Supporting the Integrated Management of Multi-morbidity (SIMM)

Lead: Scott Weich  Project manager: Emily Wood 

The SIMM study is addressing the implementation challenges of integrated care for patients with both a long term physical condition and depression. It is hosted by the School of Health and Related Research at the University of Sheffield[U1] .

The first part of the study is researching any disparity that may occur in accessing psychological therapy for depression when the patient also has a long term physical health condition. Information collected routinely by Sheffield General Practitioners (GPs) about primary and hospital care will be combined with information collected by the Sheffield Improving Access to Psychological Therapies (IAPT) service. The GP information will enable the research team to identify the numbers of people across the city with depression and long term conditions. Then data for all patients identified as having depression will be accessed and this data will be matched to the IAPT database.

The purpose is to see if people with depression and a long term condition receive different services to those who have depression but no other long term condition. This will include if there is a difference in rates of referral to IAPT, the amount of sessions in IAPT, clinical outcomes from IAPT, and also the utilisation of general hospital services such as A&E attendance and unplanned admissions. We will also see if the GP practice a person attends or if the level of deprivation a person faces makes a difference to their treatment.

Results from this part of the study will then feed into further research aiming to improve access to, and acceptability of, treatment for depression in patients with long term conditions.  

We have conducted a systematic review [U2] of the research literature to investigate the barriers and facilitators to integrated care for people who have depression and a co-morbid long-term physical condition. The purpose was to learn from the experiences of those who have researched the implementation of integrated care and to draw those lessons together. We will use this information to develop a way of overcoming these barriers and allowing the successful implementation of integrated care.

The final stage of this research project will be to implement this approach to integrated care and evaluate its success in improving access to treatment, and the success rate of that treatment, for people with depression and long term physical health conditions.