" OR DE "Dementia" OR DE "Dissociative Disorders" OR DE "Eating Disorders" OR DE "Elective Mutism" OR DE "Factitious Disorders" OR DE "Gender Identity Disorder" OR DE "Hysteria" OR DE "Impulse Control Disorders" OR DE "Koro" OR DE "Mental Disorders due to General Medical Conditions" OR DE "Neurosis" OR DE "Paraphilias" OR DE "Pe 231601
2. (((Psychosis[Title/Abstract]) OR Schizophrenia[Title/Abstract]) OR "Personality Disorder"[Title/Abstract]) OR dementia[Title/Abstract] 146963
3. 1 or 2 277886
Intervention:
4. ((person*[Title/Abstract]) OR patient*[Title/Abstract]) OR Individually[Title/Abstract] 4430361
5. (((((centred AND plan*[Title/Abstract]) OR focused AND plan*[Title/Abstract]) OR based AND plan*[Title/Abstract]) OR care AND plan*[Title/Abstract]) OR focused AND care[Title/Abstract]) OR centered AND care[Title/Abstract] 42304
6. 4 AND 5 26523
7. ((("individualized care"[Title/Abstract]) OR "individualised care"[Title/Abstract]) OR "personalised care"[Title/Abstract]) OR "personalized care"[Title/Abstract] 910
8. 6 OR 7 27280
Combined sets
9. 3 and 8 898

 

PubMed 25 September 2012
Title: Personalized care plans for patient with mental disorders
  Search terms Items found
Population:
1. “Care programme approach” 57
       

 

The search result, usually found at the end of the documentation, forms the list of abstracts

[MeSH] = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; [MeSH:NoExp] = Does not include terms found below this term in the MeSH hierarchy; * = Truncation

“ “ = Citation Marks; searches for an exact phrase

 

PsycINFO via EBSCO 12 September 2012
Title: Personalized care plans for patient with mental disorders
  Search terms Items found
Population:
2. (DE "Mental Disorders" OR DE "Adjustment Disorders" OR DE "Affective Disorders" OR DE "Alexithymia" OR DE "Anxiety Disorders" OR DE "Autism" OR DE "Chronic Mental Illness" OR DE "Dementia" OR DE "Dissociative Disorders" OR DE "Eating Disorders" OR DE "Elective Mutism" OR DE "Factitious Disorders" OR DE "Gender Identity Disorder" OR DE "Hysteria" OR DE "Impulse Control Disorders" OR DE "Koro" OR DE "Mental Disorders due to General Medical Conditions" OR DE "Neurosis" OR DE "Paraphilias" OR DE "Personality Disorders" OR DE "Pervasive Developmental Disorders" OR DE "Pseudodementia" OR DE "Psychosis" OR DE "Schizoaffective Disorder" OR DE "Affective Disorders" OR DE "Bipolar Disorder" OR DE "Major Depression" OR DE "Mania" OR DE "Seasonal Affective Disorder" OR DE "Anxiety Disorders" OR DE "Acute Stress Disorder" OR DE "Castration Anxiety" OR DE "Death Anxiety" OR DE "Generalized Anxiety Disorder" OR DE "Obsessive Compulsive Disorder" OR DE "Panic Disorder" OR DE "Phobias" OR DE "Posttraumatic Stress Disorder" OR DE "Separation Anxiety" OR DE "Chronic Mental Illness" OR DE "Chronic Psychosis" OR DE "Dementia" OR DE "AIDS Dementia Complex" OR DE "Dementia with Lewy Bodies" OR DE "Presenile Dementia" OR DE "Semantic Dementia" OR DE "Senile Dementia" OR DE "Vascular Dementia" OR DE "Dissociative Disorders" OR DE "Depersonalization" OR DE "Dissociative Identity Disorder" OR DE "Fugue Reaction" OR DE "Eating Disorders" OR DE "Anorexia Nervosa" OR DE "Binge Eating Disorder" OR DE "Bulimia" OR DE "Hyperphagia" OR DE "Kleine Levin Syndrome" OR DE "Pica" OR DE "Purging (Eating Disorders)" OR DE "Factitious Disorders" OR DE "Munchausen Syndrome" OR DE "Gender Identity Disorder" OR DE "Transsexualism" OR DE "Hysteria" OR DE "Mass Hysteria" OR DE "Impulse Control Disorders" OR DE "Explosive Disorder" OR DE "Neurosis" OR DE "Childhood Neurosis" OR DE "Experimental Neurosis" OR DE "Occupational Neurosis" OR DE "Traumatic Neurosis" OR DE "Paraphilias" OR DE "Apotemnophilia" OR DE "Exhibitionism" OR DE "Fetishism" OR DE "Incest" OR DE "Pedophilia" OR DE "Sexual Masochism" OR DE "Sexual Sadism" OR DE "Transvestism" OR DE "Voyeurism" OR DE "Personality Disorders" OR DE "Antisocial Personality Disorder" OR DE "Avoidant Personality Disorder" OR DE "Borderline Personality Disorder" OR DE "Dependent Personality Disorder" OR DE "Histrionic Personality Disorder" OR DE "Narcissistic Personality Disorder" OR DE "Obsessive Compulsive Personality Disorder" OR DE "Paranoid Personality Disorder" OR DE "Passive Aggressive Personality Disorder" OR DE "Sadomasochistic Personality" OR DE "Schizoid Personality Disorder" OR DE "Schizotypal Personality Disorder" OR DE "Pervasive Developmental Disorders" OR DE "Aspergers Syndrome" OR DE "Autism" OR DE "Rett Syndrome" OR DE "Psychosis" OR DE "Acute Psychosis" OR DE "Affective Psychosis" OR DE "Alcoholic Psychosis" OR DE "Capgras Syndrome" OR DE "Childhood Psychosis" OR DE "Chronic Psychosis" OR DE "Experimental Psychosis" OR DE "Hallucinosis" OR DE "Paranoia (Psychosis)" OR DE "Postpartum Psychosis" OR DE "Reactive Psychosis" OR DE "Schizophrenia" OR DE "Senile Psychosis" OR DE "Toxic Psychoses" OR DE "Schizoaffective Disorder" OR DE "Psychiatric Patients" OR DE "Psychiatric Symptoms" OR DE "Psychodiagnosis" OR DE "Psychodiagnostic Interview") OR (DE "Schizophrenia" OR DE "Acute Schizophrenia" OR DE "Catatonic Schizophrenia" OR DE "Childhood Schizophrenia" OR DE "Paranoid Schizophrenia" OR DE "Process Schizophrenia" OR DE "Schizophrenia (Disorganized Type)" OR DE "Schizophreniform Disorder" OR DE "Undifferentiated Schizophrenia") OR (DE "Attention Deficit Disorder" OR DE "Attention Deficit Disorder with Hyperactivity" OR DE "Attention Deficit Disorder with Hyperactivity") OR (DE "Drug Addiction" OR DE "Heroin Addiction") (DE "Mental Disorders" OR DE "Adjustment Disorders" OR DE "Affective Disorders" OR DE "Alexithymia" OR DE "Anxiety Disorders" OR DE "Autism" OR DE "Chronic Mental Illness" OR DE "Dementia" OR DE "Dissociative Disorders" OR DE "Eating Disorders" OR DE "Elective Mutism" OR DE "Factitious Disorders" OR DE "Gender Identity Disorder" OR DE "Hysteria" OR DE "Impulse Control Disorders" OR DE "Koro" OR DE "Mental Disorders due to General Medical Conditions" OR DE "Neurosis" OR DE "Paraphilias" OR DE "Pe 419909
3. TI ( Anxiety OR Psychosis OR Schizophrenia OR Paranoia OR depression OR Personality Disorders OR Autism OR Aspergers Syndrome OR Drug Addiction OR Attention Deficit Disorder ) OR AB ( Anxiety OR Psychosis OR Schizophrenia OR Paranoia OR depression OR Personality Disorders OR Autism OR Aspergers Syndrome OR Drug Addiction OR Attention Deficit Disorder ) 363753
4. 1 or 2 561282
Intervention:
5. TI person* OR TI patient* OR TI Individually OR AB person* OR AB patient* OR AB Individually 815232
6. TI ((centred N3 plan*) OR (focused N3 plan*) OR (based N3 plan*) OR (care N3 plan*) OR (focused N3 care) OR (centered N3 care)) OR AB ((centred N3 plan*) OR (focused N3 plan*) OR (based N3 plan*) OR (care N3 plan*) OR (focused N3 care) OR (centered N3 care)) 7532
7. 4 N3 5 1242
8. TI (individuali?ed OR personali?ed) N2 care OR AB (individuali?ed OR personali?ed) N2 care 555
9. 6 OR 7 1760
Combined sets
10. 3 and 8 351

 

PsycINFO via EBSCO 25 September 2012
Title: Personalized care plans for patient with mental disorders
  Search terms Items found
Population:
11. “Care programme approach” 90

 

The search result, usually found at the end of the documentation, forms the list of abstracts

AB = Abstract; DE = Term from the thesaurus; N2 = Near 2, words on both sides must appear within two words from each other N3 = Near 3, words on both sides must appear within three words from each other; TI = Title; * = Truncation; “ “ = Citation Marks; searches for an exact phrase; ? = replaces any character.

 

Cochrane 12 September 2012
Title: Personalized care plans for patient with mental disorders
  Search terms Items found
Population:
  MeSH descriptor Mental Disorders explode all trees 37672
  (Anxiety OR Psychosis OR Schizophrenia OR Paranoia OR depression OR Personality Disorders OR Autism OR Aspergers Syndrome OR Drug Addiction OR Attention Deficit Disorder OR bipolar OR mental OR psychiatric):ti,ab,kw 61752
12. 1 or 2 76266
Intervention:
  (person*):ti,ab,kw or (patient* ):ti,ab,kw or (Individually ):ti,ab,kw 367942
  ((centred NEAR/3 plan*) OR (focused NEAR/3 plan*) OR (based NEAR/3 plan*) OR (care NEAR/3 plan*) OR (focused NEAR/3 care) OR (centered NEAR/3 care)):ti,ab,kw 3081
13. 4 AND 5 2390
14. (individuali?ed OR personali?ed) NEAR/2 care :ti,ab,kw 105
15. 6 OR 7 2467
Combined sets
16. 3 and 8 454
CDSR: 11
DARE: 5
HTA: 4
EED:6

 

Cochrane 25 September 2012
Title: Personalized care plans for patient with mental disorders
  Search terms Items found
Population:
1. “Care programme approach” CDSR: 0<br/ > DARE: 0<br/ > HTA: 0<br/ > EED:0

 

The search result, usually found at the end of the documentation, forms the list of abstracts

[MeSH] = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; ti,ab,kw = Title, abstract or keyword; * = Truncation; “ “ = Citation Marks; searches for an exact phrase; NEAR/2 = Near 2, words on both sides must appear within two words from each other NEAR/3 = Near 3, words on both sides must appear within three words from each other; ? = replaces any character.

CDSR = Cochrane Database of Systematic Review
DARE = Database Abstracts of Reviews of Effects, “other reviews”
EED = Economic Evaluations
HTA = Health Technology Assessments

 

Swemed+, 19 September 2012
Title: Personalized care plans for patient with mental disorders

  Search terms Items found
Population:
2. Psychosis OR Schizophrenia OR Personality Disorder OR Autism OR Aspergers Syndrome OR Dementia OR Attention Deficit Disorder 4830
Intervention:
3. person* OR patient* OR Individually 34007
4. (centered AND care) OR (focused AND care) OR (care AND plan*) OR(based AND plan*) OR (focused AND plan*) OR (centred AND plan*) 2221
5. 4 AND 5 1455
6. "individualized care" OR "personalized care" 7
7. 6 OR 7 1457
Combined sets
8. 3 and 8 116