Predictors of Medication Compliance After Hospital Discharge in Adolescent Psychiatric Patients

1998 ◽  
Vol 8 (2) ◽  
pp. 133-141 ◽  
Author(s):  
ANNE LLOYD ◽  
WILLIAM HORAN ◽  
SUSAN R. BORGARO ◽  
JOHN M. STOKES ◽  
DAVID L. POGGE ◽  
...  
Keyword(s):  
Hospital Discharge ◽  
Medication Compliance ◽  
Psychiatric Patients

scholarly journals Association of continuity of care with readmission, mortality and suicide after hospital discharge among psychiatric patients

2020 ◽  
Vol 32 (9) ◽  
pp. 569-576
Author(s):  
Young Choi ◽  
Chung Mo Nam ◽  
Sang Gyu Lee ◽  
Sohee Park ◽  
Hwang-Gun Ryu ◽  
...  
Keyword(s):  
Hospital Discharge ◽  
Continuity Of Care ◽  
Psychiatric Patients ◽  
Psychiatric Inpatients ◽  
Post Discharge ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Nested Case Control ◽  
Control Study

Abstract Objectives The objective of this study was to identify the association between continuity of ambulatory psychiatric care after hospital discharge among psychiatric patients and readmission, mortality and suicide. Design Nationwide nested case-control study. Settings South Korea. Participants Psychiatric inpatients. Interventions Continuity of psychiatric outpatient care was measured from the time of hospital discharge until readmission or death occurred, using the continuity of care index. Main Outcome Measures Readmission, all-cause mortality and suicides within 1-year post-discharge. Results Of 18 702 psychiatric inpatients in the study, 8022 (42.9%) were readmitted, 355 (1.9%) died, and 108 (0.6%) died by suicide within 1 year after discharge. Compared with the psychiatric inpatients with a high continuity-of-care score, a significant increase in the readmission risk within 1 year after discharge was found in those with medium and low continuity of care scores. An increased risk of all-cause mortality within 1 year after hospital discharge was shown in the patients in the low continuity group, relative to those in the high-continuity group. The risk of suicide within 1 year after hospital discharge was higher in those with medium and low continuity of care than those with high continuity of care. Conclusion The results of this study provide empirical evidence of the importance of continuity of care when designing policies to improve the quality of mental health care, such as increasing patient awareness of the importance of continuity and implementation of policies to promote continuity.

scholarly journals Newly Initiated In-Hospital Antipsychotics Continued at Discharge in Non-psychiatric Patients

2018 ◽  
Vol 53 (5) ◽  
pp. 308-315 ◽  
Author(s):  
Gabriel V. Fontaine ◽  
Whitney Mortensen ◽  
Kathryn M. Guinto ◽  
Danielle M. Scott ◽  
Russell R. Miller
Keyword(s):  
Health Care ◽  
Hospital Discharge ◽  
Health Care System ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Psychiatric Illness ◽  
Psychiatric Patients ◽  
Final Analysis ◽  
To Receive ◽  
Care System

Objectives: Antipsychotics are commonly initiated in the hospital for agitation and delirium and may be inappropriately continued upon floor transfer and at discharge. We sought to evaluate the magnitude of this issue within our health care system. Methods: We conducted a multicenter, retrospective cohort study within a 22-hospital health care system to evaluate the proportion of patients without identifiable psychiatric illness who received newly initiated inpatient antipsychotics and were then continued on an antipsychotic at hospital discharge. Results: Of 23 049 patients who received at least 1 in-hospital dose of haloperidol, olanzapine, quetiapine, risperidone, or ziprasidone, 8297 patients were included in the final analysis after applying exclusion for identifiable psychiatric illness or previous antipsychotic use. Ultimately, 334 patients (4%) were discharged with a new antipsychotic prescription. Patients receiving antipsychotics at discharge were more likely as an inpatient to receive quetiapine (77.2% vs 35.9%; odds ratio [OR]: 6.1, 95% confidence interval [CI]: 4.7-8.0; P < .001) and less likely to receive haloperidol (15% vs 47%; OR: 0.2, 95% CI: 0.14-0.27; P < .001) or olanzapine (16.2% vs 20.9%; OR: 0.73, 95% CI: 0.53-0.98; P < .04). Conclusions: Antipsychotics may be inappropriately continued in non-psychiatric patients at hospital discharge. Strategies to limit potentially unnecessary antipsychotics upon discharge should be evaluated.

scholarly journals Sexual dysfunction: prevalence and associated factors in patients with mental illness receiving psychotropic medication in Nigeria

1970 ◽  
Vol 19 (4) ◽  
pp. 2973-2984 ◽  
Author(s):  
Samuel Obateru Osasona ◽  
Mary Ehimigbai
Keyword(s):  
Sexual Dysfunction ◽  
Psychotropic Medication ◽  
Medication Compliance ◽  
Psychiatric Patients ◽  
Tertiary Care ◽  
Self Esteem ◽  
Psychiatric Medication ◽  
Duration Of Treatment ◽  
Cross Sectional ◽  
Sexual Symptoms

Objectives: The objectives were to determine the prevalence of total and specific sexual dysfunction among psychiatric out-patients taking psychotropic medication, assess its relationship with some demographic and clinical variables, determine the effect of sexual dysfunction on subject’s self- esteem and compliance with medication.Methods: This descriptive, cross-sectional study was conducted in the psychiatric out-patient clinic of a Tertiary Care Teaching Hospital in Benin City. The International Index of Erectile Functioning (IIEF), Rosenberg’s self esteem scale and a socio-demographic and clinical data questionnaire were administered to 300 participants; 150 (50%) psychiatric male patients and 150 (50%) controls.Results: The prevalence of total sexual dysfunction was 48.7%, while that of the specific SDs ranged from 20.0% to 39.3%, with erectile dysfunction having the highest proportion. Age, marital status, class, dose of psychotropic medication, poly-pharmacy and duration of treatment were significantly associated with SD. Majority of patient with SD reported poor compliance with medication. Self-esteem scores had significant inverse relationship with total SD scores.Conclusion: Sexual dysfunction is prevalent amongst psychiatric patients taking psychiatric medication and has negative implications for self-esteem and medication compliance. Routine enquiry about sexual symptoms by physicians and prompt treatment of SD might enhance overall treatment success.Keywords: Sexual dysfunction, psychiatric patients, psychotropic medication, Nigeria.

Knowledge and Compliance towards Lithium Therapy among Chinese Psychiatric Patients in Hong Kong

1992 ◽  
Vol 26 (3) ◽  
pp. 444-449 ◽  
Author(s):  
Sing Lee ◽  
Y. K. Wing ◽  
K. C. Wong
Keyword(s):  
Patient Education ◽  
Therapeutic Alliance ◽  
Medication Compliance ◽  
Psychiatric Patients ◽  
Lithium Treatment ◽  
Medical Knowledge ◽  
Lithium Therapy ◽  
Chinese Patients ◽  
Drug Knowledge ◽  
Exact Relationship

Although patient education is believed to promote medication compliance, the exact relationship between the acquisition of drug knowledge and compliance during lithium treatment is unclear. A survey of 50 Chinese patients on maintenance lithium therapy revealed that their medical knowledge about lithium treatment, as measured by a “Lithium Questionnaire,” was very limited. Nonetheless, 70% of these patients were found, by multiple criteria, to be good compliers, and lithium compliance was apparently not affected by the amount of drug knowledge that patients possessed. It is argued that in the process of conducting patient education to enhance lithium compliance, a sound therapeutic alliance is more important than sheer knowledge acquisition.

scholarly journals The Wessex Recent In-Patient Suicide Study, 1

2001 ◽  
Vol 178 (6) ◽  
pp. 531-536 ◽  
Author(s):  
Elizabeth A. King ◽  
David S. Baldwin ◽  
Julia M. A. Sinclair ◽  
Nigel G. Baker ◽  
Michael J. Campbell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Discharge ◽  
Suicide Risk ◽  
Care Delivery ◽  
Psychiatric Patients ◽  
Retrospective Case ◽  
Patient Suicide ◽  
Increased Risk ◽  
Discharged Patients ◽  
History Of

BackgroundPsychiatric patients have a higher suicide risk following hospital discharge.AimsTo identify social, clinical and health-care delivery factors in recently discharged patients.MethodRetrospective case-control study of 234 patients who died within 1 year of hospital discharge, matched for age, gender, diagnosis and admission period with 431 controls. Odds ratios for identified risk factors were calculated using conditional multiple logistic regression.ResultsIndependent increased-risk factors were: not being White; living alone; history of deliberate self-harm (DSH); suicidal ideation precipitating admission; hopelessness; admission under different consultant; onset of relationship difficulties; loss of job; in-patient DSH; unplanned discharge; significant care professional leaving/on leave. Reduced-risk factors were: shared accommodation; delusions at admission; misuse of non-prescribed substances; and continuity of contact.ConclusionsContinuity of contact may reduce suicide risk. Discontinuity of care from a significant professional is associated with increased risk of suicide.

scholarly journals Motivational Interviewing and Clinical Psychiatry

2005 ◽  
Vol 50 (11) ◽  
pp. 715-721 ◽  
Author(s):  
Florence Chanut ◽  
Thomas G Brown ◽  
Maurice Dongier
Keyword(s):  
Motivational Interviewing ◽  
Clinical Psychiatry ◽  
Medication Compliance ◽  
Psychiatric Patients ◽  
Literature Survey ◽  
Motivation To Change ◽  
Established Method ◽  
Addictions Treatment ◽  
Literature Reviews ◽  
Communications Skills

Objectives: Our objectives were as follows: 1) to survey the literature on motivational interviewing (MI), “a client-centered yet directive method for enhancing intrinsic motivation to change by exploring and resolving client ambivalence” and a well-established method of brief intervention, especially in the field of addictions treatment; 2) to review hypotheses about its mode of action; and 3) to discuss its possible impact on clinical psychiatry, in particular, on teaching communications skills. Method: Literature reviews and metaanalyses of numerous clinical trials of MI for addictions treatment have already been published and are briefly summarized. So far, no literature survey exists for MI applied to psychiatric patients. This review is limited to a synthesis of the articles relevant to psychiatry and to comments based on our team's experiences with MI. Results: There is no evidence that MI achieves better results than other established techniques for treating addictions; it may simply work faster. The explanation for the method's rapid effectiveness remains speculative. Outcomes concerning the application of MI to psychiatric patients, although preliminary, are promising. Methods of assessing the integrity of MI treatment are more developed than in most psychotherapies, which permits the learning progress of trainees to be measured. Conclusions: MI offers a complement to usual psychiatric procedures. It may be worthwhile to teach it, not only for addictions but also for other broad treatment issues, such as enhancing patients' medication compliance and professionals' communication skills. Questions remain concerning MI's feasibility in psychiatry settings.

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