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Interventions to Improve Activities of Daily Living NICE Guideline NG181 Evidence Review August 2020

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Interventions to Improve Activities of Daily Living NICE Guideline NG181 Evidence Review August 2020 National Institute for Health and Care Excellence Final Rehabilitation in adults with complex psychosis and related severe mental health conditions [K] Interventions to improve activities of daily living NICE guideline NG181 Evidence review August 2020 Final This evidence review was developed by the National Guideline Alliance which is part of the Royal College of Obstetricians and Gynaecologists FINAL Contents Disclaimer The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian. Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties. NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the Welsh Government, Scottish Government, and Northern Ireland Executive. All NICE guidance is subject to regular review and may be updated or withdrawn. Copyright © NICE 2020. All rights reserved. Subject to Notice of Rights. ISBN: 978-1-4731-3828-5 FINAL Contents Contents Contents .............................................................................................................................. 4 Interventions to improve activities of daily living ............................................................. 6 Review question 5.1 What interventions specific to rehabilitation are effective for people with complex psychosis and related severe mental health conditions to improve their activities of daily living? .................................................................... 6 Introduction ........................................................................................................... 6 Summary of the protocol ....................................................................................... 6 Clinical evidence ................................................................................................... 7 Summary of clinical studies included in the evidence review ................................. 7 Quality assessment of clinical outcomes included in the evidence review ............. 8 Economic evidence ............................................................................................... 8 Summary of studies included in the economic evidence review ............................. 9 Economic model .................................................................................................... 9 Evidence statements ............................................................................................. 9 The committee’s discussion of the evidence ........................................................ 11 References .......................................................................................................... 14 Appendices ........................................................................................................................ 15 Appendix A – Review protocols .................................................................................... 15 Review protocol for review question: 5.1 What interventions specific to rehabilitation are effective for people with complex psychosis and related severe mental health conditions to improve their activities of daily living? .............................................................................................. 15 Appendix B – Literature search strategies .................................................................... 20 Literature search strategies for review question: 5.1 What interventions specific to rehabilitation are effective for people with complex psychosis and related severe mental health conditions to improve their activities of daily living? ............................................................................ 20 Databases: Medline/Embase/PsycINFO .............................................................. 20 Database: Cochrane Library ................................................................................ 24 Database: CRD ................................................................................................... 26 Appendix C – Clinical evidence study selection ............................................................ 27 Clinical study selection for: What interventions specific to rehabilitation are effective for people with complex psychosis and related severe mental health conditions to improve their activities of daily living? ....................... 27 Appendix D – Clinical evidence tables .......................................................................... 28 Clinical evidence tables for review question: 5.1 What interventions specific to rehabilitation are effective for people with complex psychosis and related severe mental health conditions to improve their activities of daily living? .............................................................................................. 28 Appendix E – Forest plots............................................................................................. 36 4 FINAL Contents Forest plots for review question: What interventions specific to rehabilitation are effective for people with complex psychosis and related severe mental health conditions to improve their activities of daily living?............ 36 Appendix F – GRADE tables ........................................................................................ 38 GRADE tables for review question: 5.1 What interventions specific to rehabilitation are effective for people with complex psychosis and related severe mental health conditions to improve their activities of daily living? .............................................................................................. 38 Appendix G – Economic evidence study selection ........................................................ 42 Economic evidence study selection for review question 5.1: What interventions specific to rehabilitation are effective for people with complex psychosis and related severe mental health conditions to improve their activities of daily living? ............................................................................ 42 Appendix H – Economic evidence tables ...................................................................... 43 Economic evidence tables for review question 5.1: What interventions specific to rehabilitation are effective for people with complex psychosis and related severe mental health conditions to improve their activities of daily living? .............................................................................................. 43 Appendix I – Economic evidence profiles ..................................................................... 44 Economic evidence profiles for review question 5.1: What interventions specific to rehabilitation are effective for people with complex psychosis and related severe mental health conditions to improve their activities of daily living? ............................................................................ 44 Appendix J – Economic analysis .................................................................................. 45 Economic evidence analysis for review question 5.1: What interventions specific to rehabilitation are effective for people with complex psychosis and related severe mental health conditions to improve their activities of daily living? ............................................................................ 45 Appendix K – Excluded studies .................................................................................... 46 Excluded clinical and economic studies for review question: 5.1 What interventions specific to rehabilitation are effective for people with complex psychosis and related severe mental health conditions to improve their activities of daily living? ...................................................... 46 Clinical studies .................................................................................................... 46 Economic studies ................................................................................................ 85 Appendix L – Research recommendations ................................................................... 90 Research recommendations for review question: 5.1 What interventions specific to rehabilitation are effective for people with complex psychosis and related severe mental health conditions to improve their activities of daily living? ............................................................................ 90 5 FINAL Interventions to improve activities of daily living Interventions to improve activities of
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