Liaison Old Age Psychiatry Service in a Medical Setting: Description of the Newcastle Clinical Service

Mukaetova‐Ladinska, Elizabeta B.; Cosker, Glynis; Coppock, Michael; Henderson, Michael T.; Ashgar, Y. Ali; Hill, Anissa E.; Scully, Ann; Robinson, David J.; Sells, K.; Brotherton, Sarah E.; Lowthian, C

doi:10.1155/2011/587457

Cited by 5 publications

(5 citation statements)

References 13 publications

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“…Liaison Services for Older Adults (LSOA) are among those that are numbered in the list of small subspecialties. Our analysis of the LSOA within our locality 2 and wider 3 confirms that the LSOAs appear to be the fastest growing liaison discipline. In Newcastle alone we witness a steady 10% yearly increase of older people referred to our service, with the overall numbers being very close to those of our Deliberate Self Harm (DSH) team (37% LSOA v .…”

supporting

confidence: 66%

Liaison services for older adults

Mukaetova‐Ladinska¹,

Scully²

2014

Br J Psychiatry

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ratio (OR) = 0.95, Wald w 2 = 13.78, P50.001). Verma et al are concerned that we excluded patients with shorter treatment durations. However, when we include all individuals who ever used stimulants, we find the same effect (OR = 0.95, Wald w 2 = 11.89, P = 0.001). Purely for illustrative purposes, we plotted the predicted probability of substance use disorder for the control group in Fig. 1. The figure shows that delay in the first age at stimulant use leads to marked increases in the probability of developing substance use disorder. In our article, we examined whether the effect of stimulant treatment depended on other factors (i.e. current use of stimulants, age at stimulant treatment initiation, age-adjusted duration of stimulant use and ageadjusted cumulative dosage), but found no other significant predictors than age at first stimulant use. Verma and colleagues refer to a meta-analysis, but provide the wrong citation. Recently, a meta-analysis on this topic was published. 2 Here no difference was found between treated and untreated patients in risk of developing substance use disorder (including alcohol, marijuana, cocaine and non-specific drugs) and nicotine use. Unfortunately, in this meta-analysis specific moderator variables such as age at first stimulant use were not taken into account, probably because of the relatively low numbers of studies to date that include such variables. We thank the authors for discovering the mistake in the table, 9% should have read 59%.

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supporting

confidence: 66%

Liaison services for older adults

Mukaetova‐Ladinska¹,

Scully²

2014

Br J Psychiatry

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“…The conclusion evidenced a lack of ownership and responsibility for these services, and further evaluation of liaison mental health service for older people was highly recommended 43. A recent quantitative prospective review of referrals to a psychiatry liaison service (Newcastle, United Kingdom) showed a significant increase in cognitive assessments (from 19% to 49%) 44. The effect of service on psychological support to patients, cost, staff training, and outcome, including length of stay and readmission, were not evaluated.…”

Section: Discussionmentioning

confidence: 99%

The Rapid Assessment Interface and Discharge service and its implications for patients with dementia

Singh

Ramakrishna²,

Williamson³

2013

CIA

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The rising prevalence of dementia will have an effect on acute care hospitals around the world. At present, around 40% of patients older than 70 years with acute medical admissions have dementia, but only half of these patients have been diagnosed. Patients with dementia have poorer health outcomes, longer hospital stays, and higher rates of readmissions and institutionalization. Worldwide, health care budgets are severely constrained. National Institute for Health and Care Excellence (NICE) has listed ten quality standards for supporting people in living well with dementia. NICE resource implications and commissioning support to implement these guidelines and improve dementia services have been recently published. Although most of the frail elderly patients with dementia are cared for by geriatricians, obstacles to making a diagnosis and to the management of dementia have been recognized. To provide a timely diagnosis of dementia, better care in acute hospital settings, and continuity of care in the community, services integrating all these elements are warranted. Extra resources also will be required for intermediate, palliative care, and mental health liaison services for people with dementia. The Birmingham Rapid Assessment Interface and Discharge service model uses a multiskilled team that provides comprehensive assessment of a person’s physical and psychological well-being in a general hospital setting. It has been shown to be an effective model in terms of reducing both length of stay and avoiding readmission. The aim of this review is to discuss the implications of the Rapid Assessment Interface and Discharge model in people with dementia and to critically compare this model with similar published service provisions.

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“…Except for a limited research work completed on service development and characterisation of the Liaison team for older adults [35], there is very little additional academic work in relation to the Liaison professional activity. Our pilot data on current scope of work by seven Liaison services in the UK indicates that education is one of the major gaps in the Liaison services [36] and needs to be urgently addressed in the light of the latest Commissioning and Quality framework for dementia and delirium.…”

Section: The Future Of Liaison Psychiatry Servicesmentioning

confidence: 99%

Current and Future Perspectives of Liaison Psychiatry Services: Relevance for Older People’s Care

Mukaetova‐Ladinska

2016

Geriatrics

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A large number of people admitted to medical wards have co-morbid mental health problems, and these predominantly include depression, dementia and delirium. An additional one third of medically ill patients remain in hospitals with undetected and, therefore, undiagnosed mental health problems. The comorbidity of mental and physical illnesses leads to poor health outcomes, prolonged inpatient stays and use of inpatient resources, involvement of various affiliated health services, introduction of medications and discharge to long-term facilities, including residential and nursing 24-h care, increased both readmission rates and mortality. The establishment of Liaison psychiatry services to meet the needs for people with mental health problems admitted to medical wards is a priority for many acute health Trusts. This has an economical background in terms of cost-savings, especially in relation to the older adults, with decreasing readmission rates and quicker hospital discharges. In the current review, we address the latest policies regarding Liaison psychiatry services; especially those for older people with dementia and delirium, and discuss their future shaping.

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Liaison Old Age Psychiatry Service in a Medical Setting: Description of the Newcastle Clinical Service

Cited by 5 publications

References 13 publications

Liaison services for older adults

Liaison services for older adults

The Rapid Assessment Interface and Discharge service and its implications for patients with dementia

Current and Future Perspectives of Liaison Psychiatry Services: Relevance for Older People’s Care

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