Adherence by Medical-Surgical Inpatients to Recommendations for Outpatient Psychiatric Treatment

Ww, Weddington

doi:10.1159/000287744

Cited by 22 publications

(15 citation statements)

References 5 publications

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“…Our study found a greater degree of post-hospitalization psychiatric aftercare follow-up (57%) than did the study by Weddington (20%) [5], but a similar rate to that found by Burstein (51%) [6]. Unlike Weddington's study, our study found no racial differences with respect to follow-up.…”

Section: Discussionsupporting

confidence: 67%

Medical Inpatients' Adherence to Outpatient Psychiatric Aftercare: A Prospective Study of Patients Evaluated by an Inpatient Consultation Liaison Psychiatry Service

Ehrenreich

Robinson

Glovinsky

et al. 2012

Int J Psychiatry Med

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Objective This study sought to determine whether patients on psychiatric medication evaluated by inpatient consultation psychiatrists followed up with psychiatric aftercare and continued psychiatric medication 8 weeks post-discharge. Barriers to care and their effect on aftercare follow-up were assessed. Method This was a prospective study of a consecutive sample of adults who received a psychiatric consultation and were prescribed psychotropic medication during hospitalization on the general medical or surgical inpatient units at the University of Maryland Medical Center. Baseline information was collected from 36 patients who received an inpatient psychiatric consultation and were: (1) prescribed psychiatric medications; and (2) discharged to home. Follow-up data was collected from 21 (58.3%) of these patients 8 weeks post-discharge. Results Of 36 patients who provided baseline data, 93% recognized they had a psychiatric disorder, 90% recognized the importance of taking psychiatric medication, and 80% recognized the importance of psychiatric aftercare. Aftercare recommendations were included in only 33% of patient discharge instructions. Of 21 patients providing follow-up data, 57% reported receiving psychiatric aftercare. Patients who did not receive psychiatric aftercare were significantly more likely to be at risk for poor literacy (88.9% vs. 33.3% Fisher's exact test = 0.024) and were less often given psychiatric aftercare instructions at discharge (22% vs. 42%). Conclusions Poor communication of aftercare instructions as well as poor literacy may be associated with lack of psychiatric aftercare. Consultation psychiatrists should assess literacy and insure aftercare information is provided to patients.

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Section: Discussionsupporting

confidence: 67%

Medical Inpatients' Adherence to Outpatient Psychiatric Aftercare: A Prospective Study of Patients Evaluated by an Inpatient Consultation Liaison Psychiatry Service

Ehrenreich

Robinson

Glovinsky

et al. 2012

Int J Psychiatry Med

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“…The majority of primary care patients express interest in nonsomatic treatments prior to or in combination with antidepressant care [84,[88][89][90][91][92][93]. Mohr et al (2006) confirmed previous findings that although patients said they would prefer psychotherapy, less than 20% actually followed-up [92,94] and half dropped out of treatment [88,95]. BOX 4 illustrates the barriers to psychotherapy found in psychotherapy access research.…”

Section: S63supporting

confidence: 65%

Collaborative depression care, screening, diagnosis and specificity of depression treatments in the primary care setting

Alexander

Richardson²,

Grypma³

et al. 2007

Expert Review of Neurotherapeutics

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The identification, referral and specific treatment of midlife patients in primary care who are distressed by mood, anxiety, sleep and stress-related symptoms, with or without clinically confirmed menopausal symptoms, are confounded by many structural issues in the delivery of women's healthcare. Diagnosis, care delivery, affordability of treatment, time commitment for treatment, treatment specificity for a particular patient's symptoms and patient receptiveness to diagnosis and treatment all play roles in the successful amelioration of symptoms in this patient population. The value of screening for depression in primary care, the limitations of commonly used screening instruments relative to culture and ethnicity, and which clinical care systems make best use of diagnostic screening programs will be discussed in the context of the midlife woman. The Sequenced Treatment Alternatives to Relieve Depression (STAR*D) program illustrates the relatively high rate of unremitted patients, regardless of clinical setting, who are receiving antidepressants. Nonmedication treatment approaches, referred to in the literature as 'nonsomatic treatments', for depression, anxiety and stress, include different forms of cognitive-behavioral therapy, interpersonal therapy, structured daily activities, mindfulness therapies, relaxation treatment protocols and exercise. The specificity of these treatments, their mechanisms of action, the motivation and time commitment required of patients, and the availability of trained practitioners to deliver them are reviewed. Midlife women with menopausal symptoms and depression/anxiety comorbidity represent a challenging patient population for whom an individualized treatment plan is often necessary. Treatment for depression comorbid with distressing menopausal symptoms would be facilitated by the implementation of a collaborative care program for depression in the primary care setting.

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“…For example, up to two thirds of depressed primary care patients would prefer psychological treatments to pharmacotherapy (Bedi et al, 2000; Brody, Khaliq, & Thompson, 1997; Churchill et al, 2000; Dwight-Johnson, Sherbourne, Liao, & Wells, 2000; O’Mahen & Flynn, 2008; Priest, Vize, Roberts, Roberts, & Tylee, 1996). However, in spite of the desirability of such services, only around 20% of patients referred for psychological treatments ever enter treatment (Brody et al, 1997; Weddington, 1983), and of those, nearly half drop out before completion (Wierzbicki & Pekarik, 1993). Such large inconsistencies between stated interest and actual follow-up suggest that substantial barriers both to initiating and to adhering to psychological interventions exist (Hollon et al, 2002; Wells et al, 2002).…”

mentioning

confidence: 99%

Perceived barriers to psychological treatments and their relationship to depression

Mohr¹,

Ho²,

Duffecy³

et al. 2010

J Clin Psychol

299

240

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In spite of repeated calls for research and interventions to overcome individual and systemic barriers to psychological treatments, little is known about the nature of these barriers. To develop a measure of perceived barriers to psychological treatment (PBPT), items derived from 260 participants were administered to 658 primary care patients. Exploratory factor analysis on half the sample resulted in 8 factors, which were supported by confirmatory factor analysis conducted on the other half. Associations generally supported the criterion validity of PBPT scales, with self-reported concurrent use of psychotherapy and psychotherapy attendance in the year after PBPT administration. Depression was associated with greater endorsement of barriers. These findings suggest that the PBPT may be useful in assessing perceived barriers.

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Adherence by Medical-Surgical Inpatients to Recommendations for Outpatient Psychiatric Treatment

Cited by 22 publications

References 5 publications

Medical Inpatients' Adherence to Outpatient Psychiatric Aftercare: A Prospective Study of Patients Evaluated by an Inpatient Consultation Liaison Psychiatry Service

Medical Inpatients' Adherence to Outpatient Psychiatric Aftercare: A Prospective Study of Patients Evaluated by an Inpatient Consultation Liaison Psychiatry Service

Collaborative depression care, screening, diagnosis and specificity of depression treatments in the primary care setting

Perceived barriers to psychological treatments and their relationship to depression

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