Schizophrenia's patient journey: a participatory model
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Fondazione The Bridge, Milano, Italy
Niguarda Hospital, Milano, Italy
ASST Spedali Civili of Brescia, Italy
Fondazione The Bridge, Italy
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A1237
Background and Objective: Schizophrenia, a severe mental disorder, in up to 60% cases has a variable but chronic course, worsening quality of life and psychosocial functioning. In response to its complexity, a two-year project was built to design a schizophrenia patient journey, including care and disease management in his path towards recovery. This survey-based study aims to share evidence-based information and real-world experiences, examining patients’ needs during their care path, and identifying gaps and areas for improvement. Methods: Three most significant steps in the journey of a patient with schizophrenia were defined: early diagnosis, management of the acute phase, long-term management. Physicians, patients as experts by experience and caregivers were involved in the surveys, to establish current best practices in the management of schizophrenia by Departments of Mental Health (MHD). For each area answers focused on agreement or disagreement on the importance of each statement, and the level of implementation. The survey was conducted through a computer-assisted Web Interviewing approach in Lombardy in 2021, and widespread throughout Italy in 2022. Finally, two multi-stakeholder Consensus Meetings are envisaged to draw a draft of the Patient Journey, also on the basis of the surveys’ results. Results: The national survey and the Consensus will be closed by the end of the year. The results collected up to now indicate a gap in the long-term management phase, in particular concerning family care, home interventions, work/study support, psychoeducational/psychotherapeutic interventions. Important gaps were also found for pharmacological restraint, collaboration with the general practitioner and in the role of experts in peer support and multiprofessional care teams. Conclusions: The survey offers an updated assessment of the priority areas of intervention for MHD Heads and covers the current limits of the NHS. Chronicity management represents a limit to be addressed in the patient journey of people with Schizophrenia.