Do patients who receive electroconvulsive therapy in Scotland get better?

2003 ◽  
Vol 27 (4) ◽  
pp. 137-140 ◽  
Author(s):  
Grace Fergusson ◽  
James Hendry ◽  
Chris Freeman
Keyword(s):  
Electroconvulsive Therapy ◽  
Clinical Setting ◽  
Rating Scale ◽  
National Level ◽  
Depressive Illness ◽  
Electronic Data Collection ◽  
Process And Outcome ◽  
Routine Clinical Setting ◽  
The Uk

Aims and MethodWe aimed to compare the practice of electroconvulsive therapy (ECT) in Scotland with the recommendations of the Royal College of Psychiatrists, to determine the characteristics of patients who receive ECT, to assess the outcome of ECT given in a routine clinical setting and to develop a system of quality assurance for ECT. Between February 1997 and March 2000, an audit of ECT measured the quality of treatment given at all clinics in Scotland. Audit tools were designed and standards set for the process, and outcome of treatment and interventions were identified to address any variance prior to each audit cycle. An electronic data collection system was developed and a website produced for the purpose of continued audit and information sharing.ResultsThe annual rate of ECT in Scotland was 142 individual treatments per 100 000 of the total population. Electroconvulsive therapy was given mainly to White adult patients with a depressive illness who had consented to treatment. Clinical improvement, as measured by at least a 50% reduction in the Montgomery–Åsberg Rating Scale for Depression (MADRS) score, was evident in 71.2% of patients with a depressive episode.Clinical ImplicationsThe audit of ECT is achievable at a national level, ECT is effective in a routine clinical setting and the standards at ECT in Scotland are higher than the UK average.

scholarly journals Do patients who receive electroconvulsive therapy in Scotland get better?

2003 ◽  
Vol 27 (04) ◽  
pp. 137-140
Author(s):  
Grace Fergusson ◽  
James Hendry ◽  
Chris Freeman
Keyword(s):  
Electroconvulsive Therapy ◽  
Clinical Setting ◽  
Rating Scale ◽  
National Level ◽  
Depressive Illness ◽  
Electronic Data Collection ◽  
Process And Outcome ◽  
Routine Clinical Setting ◽  
The Uk

Aims and Method We aimed to compare the practice of electroconvulsive therapy (ECT) in Scotland with the recommendations of the Royal College of Psychiatrists, to determine the characteristics of patients who receive ECT, to assess the outcome of ECT given in a routine clinical setting and to develop a system of quality assurance for ECT. Between February 1997 and March 2000, an audit of ECT measured the quality of treatment given at all clinics in Scotland. Audit tools were designed and standards set for the process, and outcome of treatment and interventions were identified to address any variance prior to each audit cycle. An electronic data collection system was developed and a website produced for the purpose of continued audit and information sharing. Results The annual rate of ECT in Scotland was 142 individual treatments per 100 000 of the total population. Electroconvulsive therapy was given mainly to White adult patients with a depressive illness who had consented to treatment. Clinical improvement, as measured by at least a 50% reduction in the Montgomery–Åsberg Rating Scale for Depression (MADRS) score, was evident in 71.2% of patients with a depressive episode. Clinical Implications The audit of ECT is achievable at a national level, ECT is effective in a routine clinical setting and the standards at ECT in Scotland are higher than the UK average.

scholarly journals Trainee views on active problems and issues in UK psychiatry

2000 ◽  
Vol 24 (9) ◽  
pp. 336-338 ◽  
Author(s):  
Rowan Wilson ◽  
Catherine L. Corby ◽  
Maria Atkins ◽  
Geoff Marston
Keyword(s):  
Royal College ◽  
National Level ◽  
Clinical Implications ◽  
Recruitment And Retention ◽  
Public Expectations ◽  
The Uk

Aims and MethodA questionnaire sent to trainees in three regions of the UK asked them which current issues they felt were most important in psychiatry. Comments were invited of ways to improve the UK practice of psychiatry.ResultsTrainees from each of the regions were concerned about inadequate resourcing, public expectations, manpower and quality of training. Solutions to these problems were collated.Clinical ImplicationsThe opinion of trainees reflects the recent initiatives undertaken by the Royal College of Psychiatrists to improve recruitment and retention. Consultants and trainees have similar concerns, which need to be addressed and monitored at a local and national level.

scholarly journals Measuring patient and carer experience related to paediatric gastrointestinal endoscopy: multicentre questionnaire study

2020 ◽  
Vol 11 (6) ◽  
pp. 448-453
Author(s):  
Jessica Wai Yan Wan ◽  
Elizabeth Griffiths ◽  
Rosalind Rabone ◽  
Zahmeena Zuhair ◽  
Zuzana Londt ◽  
...  
Keyword(s):  
Rating Scale ◽  
Global Rating Scale ◽  
Global Rating ◽  
Microsoft Excel ◽  
Age Appropriate ◽  
Patient Advice ◽  
The Uk ◽  
Quality Improvement Tool ◽  
Experience Questionnaire

BackgroundThe Paediatric Endoscopy Global Rating Scale (P-GRS) is a quality improvement tool used in the UK. An important aspect of this includes regular surveys on the patient and/or carer’s endoscopy experience. The aim of our study was to design and implement a patient/carer experience questionnaire.MethodsThis questionnaire was designed to obtain feedback on patient and/or carer satisfaction with their endoscopy experience. Question selection was based on relevant measures in the endoscopy Global Rating Scale, with input from clinical governance, Patient Advice and Liaison Service and a hospital youth forum. This was distributed to patients and/or carers in three UK paediatric endoscopy services during six surveys between 2013 and 2018. Data were then collated and analysed on Microsoft Excel for Office 365 MSO (16.0.11901.20070).ResultsOverall, 830 endoscopic procedures occurred during the six survey periods. 270 questionnaires were returned. Feedback from the questionnaires were mostly positive (overall satisfaction rated ‘excellent’ or ‘good’ was seen in 87% of responses) but also identified areas of improvement, such as in managing postprocedure pain and having a separate space for adolescents for preprocedure discussions. Improvements in satisfaction scores were noted in one unit over time, particularly in preprocedure preparation (from 86% to 100%), and overall satisfaction with endoscopy experience (81%–100%).ConclusionAll three paediatric endoscopy services found this questionnaire useful in identifying areas needing improvement and in demonstrating compliance with measures within the P-GRS quality of patient experience domain. Further work includes exploring ways to increase response rates, as well as developing age-appropriate and electronic versions.

scholarly journals The Endoscopy Global Rating Scale – Canada: Development And Implementation of a Quality Improvement Tool

2013 ◽  
Vol 27 (2) ◽  
pp. 74-82 ◽  
Author(s):  
Donald MacIntosh ◽  
Catherine Dubé ◽  
Roger Hollingworth ◽  
Sander Veldhuyzen van Zanten ◽  
Sandra Daniels ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Quality ◽  
Rating Scale ◽  
Two Dimensions ◽  
Care Quality ◽  
Global Rating Scale ◽  
Global Rating ◽  
Charge Nurse ◽  
The Uk

BACKGROUND: Increasing use of gastrointestinal endoscopy, particularly for colorectal cancer screening, and increasing emphasis on health care quality highlight the need for endoscopy facilities to review the quality of the service they offer.OBJECTIVE: To adapt the United Kingdom Global Rating Scale (UK-GRS) to develop a web-based and patient-centred tool to assess and improve the quality of endoscopy services provided.METHODS: Based on feedback from 22 sites across Canada that completed the UK endoscopy GRS, and integrating results of the Canadian consensus on safety and quality indicators in endoscopy and other Canadian consensus reports, a working group of endoscopists experienced with the GRS developed the GRS-Canada (GRS-C).RESULTS: The GRS-C mirrors the two dimensions (clinical quality and quality of the patient experience) and 12 patient-centred items of the UK-GRS, but was modified to apply to Canadian health care infrastructure, language and current practice. Each item is assessed by a yes/no response to eight to 12 statements that are divided into levels graded D (basic) through A (advanced). A core team consisting of a booking clerk, charge nurse and the physician responsible for the unit is recommended to complete the GRS-C twice yearly.CONCLUSION: The GRS-C is intended to improve endoscopic services in Canada by providing endoscopy units with a straightforward process to review the quality of the service they provide.

scholarly journals Orthodontic apps: an assessment of quality (using the Mobile App Rating Scale (MARS)) and behaviour change techniques (BCTs)

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
N. R. Siddiqui ◽  
S. J. Hodges ◽  
M. O. Sharif
Keyword(s):  
Behaviour Change ◽  
Rating Scale ◽  
Mobile App ◽  
Behaviour Change Techniques ◽  
List Type ◽  
Behaviour Change Wheel ◽  
Current Availability ◽  
The Uk ◽  
Google Play

Abstract Background Apps have been shown to be an effective tool in changing patients’ behaviours in orthodontics and can be used to improve their compliance with treatment. The Behaviour Change Techniques (BCTs) and quality (using MARS) within these apps have previously not been published. Objectives To evaluate the quality of these apps aiming to change behaviour. To assess BCTs used in patient focused orthodontic apps. Methods The UK Google Play and Apple App Stores were searched to identify all orthodontic apps and 305 apps were identified. All 305 apps were assessed for the presence of BCTs using an accepted taxonomy of BCTs (Behaviour Change Wheel (BCW)), widely utilised in healthcare. Of those containing BCTs, the quality was assessed using the Mobile App Rating Scale (MARS), a validated and multi-dimensional tool which rates apps according to 19 objective criteria. Data collection was carried out by two calibrated, independent assessors and repeated after 6 weeks for 25% of the apps by both assessors. Results BCTs were found in 31 apps, although only 18 of them were analysed for quality and 13 apps were excluded. Six different BCTs were identified: these were most commonly ‘prompts/cues’, and ‘information about health consequences’. All apps were shown to be of moderate quality (range 3.1–3.7/5). Inter-rater and intra-rater reliability for BCT and quality assessment were excellent. Conclusions The current availability of orthodontic apps of sufficient quality to recommend to patients is very limited. There is therefore a need for high-quality orthodontic apps with appropriate BCTs to be created, which may be utilised to improve patients’ compliance with treatment.

Antidepressants: Partial Response in Chronic Depression

1994 ◽  
Vol 165 (S26) ◽  
pp. 37-41 ◽  
Author(s):  
Jan Fawcett
Keyword(s):  
Partial Response ◽  
Maintenance Treatment ◽  
Rating Scale ◽  
Treatment Resistance ◽  
Active Treatment Group ◽  
Depressive Illness ◽  
Chronic Depression ◽  
Work Impairment ◽  
Total Failure

Although most studies of chronic depression show significant improvements with antidepressants versus placebo, the average Hamilton Depression Rating Scale results attained in the active-treatment group range between 10 and 14, suggesting that many patients only partially responded and failed to reach premorbid levels of symptom remission. Studies on the fate of these patients suggest that they are much more vulnerable to relapse, work impairment and suicide. Thus, partial response may be one form of treatment resistance, falling between total failure of response in a minority of patients, and a tendency to relapse or recur despite adequate maintenance treatment. Further study is needed to address the problem of improving the quality of response and attempting to reduce the detrimental effects of depressive illness in terms of relapse and recurrence.

Use of ultrabrief pulse width electroconvulsive therapy to induce therapeutic seizures in an elderly patient with a high seizure threshold: a case report

2019 ◽  
Vol 28 (3) ◽  
pp. 291-296
Author(s):  
David Plevin ◽  
Susan Waite
Keyword(s):  
Case Report ◽  
Electroconvulsive Therapy ◽  
Pulse Width ◽  
Depressive Illness ◽  
Electrode Placement ◽  
Seizure Threshold ◽  
Augmentation Strategies ◽  
Seizure Quality ◽  
Unipolar Major Depression

Objective: This case report describes a 73-year-old man suffering from unipolar major depression with melancholic features, in whom treatment with electroconvulsive therapy (ECT) proved difficult due to inadequate seizure generation. Methods: A number of augmentation strategies were trialled in an attempt to improve seizure quality. Pre-ECT and Post-ECT measurement of symptoms, quality of life and cognition were undertaken with a variety of validated scales. Results: The single most efficacious strategy to elicit therapeutic seizures was the use of right unilateral (RUL) electrode placement with an ultrabrief pulse width. The patient subsequently had a resolution of his depressive illness, with a concomitant improvement in cognitive functioning. Conclusion: This case demonstrates that a number of ECT augmentation strategies can be used in routine clinical practice for patients with high seizure thresholds. It highlights that UB pulse width may be considered earlier in the treatment course for patients in whom conventional brief pulse ECT fails to generate effective seizures.

scholarly journals Validity of a three-variable Juvenile Arthritis Disease Activity Score in children with new-onset juvenile idiopathic arthritis

2012 ◽  
Vol 72 (12) ◽  
pp. 1983-1988 ◽  
Author(s):  
Flora Mcerlane ◽  
Michael W Beresford ◽  
Eileen M Baildam ◽  
S E Alice Chieng ◽  
Joyce E Davidson ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Disease Activity ◽  
Clinical Setting ◽  
Disease Activity Score ◽  
Juvenile Arthritis ◽  
Activity Score ◽  
Childhood Arthritis ◽  
Disease Patterns ◽  
Routine Clinical Setting ◽  
The Uk

ObjectivesTo investigate the validity and feasibility of the Juvenile Arthritis Disease Activity Score (JADAS) in the routine clinical setting for all juvenile idiopathic arthritis (JIA) disease categories and explore whether exclusion of the erythrocyte sedimentation rate (ESR) from JADAS (the ‘JADAS3’) influences correlation with single markers of disease activity.MethodsJADAS-71, JADAS-27 and JADAS-10 were determined at baseline for an inception cohort of children with JIA in the Childhood Arthritis Prospective Study. JADAS3-71, JADAS3-27 and JADAS3-10 were determined using an identical formula but with exclusion of ESR. Correlation of JADAS with JADAS3 and single measures of disease activity/severity were determined by category.ResultsOf 956 eligible children, sufficient data were available to calculate JADAS-71, JADAS-27 and JADAS-10 at baseline in 352 (37%) and JADAS3 in 551 (58%). The median (IQR) JADAS-71, JADAS-27 and JADAS-10 for all 352 children was 11 (5.9–18), 10.4 (5.7–17) and 11 (5.9–17.3), respectively. Median JADAS and JADAS3 varied significantly with the category (Kruskal–Wallis p=0.0001), with the highest values in children with polyarticular disease patterns. Correlation of JADAS and JADAS3 across all categories was excellent. Correlation of JADAS71 with single markers of disease activity/severity was good to moderate, with some variation across the categories. With the exception of ESR, correlation of JADAS3-71 was similar to correlation of JADAS-71 with the same indices.ConclusionsThis study is the first to apply JADAS to all categories of JIA in a routine clinical setting in the UK, adding further information about the feasibility and construct validity of JADAS. For the majority of categories, clinical applicability would be improved by exclusion of the ESR.

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