Clinical pathways are known to be key in managing chronic conditions in an effective and sustainable way. This is particularly true in psychiatry, characterized by chronicity and managerial challenges. In particular, the borderline personality disorder is a highly complicated disorder to manage. Although numerous international guidelines converge on the urge of defining clinical pathways and a stepped-care model for its effective treatment, it is unknown to what extent these guidelines have been implemented into concrete changes in the provision of care. The objective of this study is to pursue a preliminary assessment of whether there exists coherence between the provision of formal health dispositions or guidelines and end-users' perception of the change they should imply. A pilot study investigating the perception of parents of patients with borderline disorder on continuity of care has been conducted in three Italian regions. Results suggest that pathways do exist and are partially able to reach their intended effects, although concrete accessibility is still a major issue. Future studies should build on these preliminary results through quantitative investigation and further explore their causes.
Keywords: Italy; accessibility; clinical pathways; guideline implementation; psychiatry; stepped care.
© 2021 The Authors. The International Journal of Health Planning and Management published by John Wiley & Sons Ltd.