An Evaluation of Inpatient Treatment Continuation and Hospital Readmission Rates in Patients with Bipolar Disorder Treated with Aripiprazole or Quetiapine
Abstract:No difference was observed in inpatient antipsychotic treatment continuation and 30-day hospital readmission rates in patients treated with either aripiprazole or quetiapine.
“…In the present study, patient race/ethnicity was not found to predict readmission across the time periods examined. This finding is consistent with previous research that found no relationship between race/ethnicity and psychiatric readmission (Appleby et al, 1993;Kreys et al, 2013;Schmutte et al, 2010).…”
Section: Discussionsupporting
confidence: 93%
“…Among studies that included patients with schizophrenia and/or affective disorders (Appleby et al, 1993; Monnely, 1997; Swett, 1995) as well as studies that only included patients with BD (Kessing et al, 2004; Kreys et al, 2013; Patel et al, 2005), a greater number of prior psychiatric hospitalizations was found to increase the risk of readmission.…”
Section: Introductionmentioning
confidence: 99%
“…A few studies have examined risk factors for readmission in samples that included only patients with BD (Kessing et al, 2004; Kreys et al, 2013; Patel et al, 2005; Perlick et al, 1999; Woo et al, 2014). In addition to the impact of the number of BD episodes on psychiatric readmission as reported above (Kessing et al, 2004), one prospective study examined the effect of clinical symptoms as risk factors for psychiatric readmission among 100 patients with BD (Perlick et al, 1999), and three studies examined the effect of medication differences on psychiatric readmission among patients with BD (Kreys et al, 2013; Patel et al, 2005; Woo et al, 2014). Two studies examining the effects of medication differences on psychiatric readmission for patients with BD found no relationship between medication differences and psychiatric readmission; however, both studies found a greater number of prior psychiatric hospitalizations increased readmission risk (Kreys et al, 2013; Patel et al, 2005).…”
Our study found enabling and need factors to be the strongest predictors of psychiatric readmission, suggesting that the prevention of psychiatric readmission for patients with bipolar disorder at safety-net hospitals may be best achieved by developing and implementing innovative transitional care initiatives that address the issues of multiple psychiatric hospitalizations, housing instability, insurance coverage and functional impairment.
“…In the present study, patient race/ethnicity was not found to predict readmission across the time periods examined. This finding is consistent with previous research that found no relationship between race/ethnicity and psychiatric readmission (Appleby et al, 1993;Kreys et al, 2013;Schmutte et al, 2010).…”
Section: Discussionsupporting
confidence: 93%
“…Among studies that included patients with schizophrenia and/or affective disorders (Appleby et al, 1993; Monnely, 1997; Swett, 1995) as well as studies that only included patients with BD (Kessing et al, 2004; Kreys et al, 2013; Patel et al, 2005), a greater number of prior psychiatric hospitalizations was found to increase the risk of readmission.…”
Section: Introductionmentioning
confidence: 99%
“…A few studies have examined risk factors for readmission in samples that included only patients with BD (Kessing et al, 2004; Kreys et al, 2013; Patel et al, 2005; Perlick et al, 1999; Woo et al, 2014). In addition to the impact of the number of BD episodes on psychiatric readmission as reported above (Kessing et al, 2004), one prospective study examined the effect of clinical symptoms as risk factors for psychiatric readmission among 100 patients with BD (Perlick et al, 1999), and three studies examined the effect of medication differences on psychiatric readmission among patients with BD (Kreys et al, 2013; Patel et al, 2005; Woo et al, 2014). Two studies examining the effects of medication differences on psychiatric readmission for patients with BD found no relationship between medication differences and psychiatric readmission; however, both studies found a greater number of prior psychiatric hospitalizations increased readmission risk (Kreys et al, 2013; Patel et al, 2005).…”
Our study found enabling and need factors to be the strongest predictors of psychiatric readmission, suggesting that the prevention of psychiatric readmission for patients with bipolar disorder at safety-net hospitals may be best achieved by developing and implementing innovative transitional care initiatives that address the issues of multiple psychiatric hospitalizations, housing instability, insurance coverage and functional impairment.
“…Some studies focused on at least one substance use disorder (alcohol dependence, alcohol abuse, alcoholic psychosis, drug dependence, drug abuse, drug psychosis) or inpatients in a substance abuse treatment program with a main alcohol/drug diagnosis or dual diagnosis patients [15, 21–24, 32]. Five studies were restricted to diagnosis of schizophrenia or schizoaffective disorders or psychosis [33–37]; four to diagnosis of affective disorder [19, 26, 38, 39]; two to diagnosis of dementia [18, 40]. …”
Section: Resultsmentioning
confidence: 99%
“…Six papers [17, 28, 35, 39, 48, 66] analysed different aspects of pharmacological treatment (such as dosage or medication prescription), but it resulted significant in only the three of them discussed below and always in bivariate associations. Being on depot injectable antipsychotic medication turned out as a risk factor, while using atypical antipsychotic medication was protective towards readmission [66].…”
Section: Categories Of Pre-discharge Variables Analysedmentioning
BackgroundReadmission rate is considered an indicator of the mental health care quality. Previous studies have examined a number of factors that are likely to influence readmission. The main objective of this systematic review is to identify the studied pre-discharge variables and describe their relevance to readmission among psychiatric patients.MethodsStudies on the association between pre-discharge variables and readmission after discharge with a main psychiatric diagnosis were searched in the bibliographic databases Ovid Medline, PsycINFO, ProQuest Health Management and OpenGrey. Relevant publications published between January 1990 and June 2014 were included. For each variable, the number of papers that considered it as a predictor of readmission and that found a significant association was recorded, together with the association direction and whether it was found respectively in bivariate and in multivariate analyses.ResultsOf the 734 articles identified in the search, 58 papers were included in this review, mainly from the USA and concerning patients with severe mental disorders. Analysed variables were classified according to the following categories: patients’ demographic, social and economic characteristics; patients’ clinical characteristics; patients’ clinical history; patients’ attitude and perception; environmental, social and hospital characteristics; and admission and discharge characteristics. The most consistently significant predictor of readmission was previous hospitalisations. Many socio-demographic variables resulted as influencing readmission, but the results were not always homogeneous. Among other patients’ clinical characteristics, diagnosis and measures of functional status were the most often used variables. Among admission characteristics, length of stay was the main factor studied; however, the results were not very consistent. Other relevant aspects resulted associated with readmission, including the presence of social support, but they have been considered only in few papers. Results of quality assessment are also reported in the review. The majority of papers were not representative of the general psychiatric population discharged from an inpatient service. Almost all studies used multivariate analytical methods, i.e., confounders were controlled for, but only around 60% adjusted for previous hospitalisation, the variable most consistently considered associated to readmission in the literature.ConclusionsThe results contribute to increase knowledge on pre-discharge factors that could be considered by researchers as well as by clinicians to predict and prevent readmissions of psychiatric patients. Associations are not always straightforward and interactions between factors have to be considered.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-1114-0) contains supplementary material, which is available to authorized users.
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