Canadian Practice Guidelines for Comprehensive Community Treatment for Schizophrenia and Schizophrenia Spectrum Disorders

Addington, Donald; Anderson, Elizabeth; Kelly, Martina; Lesage, Alain; Summerville, Chris

doi:10.1177/0706743717719900

Cited by 23 publications

(15 citation statements)

References 62 publications

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“…7 They also may not receive adequate support from services or from their families after discharge, increasing risks of rehospitalization. 7 Patients with serious MD need expedited access to care and intensive follow-up, as offered by assertive community treatment, intensive case management teams or day hospitals 58 to avoid readmission. The association between adjustment disorders and early readmission has rarely been observed.…”

Section: Discussionmentioning

confidence: 99%

Factors Related to 30-day Readmission following Hospitalization for Any Medical Reason among Patients with Mental Disorders: Facteurs liés à la réhospitalisation à 30 jours suivant une hospitalisation pour une raison médicale chez des patients souffrant de troubles mentaux

2020

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Objective: This study evaluated the contributions of clinical, sociodemographic, and service use variables to the risk of early readmission, defined as readmission within 30 days of discharge following hospitalization for any medical reason (mental or physical illnesses), among patients with mental disorders in Quebec (Canada). Methods: In this longitudinal study, 2,954 hospitalized patients who had visited 1 of 6 Quebec emergency departments (ED) in 2014 to 2015 (index year) were identified through clinical administrative databanks. The first hospitalization was considered that may have occurred at any Quebec hospital. Data collected between 2012 and 2013 and 2013 and 2014 on clinical, sociodemographic, and service use variables were assessed as related to readmission/no readmission within 30 days of discharge using hierarchical binary logistic regression. Results: Patients with co-occurring substance-related disorders/chronic physical illnesses, serious mental disorders, or adjustment disorders (clinical variables); 4+ outpatient psychiatric consultations with the same psychiatrist; and patients hospitalized for any medical reason within 12 months prior to index hospitalization (service use variables) were more likely to be readmitted within 30 days of discharge. Patients who made 1 to 3 ED visits within 1 year prior to the index hospitalization, had their index hospitalization stay of 16 to 29 days, or consulted a physician for any medical reason within 30 days after discharge or prior to the readmission (service use variables) were less likely to be rehospitalized. Conclusions: Early hospital readmission was more strongly associated with clinical variables, followed by service use variables, both playing a key role in preventing early readmission. Results suggest the importance of developing specific interventions for patients at high risk of readmission such as better discharge planning, integrated and collaborative care, and case management. Overall, better access to services and continuity of care before and after hospital discharge should be provided to prevent early hospital readmission.

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Section: Discussionmentioning

confidence: 99%

Factors Related to 30-day Readmission following Hospitalization for Any Medical Reason among Patients with Mental Disorders: Facteurs liés à la réhospitalisation à 30 jours suivant une hospitalisation pour une raison médicale chez des patients souffrant de troubles mentaux

2020

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“…Serious MD did not predict recurrent high ED use, which was surprising. This may be a result of previous Quebec mental health reforms that mandated the reinforcement of programs such as assertive community treatment [ 66 , 67 ] or intensive case management [ 66 , 67 ] targeting patients with serious MD or with high rates of ED use and hospitalizations or may reflect the more recent implementation of innovative programs involving home treatment teams for serious MD [ 68 ]. These programs are known to be effective in reducing ED use and hospitalizations [ 66 , 67 ].…”

Section: Discussionmentioning

confidence: 99%

Predictors of Recurrent High Emergency Department Use among Patients with Mental Disorders

Gentil

Grenier

Vasiliadis

et al. 2021

IJERPH

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Few studies have examined predictors of recurrent high ED use. This study assessed predictors of recurrent high ED use over two and three consecutive years, compared with high one-year ED use. This five-year longitudinal study is based on a cohort of 3121 patients who visited one of six Quebec (Canada) ED at least three times in 2014–2015. Multinomial logistic regression was performed. Clinical, sociodemographic and service use variables were identified based on data extracted from health administrative databases for 2012–2013 to 2014–2015. Of the 3121 high ED users, 15% (n = 468) were recurrent high ED users for a two-year period and 12% (n = 364) over three years. Patients with three consecutive years of high ED use had more personality disorders, anxiety disorders, alcohol or drug related disorders, chronic physical illnesses, suicidal behaviors and violence or social issues. More resided in areas with high social deprivation, consulted frequently with psychiatrists, had more interventions in local community health service centers, more prior hospitalizations and lower continuity of medical care. Three consecutive years of high ED use may be a benchmark for identifying high users needing better ambulatory care. As most have multiple and complex health problems, higher continuity and adequacy of medical care should be prioritized.

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“…As a transition step between inpatient and outpatient treatment frequently are used day care programs [8]. According to the previously published data on treatment efficacy at the Day Hospital which indicate a faster withdrawal of symptoms, lower treatment costs as opposed to inpatient treatment [5], and fewer hospitalizations for patients treated at Day Hospital and longer illness remission after treatment [24,26].…”

Section: Discussionmentioning

confidence: 99%

“…The goal of inpatient treatment is to stabilize the patient with psychopharmaceuticals and socio-therapeutic treatments and ultimately to recover them to the level of functionality that would allow further treatment via a Day Hospital or an outpatient form of treatment, for both of which a significantly higher level of insight and compliance is needed [4]. After inpatient psychiatric stabilization, the patient is admitted to a therapeutic community within the framework of socio-therapy and psychotherapy programs with the implementation of psychosocial interventions integrated with psychopharmacotherapy [5,6]. After hospital discharge, treatment continues in the outpatient setting, with regular psychiatric check-ups and sometimes as a weekly group therapy.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Clinical and Sociodemographic Characteristics of Patients with Schizophrenia Treated Stationary and at Day Hospital

Blažinović

Orlović²,

Karlović

et al. 2019

Arch. Psychiatry Res.

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The contemporary concept of treating schizophrenia tends to achieve functional remission, reducing the number and length of hospitalizations and improving the quality of life of patients. The aim of this study was to identify and compare the sociodemographic and clinical characteristics of patients with schizophrenia treated stationary and those treated at Day Hospital. This study, with the four month time interval, randomly included 60 participants with schizophrenia aged 18 to 55, who were divided into two groups. First group of 30 participants was treated only stationary, and the other 30 participants were treated only at Day Hospital. Each participant completed a sociodemographic and clinical characteristics questionnaire which was created for the purpose of this research. The results showed that participants treated at Day Hospital are younger, have a higher education level, and are more capable of working and functioning adequately. They are also more likely to receive psychiatric treatment from the early stages of their illness. Furthermore, participants treated in the Day Hospital setting have been less frequently hospitalized due to their illness (fewer acute episodes) than inpatients, which was statistically significant (t = 3,763; p = 0,001), as a consequence of which they have a longer remission periods. This could contribute to better personal and social functioning, as well as to a better management of daily life, and thus implies a higher level of life quality compared to the inpatients.

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Canadian Practice Guidelines for Comprehensive Community Treatment for Schizophrenia and Schizophrenia Spectrum Disorders

Cited by 23 publications

References 62 publications

Factors Related to 30-day Readmission following Hospitalization for Any Medical Reason among Patients with Mental Disorders: Facteurs liés à la réhospitalisation à 30 jours suivant une hospitalisation pour une raison médicale chez des patients souffrant de troubles mentaux

Factors Related to 30-day Readmission following Hospitalization for Any Medical Reason among Patients with Mental Disorders: Facteurs liés à la réhospitalisation à 30 jours suivant une hospitalisation pour une raison médicale chez des patients souffrant de troubles mentaux

Predictors of Recurrent High Emergency Department Use among Patients with Mental Disorders

Comparison of Clinical and Sociodemographic Characteristics of Patients with Schizophrenia Treated Stationary and at Day Hospital

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