scholarly journals Monitoring lithium treatment: evaluation of current management

1999 ◽  
Vol 23 (2) ◽  
pp. 83-86 ◽  
Author(s):  
Anita Kotak ◽  
Ann Elaine Arnold ◽  
Peter Frost
Keyword(s):  
General Practitioners ◽  
Response Rate ◽  
Lithium Treatment ◽  
Postal Survey ◽  
Treatment Evaluation ◽  
Lithium Therapy ◽  
Clinical Implications ◽  
Current Management ◽  
Monitoring Practice

Aims and methodA postal survey of 81 general practitioners (GPs) who were Involved in lithium monitoring was undertaken, to compare their views on lithium therapy with their monitoring practice, and with the practice of psychiatrists.ResultsForty-seven replied (response rate 50.6%). There was considerable variation in GP knowledge of lithium therapy. GPs made fewer requests but wanted more information.Clinical implicationsWritten reminders and information on lithium would be useful to GPs.

scholarly journals Availability and acceptability of home treatment for acute psychiatric disorders

2000 ◽  
Vol 24 (5) ◽  
pp. 169-171 ◽  
Author(s):  
Andrew J. Owen ◽  
S. P. Sashidharan ◽  
Lyse J. Edwards
Keyword(s):  
Mental Health ◽  
Response Rate ◽  
Postal Survey ◽  
Home Treatment ◽  
Clinical Implications ◽  
Health Authorities ◽  
Low Levels ◽  
The Uk ◽  
Do So ◽  
Future Plans

Aims and MethodsTo ascertain current levels of access to home treatment for those with acute mental illness and future plans of trusts and purchasing authorities to provide such services. Also, to assess the attitudes of these organisations towards this form of treatment. A postal survey of all mental health trusts and purchasing authorities within the UK was carried out.ResultsOne hundred and seventy-two trusts and 82 health authorities returned questionnaires, representing a response rate of 75% and 67% respectively. Only 27 (16%) of trusts provided home treatment but 58 (40%) had plans to do so. All health authorities and 97% of trusts were in favour of the principle of providing home treatment.Clinical ImplicationsDespite the low levels of provision of home treatment trusts and health authorities were strongly in favourof it. There is likely to be a large increase in its availability over the next 12 months.

scholarly journals Psychiatry of learning disability – a future with mental health?

2002 ◽  
Vol 26 (8) ◽  
pp. 299-301 ◽  
Author(s):  
R. Alexander ◽  
A. Regan ◽  
S. Gangadharan ◽  
S. Bhaumik
Keyword(s):  
Mental Health ◽  
Learning Disability ◽  
Social Services ◽  
Service Provision ◽  
Postal Survey ◽  
Clinical Implications ◽  
Current Management ◽  
Process Of Change ◽  
Management Changes ◽  
Integrated Mental Health

Aims and MethodA postal survey was sent to all consultants in the psychiatry of learning disability from four English regions. Their views on job satisfaction, their core roles and the management re-structuring of services were elicited.ResultsThe proportion agreeing or strongly agreeing with each management option was 79% for integrated mental health–learning disability trusts, 61% for specialist learning disability trusts, 47% for care trusts, 10% for primary care trusts and 5% for social services. Only 34% felt consulted or able to influence the process of change and only 33% were satisfied with the current management changes within their trust but 67% were satisfied overall with their jobs.Clinical ImplicationsManagement from integrated mental health–learning disability trusts is the most preferred option for psychiatrists in learning disability. A large number of consultants, though otherwise satisfied with their jobs, feel excluded or unable to influence the current changes in management structures. A model of integrated service provision in line with the government's learning disability strategy is presented.

scholarly journals The Use of Computerized Decision Support Systems in Preventive Cardiology—Principal Results from the National Precard® Survey in Denmark

2005 ◽  
Vol 12 (1) ◽  
pp. 52-55 ◽  
Author(s):  
Lise Bonnevie ◽  
Troels Thomsen ◽  
Torben Jørgensen
Keyword(s):  
General Practitioners ◽  
Response Rate ◽  
Postal Survey ◽  
Survey Response ◽  
Management Tool ◽  
Favourable Effect ◽  
Cvd Risk ◽  
Technical Problems ◽  
Preventive Cardiology ◽  
Survey Response Rate

Background The PRECARD® program has been used for electronic cardiovascular disease (CVD) risk assessment and management in Denmark since 1999. The use of and attitudes toward the program are reported. Design and Methods Using an Internet and postal survey to all Danish general practitioners, a total of 592 Danish general practitioners participated in the Internet part of the survey (response rate 19%) and 291 in the postal survey (response rate 73%). Results in all, 21.5% of the GPs use PRECARD®, whereas 10% are ex-users. The program is used on average once a week and 64% of the users report that PRECARD® prolongs the consultation somewhat or a lot Both users and ex-users perceive the program to have a favourable effect on the patients, and as an improvement to the dialogue between GP and patient Reasons for no longer using the program are varied, such as technical problems and lack of routine with the program. Conclusions Our results indicate that an electronic risk management tool like PRECARD®, is perceived as a quality improvement in preventive cardiology in primary care. However the use of the program is not optimal and it may prolong the consultation. Eur J Cardiovasc Prev Rehabil 12:52-55 © 2005 The European Society of Cardiology

scholarly journals Patients' knowledge of their lithium therapy

1998 ◽  
Vol 22 (12) ◽  
pp. 740-743 ◽  
Author(s):  
J. Anderson ◽  
K. Sowerbutts
Keyword(s):  
Affective Disorders ◽  
Response Rate ◽  
Lithium Therapy ◽  
Clinical Implications ◽  
Theoretical Knowledge ◽  
Level Of Knowledge ◽  
Structured Questionnaire

Aims and methodUsing a semi-structured questionnaire, we surveyed the patients attending an out-patient affective disorders clinic, enquiring about their knowledge of their lithium therapy.ResultsThe response rate was 68%. In general, the level of knowledge relating to their own treatment was good, however we were able to identify particular areas of deficiency in their theoretical knowledge.Clinical implicationsThe only factor we could identify which had a significant effect on patients' level of knowledge was having received education on lithium in more than one form.

Usage of clozapine and the new neuroleptics

1999 ◽  
Vol 23 (8) ◽  
pp. 478-480
Author(s):  
M. F. Bristow
Keyword(s):  
General Practitioner ◽  
General Practitioners ◽  
Atypical Antipsychotic ◽  
Response Rate ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
England And Wales

Aims and methodTo explore clozapine and atypical antipsychotic usage in England and Wales, particularly availability, restrictions on use and shifting of prescribing to general practitioners. To examine the hypothesis that respondents in acute trusts would encounter more restrictions. Method used – postal questionnaire sent to general psychiatrists derived from the 1996 Medical Directory.ResultsThere was an 80% response rate and over 90% of respondents used clozapine, with only 9% reporting any difficulty in obtaining it. Difficulty was not associated with any particular type of trust. Only about 4% of respondents suggested that general practitioners regularly took over the prescribing costs of the drug.Clinical implicationsOptimistic, with widespread usage and few difficulties in obtaining clozapine. General practitioner prescribing is still very low and needs to increase.

scholarly journals Old age psychiatry: a speciality in transition

1999 ◽  
Vol 23 (6) ◽  
pp. 331-335 ◽  
Author(s):  
John Wattis ◽  
Andrew MacDonald ◽  
Paul Newton
Keyword(s):  
Old Age ◽  
Response Rate ◽  
Academic Development ◽  
Postal Survey ◽  
Psychiatric Services ◽  
Clinical Implications ◽  
Early Onset Dementia ◽  
Catchment Areas ◽  
Old Age Psychiatry

Aims and methodsWe aimed to update Information on the development of old age psychiatric services using a postal survey of consultants.ResultsThe response rate (51%) was lower than previous surveys in the 1980s. Senior academic appointments showed little increase and academic posts were largely National Health Service (NHS) funded. Services had smaller catchment areas and increased numbers of staff in medicine, nursing and social work, but not in occupational therapy, physiotherapy and psychology. Relative workload was increasing and most services included early-onset dementia. There was a decrease in provision of NHS long-stay beds with only marginal changes in other facilities.Clinical implicationsServices were offering more to patients than previously. Weakness in academic development may cause problems for the future; the results suggested that recruitment in some disciplines may already be problematical. There is a need to develop the role of NHS long-stay facilities.

scholarly journals Irish Psychiatric Association survey of psychiatric services in Ireland

2004 ◽  
Vol 28 (10) ◽  
pp. 364-367 ◽  
Author(s):  
V. O'Keane ◽  
A. Jeffers ◽  
E. Moloney ◽  
S. Barry
Keyword(s):  
Mental Health ◽  
Catchment Area ◽  
Response Rate ◽  
Negative Relationship ◽  
Postal Survey ◽  
Psychiatric Services ◽  
Clinical Implications ◽  
Consultant Psychiatrist ◽  
Survey Form ◽  
Catchment Areas

Aims and MethodThe Irish Psychiatric Association conducted a national survey of psychiatric services in Ireland to examine clinical resources in relation to the relative affluence of catchment areas. A consultant psychiatrist from each catchment area was sent a postal survey form (August 2002) and the data received were cross-referenced with measures of relative affluence.ResultsThere was a 72% response rate. A negative relationship emerged between indices of need and both the number of acute beds and the number of consultant psychiatrists per head of the population.Clinical ImplicationsThe results of this survey indicate that clinical resources in mental health in Ireland are not concentrated in areas of greatest need, but paradoxically have been best developed in areas of greatest affluence.

Lithium can cause hyperthyroidism as well as hypothyroidism: A systematic review of an under-recognised association

2019 ◽  
Vol 53 (5) ◽  
pp. 384-402 ◽  
Author(s):  
Fiona Fairbrother ◽  
Nicola Petzl ◽  
James G Scott ◽  
Steve Kisely
Keyword(s):  
Cohort Studies ◽  
Clinical Symptoms ◽  
Case Reports ◽  
Lithium Treatment ◽  
Affective State ◽  
Case Series ◽  
Case Control ◽  
Lithium Therapy ◽  
Clinical Implications ◽  
Cross Sectional

Objective: Hypothyroidism is a well-documented consequence of lithium treatment. Less well known is a possible association between lithium therapy and hyperthyroidism. This may have clinical implications as rapid changes in thyroid hormones may worsen a person’s affective state, while symptoms of hyperthyroidism can mimic those of mania. We therefore systematically reviewed the published literature for evidence of lithium-induced hyperthyroidism. Methods: We searched PubMed, Embase and CINAHL for articles where individuals developed biochemically confirmed hyperthyroidism (with or without clinical symptoms), while on lithium therapy for an affective illness. We included case reports, case series, cross-sectional, case control and cohort studies. Results: We included 52 studies, 39 of which were individual case reports and 3 were case series. There were 10 cross-sectional or case control or cohort studies. All the research designs suggested an association between the prescription of lithium and hyperthyroidism. However, these findings were limited by the quality of the included studies, small number of participants and the general lack of either a clear temporal relationship or dose response. Conclusion: Hyperthyroidism is an uncommon side-effect of lithium compared to hypothyroidism but may have clinical implications. However, large prospective studies are required to clarify this association and to further inform the management of patients treated with lithium where hyperthyroidism occurs.

scholarly journals Physical activity counselling in Ireland: a survey of doctors’ knowledge, attitudes and self-reported practice

2019 ◽  
Vol 5 (1) ◽  
pp. e000572 ◽  
Author(s):  
Sarah O'Brien ◽  
Lucia Prihodova ◽  
Mairéad Heffron ◽  
Peter Wright
Keyword(s):  
Physical Activity ◽  
General Practitioners ◽  
Royal College ◽  
Patient Preference ◽  
Online Survey ◽  
Response Rate ◽  
Further Education ◽  
Pharmaceutical Intervention ◽  
And Training ◽  
Do So

ObjectivePhysical activity (PA) counselling has been shown to raise awareness of the importance of PA and to increase the rate of PA engagement among patients. While much attention has been paid to examining the knowledge, attitudes and practice of general practitioners in relation to PA counselling, there is less literature examining such issues in hospital-based doctors in Ireland and further afield. This study aimed to explore doctors’ PA counselling practices and to analyse how this related to their level of PA knowledge, training and attitudes.MethodsAn invitation to participate in an online survey was sent to 4692 members of the Royal College of Physicians of Ireland who were listed as having an address in Ireland. Descriptive and explorative analyses of the data were performed using IBM SPSS V.22.0.ResultsA total of 595 valid responses were included (response rate 12.7%; 42.7% male, 42.6±12.1 years). The majority reported enquiring about PA levels (88.0%) and providing PA counselling (86.4%) in at least some of their patients. Doctors who saw it as their role and those who felt more effective/confident in providing PA counselling were significantly more likely to do so. A perceived lack of patient interest in PA and patient preference for pharmaceutical intervention were significant barriers to undertaking PA counselling.ConclusionThis study demonstrates the need for further education and training in PA counselling in Ireland with a particular focus on improving the attitudes and self-efficacy of doctors in this area at both undergraduate and postgraduate levels.

scholarly journals Cognitive therapy training for psychiatrists: impact on individual clinical practice

2004 ◽  
Vol 28 (4) ◽  
pp. 117-119 ◽  
Author(s):  
G. Swift ◽  
I. Durkin ◽  
C. Beuster
Keyword(s):  
Clinical Practice ◽  
Cognitive Therapy ◽  
Response Rate ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
Previous Survey ◽  
Therapy Training ◽  
Training And Supervision ◽  
Improved Outcomes ◽  
Therapy Sessions

Aims and MethodWe aimed to survey how psychiatrists with in-depth training in cognitive therapy use these skills. A postal questionnaire based on a previous survey was sent to all psychiatrists who are accredited members of the British Association for Behavioural and Cognitive Psychotherapies.ResultsThere was a 94% response rate. Psychiatrists in non-psychotherapy posts used formal cognitive therapy, with an average of 20% of new patients compared with 65% for those in psychotherapy posts, and were less satisfied with the extent to which they were able to use their skills (20%v. 80%). A total of 85% of respondents described themselves as being involved in teaching, training and supervision of cognitive therapy.Clinical ImplicationsUnless psychiatrists are planning on working in specialised psychotherapy posts, they are unlikely to use cognitive therapy training in formal therapy sessions. Further research is needed to determine whether cognitive therapy training for psychiatrists translates into improved outcomes for patients.

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