scholarly journals Comparing general practitioners and specialist alcohol services in the management of alcohol withdrawal

2000 ◽  
Vol 24 (6) ◽  
pp. 214-215 ◽  
Author(s):  
P. C. Naik ◽  
J. Lawton ◽  
L. W. Brownell
Keyword(s):  
General Practitioners ◽  
Alcohol Withdrawal ◽  
Postal Questionnaire ◽  
B Vitamins ◽  
Clinical Implications ◽  
Pharmacological Management ◽  
History Of

Aims and MethodA postal questionnaire was used to compare the pharmacological management of alcohol withdrawal as carried out by a group of general practitioners and specialist alcohol services.ResultsGeneral practitioners were significantly more likely to prescribe chlormethiazole, less likely to use B vitamins and less likely to admit patients with a history of withdrawal complications.Clinical ImplicationsGeneral practitioners need training in order to improve their management of alcohol withdrawal.

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 Pharmacological management of alcohol withdrawal in a general hospital

2008 ◽  
Vol 32 (12) ◽  
pp. 452-454
Author(s):  
Siobhain Quinn ◽  
Rani Samuel ◽  
Jim Bolton ◽  
Borislav Iankov ◽  
Anna Stout
Keyword(s):  
General Hospital ◽  
Brain Damage ◽  
Alcohol Withdrawal ◽  
Clinical Implications ◽  
National Guidelines ◽  
Pharmacological Management ◽  
Before And After ◽  
Alcohol Detoxification ◽  
Alcohol Dependent

Aims and MethodTo assess the quality of prescriptions for alcohol detoxification and vitamin prophylaxis for in-patients who were alcohol-dependent in a general hospital, before and after the introduction of prescribing guidelines. We assessed 27 prescription charts before and 22 after intervention against standards based on national guidelines.ResultsThere was an increase of 43% (95% CI 20–65%) in the proportion of alcohol detoxification prescriptions that met the guidelines. for vitamin prophylaxis there was an increase of 64% (95% CI 42–85%).Clinical ImplicationsThe pharmacological management of alcohol withdrawal in the general hospital can be significantly improved by promoting and making readily available a prescribing guideline. In turn, this may reduce alcohol-related brain damage.

scholarly journals Survey of suicides in the Fife region of Scotland

1999 ◽  
Vol 23 (5) ◽  
pp. 267-269
Author(s):  
Fergus Douds ◽  
Vicky Bridges
Keyword(s):  
Risk Factors ◽  
General Practitioner ◽  
General Practitioners ◽  
Clinical Audit ◽  
Psychiatric Services ◽  
Clinical Implications ◽  
History Of ◽  
Previous Contact ◽  
General Practices ◽  
Reduce Risk

Aims and methodsSuicides in the Fife region were investigated over a two-year period. The timing of the final contact with general practitioners and psychiatric services was ascertained. Data were collected from procurators fiscal records, general practices, and where applicable, psychiatric records.ResultsThere were 74 suicide victims during the study period. Forty-six per cent of suicide victims saw their general practitioner in the month before death, and 55% had a history of previous contact with psychiatric services, although only 27% of this group saw a psychiatrist in the month before death.Clinical implicationsClinical audit of suicide is an important task for psychiatric services. Practitioners must continually assess risk and attempt, where possible, to reduce risk factors.

scholarly journals Correspondence from substance misuse services – what do general practitioners really want?

2006 ◽  
Vol 30 (8) ◽  
pp. 292-294
Author(s):  
Devatha Radhae Shyam ◽  
Hugh Williams
Keyword(s):  
General Practitioners ◽  
Questionnaire Survey ◽  
Substance Misuse ◽  
Quality Standards ◽  
Management Plan ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
Medication Prescribing

Aims and MethodTo improve the quality of correspondence by identifying what general practitioners (GPs) regarded as the important attributes in patient letters from a substance misuse service. A postal questionnaire survey was carried out to determine the views of general practitioners in Brighton and Hove City.ResultsResponses were obtained from 32 out of 45 GP surgeries (71%) and indicated that correspondence should be prompt, concise and regular. An assessment summary, management plan and clear medication prescribing arrangements between primary and secondary services were considered particularly important.Clinical ImplicationsNew quality standards for correspondence to GPs have been implemented by the Brighton Substance Misuse Service. These might be of interest to other such services.

scholarly journals Drug services in England and Wales: a survey of treatment providers and their medical leads

2006 ◽  
Vol 30 (4) ◽  
pp. 140-142
Author(s):  
Nick Airey ◽  
Stuart McLaren
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Social Services ◽  
General Practitioners ◽  
Questionnaire Survey ◽  
Drug Action ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
England And Wales ◽  
Treatment Providers

Aims and MethodWe undertook a postal questionnaire survey of drug action teams in England and Wales with the aim of clarifying the nature of statutory specialist drug services.ResultsOf 159 drug action teams, 110 (69%) responded; 64 (58%) reported that mental health trusts exclusively provided their specialist drug services. Other providers were primary care and acute trusts, the non-statutory sector and social services. The majority of medical leads were psychiatrists (123 senior posts with 20% vacant/occupied by a locum), then general practitioners (GPs) (42) and other specialists (4).Clinical ImplicationsSpecialist drug services are offered by a range of treatment providers, with the medical lead being taken by GPs and other specialists in some areas. In view of the current difficulty in recruiting psychiatrists, we propose that alternative training pathways are considered for addiction specialists.

scholarly journals Droperidol dropped; consultants not consulted

2003 ◽  
Vol 27 (08) ◽  
pp. 301-304
Author(s):  
Gavin Reid ◽  
Mark Hughson
Keyword(s):  
Questionnaire Survey ◽  
Clinical Care ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
The West ◽  
Abrupt Withdrawal ◽  
Before And After ◽  
Adequate Evaluation ◽  
Psychiatric Profession ◽  
The Impact

Aims and Method We conducted a postal questionnaire survey of the practice of rapid tranquillisation among 215 consultant psychiatrists in the West of Scotland, before and after the withdrawal of droperidol by the manufacturer. Results One hundred and eighty questionnaires (84% of those sent) were returned. Droperidol had been used extensively, often combined with lorazepam, for rapid tranquillisation. The main replacement suggested for droperidol was haloperidol. About half of the respondents to our survey chose to comment on the withdrawal of droperidol. More than half of the comments were unfavourable, including lack of an adequate replacement and lack of consultation with the psychiatric profession. Clinical Implications The abrupt withdrawal of droperidol, partly for commercial reasons, was regrettable. There was no time for an adequate evaluation of possible replacement medications and a lack of consultation with the profession regarding the impact on clinical care.

scholarly journals Ketogenic diet reduces alcohol withdrawal symptoms in humans and alcohol intake in rodents

2021 ◽  
Vol 7 (15) ◽  
pp. eabf6780
Author(s):  
Corinde E. Wiers ◽  
Leandro F. Vendruscolo ◽  
Jan-Willem van der Veen ◽  
Peter Manza ◽  
Ehsan Shokri-Kojori ◽  
...  
Keyword(s):  
Ketogenic Diet ◽  
Alcohol Withdrawal ◽  
Alcohol Use Disorder ◽  
Alcohol Intake ◽  
Anterior Cingulate ◽  
Dorsal Anterior Cingulate Cortex ◽  
Beneficial Effects ◽  
Alcohol Cues ◽  
History Of ◽  
To Receive

Individuals with alcohol use disorder (AUD) show elevated brain metabolism of acetate at the expense of glucose. We hypothesized that a shift in energy substrates during withdrawal may contribute to withdrawal severity and neurotoxicity in AUD and that a ketogenic diet (KD) may mitigate these effects. We found that inpatients with AUD randomized to receive KD (n = 19) required fewer benzodiazepines during the first week of detoxification, in comparison to those receiving a standard American (SA) diet (n = 14). Over a 3-week treatment, KD compared to SA showed lower “wanting” and increased dorsal anterior cingulate cortex (dACC) reactivity to alcohol cues and altered dACC bioenergetics (i.e., elevated ketones and glutamate and lower neuroinflammatory markers). In a rat model of alcohol dependence, a history of KD reduced alcohol consumption. We provide clinical and preclinical evidence for beneficial effects of KD on managing alcohol withdrawal and on reducing alcohol drinking.

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.

scholarly journals Evaluation of a mental health website for teenagers

2006 ◽  
Vol 30 (5) ◽  
pp. 175-178 ◽  
Author(s):  
Sukru Ercan ◽  
Andrew Kevern ◽  
Leo Kroll
Keyword(s):  
Mental Health ◽  
Social Workers ◽  
General Practitioners ◽  
School Nurses ◽  
The Self ◽  
Clinical Implications ◽  
Self Assessment ◽  
Perceived Need ◽  
Screening Questionnaires ◽  
Assessment Questionnaire

Aim and MethodRu-ok.com is a recently developed website that includes a self-assessment questionnaire. The aim of this study was to evaluate the website and compare the self-assessment questionnaire with established screening questionnaires. A total of 105 teenagers from schools completed three paper-based questionnaires and the online ru-ok.com questionnaire.ResultsThe website receives 730 visits a week. Visits to the advice section and stories about mental health and relationships account for 35% of activity. Of the returned questionnaires, 80% were positive about the website. There were modest and expected correlations between the website questionnaire (RU–OK) and the Mood and Feelings (MFQ) and Strength and Difficulties (SDQ) questionnaires.Clinical ImplicationsInternet-based self-assessment is feasible and acceptable to teenagers. Self-assessment of perceived need by teenagers may be a useful tool for tier one professionals, including teachers, general practitioners, school nurses, social workers and learning mentors.

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