Medication Discontinuation in Patients After Discharge From a Psychiatric Hospital

Abdullah-Koolmees, H.; Gardarsdóttir, Helga; Yazir, Dilek; Stoker, Lennart J.; Vuyk, Judith; Egberts, Toine C. G.; Heerdink, Eibert R.

doi:10.1177/1060028015593763

Cited by 3 publications

(2 citation statements)

References 45 publications

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“…The majority of studies investigating medication changes after discharge have focussed on general or psychiatric hospital settings [ 4 ]. Little is known about medication changes in patients with PD after discharge from a movement disorder unit.…”

Section: Introductionmentioning

confidence: 99%

Self-Reported Nonadherence Predicts Changes of Medication after Discharge from Hospital in People with Parkinson’s Disease

Feldmann

Zipprich

Witte

et al. 2020

Parkinson's Disease

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Background. Medication is often changed after hospital discharge in people with Parkinson’s disease (PD). Objective. This observational study aimed to describe changes in PD medication after discharge and explore their association with self-reported adherence and clinical parameters. Methods. During hospitalisation sociodemographic characteristics, the Movement Disorder Society-sponsored revision of the Unified PD Rating Scale for motor function (MDS-UPDRS III), Hoehn and Yahr (H&Y) stage, levodopa equivalent daily dose (LEDD), Beck Depression Inventory II (BDI-II) score, Montreal Cognitive Assessment (MoCA) score, nonmotor symptoms questionnaire (NMSQ), and Stendal Adherence to Medication Score (SAMS) were collected in 125 people with PD. A semistructured interview was conducted 1 month after discharge to determine the extent and reasons for medication changes. Results. Thirty-eight patients (30.4%) changed their PD medication after discharge. Most changes (20.8%) were performed by physicians while 9.6% of patients changed their medication by themselves due to side effects, missing effect of the medication, missing knowledge about the indication, running out of medication, or nonspecific reason. This led to decreased doses while changes by physicians resulted in both increase and decrease of doses as well as new drug prescription. Patients without changes, patients with changes performed by them, and patients with changes performed by physicians did not differ in age, disease duration, MDS-UPDRS III, LEDD, NMSQ, MoCA, BDI-II, gender, marital status, or education. However, patients who themselves made the changes were more likely to be nonadherent according to baseline SAMS. Patients who made changes after discharge had higher SAMS modification and forgetting subscores than patients without changes or with changes made by physicians. Conclusion. Both intended and unintended nonadherence occur in patients who change medication after discharge. The use of an adherence questionnaire during inpatient treatment may help detect patients with higher risk of changing medication after discharge.

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Section: Introductionmentioning

confidence: 99%

Self-Reported Nonadherence Predicts Changes of Medication after Discharge from Hospital in People with Parkinson’s Disease

Feldmann

Zipprich

Witte

et al. 2020

Parkinson's Disease

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“…Previous studies have revealed a nonadherence rate of 43% to prescribed medications among non-forensic psychiatric outpatients (4). Post-discharge, 68% of general psychiatric patients discontinued their psychiatric medication, and 25% discontinued using antipsychotics within 3 months after discharge (5). Research focusing only on individuals with schizophrenia indicated that as many as 74% of the group discontinued the specific type of pharmacological treatment within 18 months (6).…”

Section: Introductionmentioning

confidence: 99%

Post-discharge pharmacological treatment discontinuation of forensic psychiatric patients in Sweden

Noland,

Virtanen,

Klötz Logan

et al. 2024

Front. Psychiatry

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IntroductionMost forensic psychiatric patients have chronic psychiatric disorders that require long-term pharmacological treatment even after discharge from care. However, the prevalence and correlates of post-discharge medication discontinuation in this patient group remain unclear.ObjectiveThe aim of this study was to investigate the prevalence and correlates of post-discharge discontinuation of pharmacological treatment in forensic psychiatric patients in Sweden.MethodsData on individuals discharged from forensic psychiatric care between 2009 and 2018 (n = 1,142) with ongoing pharmacological treatment at the time of discharge (n = 856) were identified from the Swedish National Forensic Psychiatric Register. Cox regression models were used to estimate the association between patient characteristics and medication discontinuation.ResultsOf the 856 individuals with pharmacological treatment at discharge, 488 (57%) discontinued treatment within 2 years of discharge. Factors associated with an increased risk of treatment discontinuation varied between different types of psychotropic medications: the most important correlate was comorbidity between psychosis and personality disorder. Higher age at discharge, longer length of stay, having a history of several psychiatric care episodes, having a trustee, having a limited guardian, and a residing in a supported living accommodation at the time of discharge were associated with a decreased rate of medication discontinuation. This applied for antipsychotics, antidepressants, antiepileptics, and any psychotropic medication, but not for psychostimulants or drugs used in addictive disorders.ConclusionFor many former forensic psychiatric patients, there are situational factors associated with medication discontinuation. This insight holds significance for professionals who are involved in pre-discharge planning within forensic psychiatric care and those who interact with this cohort of former patients post-discharge.

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‘Big data’ in mental health research: current status and emerging possibilities

Stewart

Davis

2016

Soc Psychiatry Psychiatr Epidemiol

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Purpose‘Big data’ are accumulating in a multitude of domains and offer novel opportunities for research. The role of these resources in mental health investigations remains relatively unexplored, although a number of datasets are in use and supporting a range of projects. We sought to review big data resources and their use in mental health research to characterise applications to date and consider directions for innovation in future.MethodsA narrative review.Results Clear disparities were evident in geographic regions covered and in the disorders and interventions receiving most attention.Discussion We discuss the strengths and weaknesses of the use of different types of data and the challenges of big data in general. Current research output from big data is still predominantly determined by the information and resources available and there is a need to reverse the situation so that big data platforms are more driven by the needs of clinical services and service users.

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Medication Discontinuation in Patients After Discharge From a Psychiatric Hospital

Cited by 3 publications

References 45 publications

Self-Reported Nonadherence Predicts Changes of Medication after Discharge from Hospital in People with Parkinson’s Disease

Self-Reported Nonadherence Predicts Changes of Medication after Discharge from Hospital in People with Parkinson’s Disease

Post-discharge pharmacological treatment discontinuation of forensic psychiatric patients in Sweden

‘Big data’ in mental health research: current status and emerging possibilities

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