Patient-held shared care records for individuals with mental illness. Randomised controlled evaluation.

Abstract

Few formalized shared care schemes exist within psychiatry and the evidence base for sharing psychiatric care is weak. To evaluate the utility of patient-held shared care records for individuals with long-term mental illness. Cluster-randomised controlled parallel-group 12-month trial involving 90 patients with long-term mental illness drawn from 28 general practices. 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). Patient-held records may not be helpful for patients with long-term mental illness.