Finding Evidence in Information Overload

Recent Education Event

We were very fortunate to have Jeanette Smith from CADTH (Canadian Agency for Drugs and Technologies in Health) join us for 2 sessions on Feb 19 to educate us on the difference of Evidence vs Information. She shared a wealth of information, some of which I will try to capture and share here, for those who were unable to attend.

Sifting through Information Overload to find the Evidence

Here is a link to a news article about peanut allergies in The Globe and Mail:

http://www.theglobeandmail.com/life/health-and-fitness/health/scientists-find-peanut-eating-in-infancy-prevents-allergy/article23159472/

Here are a couple paragraphs from the article with the important searchable information highlighted.

“This is an important clinical development and contravenes previous guidelines,” said Gideon Lack, who led the study at King’s College London.

In results published in the New England Journal of Medicine, Lack found that fewer than 1 percent of the children who ate peanut regularly as required had become allergic by the end of the study, while 17.3 percent in the avoidance group had developed peanut allergy.

By searching for the following in Google, "Lack peanut allergy New England Journal of Medicine" I found the study as the first result in Google. The link to the study is below.

http://www.nejm.org/doi/full/10.1056/NEJMoa1414850

Clinical Trial vs Study vs Expert Opinion

There is a significant difference between a double blind clinical trial funded by a source with no vested interest in the outcome and an expert opinion. Someone with an expert opinion may or may not be correct, but there is not quality data to back it up either way. Not all clinical trials are of a high quality. If you are digging deeply and wish to ensure that you are using sound data to make important health decisions, and you are relying on a clinical trial, please ensure it was completed using sound practices. Studies fall somewhere in between. They are created by looking back at data that has been gathered. There are fewer controls in place and there are more variables that are in play. Keep in mind this acronym: 

PICO 

Patient Population: Are you looking at the same population being studied as is relevant to you (age, diagnosis, sex)

Intervention: What intervention is being investigated (medication, therapy, technology)

Comparators: Is the intervention being compared to another intervention or to placebo (drug being compared to other therapies, or placebo, or other drug, and/or various dosages)

Outcomes: What are the outcomes? Pay attention to the numbers 5 percent showed improvement, is different than 90 percent. Also how much improvement?

Ghosts

The people who write the studies are not always the people who perform them. Some companies hire and train study writers to project the study in a certain light. If one intervention is 5% effective and another is 6% effective, a study writer could say that the second intervention is 25% MORE effective that the first, yet there is only 1% difference in the outcome and both are not very effective at all. Be careful of the spin.

MICAOntario (Mental Illness Caregivers Association)

This workshop was presented in partnership with MICA. They are a great organization comprised of family members, caregivers and consumers committed to assisting caregivers and their family members in managing the effects of serious and persistent mental illness and/or addictions through education, guidance and support. Their website is below.

http://micaontario.com/index.php

Other websites of interest for research

The Canadian Agency for Drugs and Technologies in Health (CAN)

http://www.cadth.ca/en

The National Institute for Health and Care Excellence (UK)

https://www.nice.org.uk

The Agency for Healthcare Research and Quality (USA)

http://www.ahrq.gov

The Cochrane Collaboration (International)

http://www.cochrane.org

WRAP being offered by MHSP The Link

WRAP Wellness Recovery Action Plan

I have just received confirmation that The Link will be offering a WRAP workshop for people with mental illnesses. WRAP stands for Wellness Recovery Action Plan and is a framework that is created to help a person understand what they look, feel and act like when they feel well, when they are starting to slip in their wellness, and help them take steps to avoid becoming seriously unwell. This tool helps a person to be more involved in managing their own care and identifying what works best for them, and who they would like to have involved in their care.
Below is a link to the WRAP website which gives further information on the process.
http://www.mentalhealthrecovery.com/wrap/
Contact The Link for more information or to register.
http://www.mhsp-links.ca
613-284-4608
Tues Feb 3 2-3:30pm for 8 weeks.

Workshop about Health Evidence 

Thurs February 19 2015 

2-4pm for Service Providers

6-8pm for General Public

The Link - Mental Health Support Project

88 Cornelia St W Unit A4

email mentalhealthfamilies@gmail.com for inquiries.

“A new study released today says…”

Every day media outlets bombard us with findings from the latest research — evidence intended to shed new light on ways to improve our personal health or our healthcare systems. Beyond the media, the Internet also provides abundant access to countless sources of health information and evidence, making it readily available for all to explore. But for those of us with little to no experience in science or healthcare or research, how do we make sense of all that information? What is it saying and what can we trust?

This introductory workshop will begin with an examination of the concepts of evidence in healthcare, the information that clinicians and decision-makers rely on when making choices for patients and for our healthcare systems.  Participants will learn some basic tips and tricks for locating evidence and then delve into the key factors that a well-designed, meaningful study should contain.  Next, with examples in hand and working in small guided discussion groups, participants will learn how to read a scientific study through a critical lens to uncover its key basic messages. What is this research actually telling us? We’ll end by taking a look at the concept of health technology assessment, discussing its role and value in the world of decision-making.

Geared to patients, their family members and advocates, students, junior-level government and health system administrators, anyone interested in an introduction to health evidence, this session will provide a first step on that journey of understanding.

A Busy Year Ahead

January Support Group 

Since New Year's Day falls on our usual support group night, I've made the executive decision to push our group back to Thursday January 8th at 7pm. We have a very appropriate speaker coming to our January meeting. Angie Storey, a retiring case manager at Lanark County Mental Health, has graciously agreed to present a Compassion Fatigue (cost of caregiving) workshop to us. I know I am a little worn out after the holidays and all that goes along with supporting family members with mental health challenges through the hectic and intensive festivities. I don't imagine that I am alone in feeling this way!

Giving and Taking Advice

I had a moment today in conversation with a person about a situation with their loved one, where I gave some very good advice which I needed reminding of. I said that the most important voice you listen to is your own. That is why it is so important to be mindful of whether your internal voice has a positive or negative influence.
If your internal voice is saying, "I'm tired", "I'm so hard done by", "I don't have the energy", then that is the way your outlook becomes. If you catch yourself saying these things to yourself, try modifying the message to have a more positive, but realistic tone. "I should start to feel more awake once I have my shower, it always feels so good." This may seem silly, but the soundtrack going on in our head truly has a huge impact on our wellbeing, being mindful of what it is saying and making some small changes can have a very real, positive impact on our lives.

Education Event

In partnership with MICA http://micaontario.com Mental Illness Caregivers Association, we will be hosting a workshop for service providers and the public. This workshop will be valuable to those people who do their own research on illnesses and treatments. It is designed to help people understand and evaluate the quality of medical studies. There is abundant information available and it can be hard to determine what information has valid scientific evidence supporting it, and what information exists without such evidence. We have all seen the media present new studies in flashy headlines as concrete facts and then the following week the media can claim the opposite is true. This workshop will give you the tools to look behind the headline.
When:
Thursday February 19th
Service Providers: 2-4pm
General Public 6-8pm
Where:
Mental Health Support Project - The Link
88 Cornelia St West Unit A4

November meeting with Lanark County Mental Health's Director

We have finished SFT

Strengthening Families Together is done for the season. Six people took the course and the responses have been mostly positive. I learned about some relaxation exercises to do for self care. I have often tried to find an hour or more to put aside to do meditation, but there are many ways we can learn to relax our bodies and quiet our minds in a shorter timespan. Unfortunately, relaxation doesn't rank high in priority when dealing with our busy work and home lives, so finding ways to let some tension go during our day is important.
Here is a link to a WebMD article listing many ways to incorporate a relaxation habit into your day. I like number 5.

http://www.webmd.com/balance/guide/blissing-out-10-relaxation-techniques-reduce-stress-spot

November Support and Education Meeting

We are very fortunate to have the Director of Lanark County Mental Health, Diana McDonnell coming to our support meeting to outline services provided by LCMH as well as answer any related questions you may have. Please come and take advantage of this opportunity. Our meetings are the first Thursday of the month as usual. This month will be November 6th from 7-9pm.

October Support and Education

ODSP (Ontario Disability Support Program) Presentation

Our first Thursday of the month meeting in October will include a presentation by ODSP about the details of their program. We will be meeting at 7pm at The Link (88 Cornelia Street), in the same building as Lanark County Mental Health.
Understanding the financial supports that are available to our loved ones can help ease some of the burden of caring for them. There can be many sources of strain while caring for someone with a mental health disability. It is valuable to learn about ways to mitigate that strain. There are lots of demands on our finances during a crisis; hospital parking fees, paying out of pocket for medications, ambulance costs, helping our loved one keep their bills paid during their mental health crisis, eating out rather than at home, increased gas costs for appointments. These are cost that we don't consider when creating budgets. During our monthly meeting we will be able to learn how ODSP works and how to apply. For those who may already be receiving support through ODSP, there are parts of the program that you may be unaware of.

Strengthening Families Together (SFT)

On Tues Sept 23 we had our first SFT session. It generated lots of good discussions and I hope that it was helpful for those who attended. The first session dealt with Schizophrenia and Psychosis. There was some surprise when we discussed the prevalence of schizophrenia in our society. It affects 1% of the population and 3% of people will experience a psychotic episode at some point in their lives. Experiencing a psychotic episode does not mean that a diagnosis of schizophrenia necessarily follows. There are other causes of a psychotic episode, so careful diagnosis is important. 

Our second session will cover treatment and recovery. We will look at medication, psycho-social interventions and wellness plans.

Communication

I have found the following video very enlightening as it pertains to relating to someone who does not believe they have a mental illness. This video is by Dr. Xavier Amador, author of "I Am Not Sick, I Don't Need Help!" He is a very engaging speaker who speaks in a way laypeople can understand. Please click the link below to view him speaking at a conference.

https://www.youtube.com/watch?v=LdVj8gXsETs

September is going to be hopping

Welcome to Fall

The lazy days of summer are coming to a close and the return to a more routine schedule is a welcome relief for most people with mental illness (and their families).
Having a regular wake time can be more important than having a regular sleep time. Encouraging people who struggle to maintain normal sleeping schedules to wake at the same time every day, even if they go back to sleep after being up for a half hour, can be helpful in resetting and maintaining healthy sleep hygiene.

This Month's Support Meeting

Thursday September 4th at 7pm we will meet at The Link in Smiths Falls (same building as LCMH).

We will have a guest speaker to cover tax benefits that apply to people with disabilities and their families. Heather Chapman, who is an accountant in Brockville, has been very helpful, knowledgeable and compassionate. Her contact information is: 

www.heatherchapman.ca 

613-865-9014 

84 King Street West Suite 205 

Brockville ON K6V 3P9.

SFT

Strengthening Families Together will be run this September/October at The Link in Smiths Falls.

Please contact mentalhealthfamilies@gmail.com to register.

The course will run 4 Tuesdays in a row, starting September 23rd from 7-9pm.

Please visit http://www.schizophrenia.on.ca/Programs-Services/Strengthening-Families

to learn more about the Strengthening Families Together course. 

Summer Support

Our support group meeting has come out of nowhere. Tomorrow, Thursday July 3rd, we will meet again at the Link in Smiths Falls. I have been attending the Strengthening Families Together Online course and look forward to sharing my experiences with this format.

Another issue that I have recently experienced is estate planning for families who have people with disabilities. I have done some research and came across a very informative article. Here is a link to Special Needs Planning. The beginning of the article covers various ways of creating a will. What I found most informative was the various benefits and drawbacks of the types of giving available.

 http://www.specialneedsplanning.ca/tools.html

The Inheritance Trust

This type of trust allows Ontario residents who receive ODSP (Ontario Disability Support Program) to inherit up to $100 000.00 without impacting their ODSP eligibility. The biggest issue to consider with this type of trust is that if the trust accrues interest or grows in value to over $100 000.00, then the ODSP payments are reduced dollar for dollar by that amount. One issue which could be considered a benefit depending on the individual's situation is that the beneficiary can only withdraw $6000 in a 12 month period, unless it is used for purposes related to the disability. If the beneficiary withdraws more, their benefits are reduced dollar for dollar.

The Registered Disability Savings Plan (RDSP)

This savings plan provides an option for estate planning that doesn't require a trust or a trustee. This also allows for accessing significant government money. Contributions max out at $200 000.00 and it is after tax money which is contributed, therefor that money isn't taxed upon withdrawal. The government money which is contributed and the growth or interest is taxed upon withdrawal. The beneficiary can access the funds in the RDSP so long as the amount withdrawn is over and above the amount that the government has contributed.
In future posts I will go into more detail about the RDSP, for now here is a link with more information. 

http://rdsp.com

The Henson Trust - The Absolute Discretionary Trust

This type of giving relies on a trustee to manage the investment, management and disbursement from the trust. There are fewer restrictions than in the previous two types of giving. The trustee could in fact use money from the trust to create and fund an RDSP in order to access the government matching funds, while keeping some funds for use before the beneficiary reaches retirement age.