Transitions of care in mental health

Abstract

Introduction:The occurrence of mental disorders and chronic diseases is associated with low treatment compliance and an increased mortality. The main objective of this study was to analyze medication prescriptions at hospital discharge in order to verify the patients' access to the prescribed treatment.Methods: This is a descriptive and retrospective study performed between September 2013 and September 2018 with patients admitted in the psychiatric ward of a university hospital in the state of Rio Grande do Sul. The studied patients consisted of 274 adults over 18 years of age admitted to this hospital with at least one psychiatric comorbidity included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) who lived in the city of Porto Alegre used specially controlled drugs, and had been hospitalized for at least 7 days.Results: Out of the 274 patients, 68.5% were readmitted once, 17.5% were readmitted twice, 9.5% were readmitted 3times, and 4.5% went through this process 4 times or more. A significant association (p = 0.014) was observed between the number of drugs not included in the Municipal Essential Medicines List upon first readmission and the number of readmissions. Among patients who were readmitted 3 times or more, 79% were prescribed drugs that were not on this list. Conclusions:The understanding of how therapeutic itineraries are established when searching for drugs contributes to setting effective lines of care where professionals may position themselves more proactively to reduce mental health complications.

Transition of Care for Individuals with Mental Disorders in Brazil: A Contextual Analysis

“…However, inadequate care transitions can impair communication between patients and health professionals. It is emphasized that therapeutic planning and standardized information transfer facilitate communication, reception, systematic assistance, and action management to support safe care for this population ( 19 ) .…”

“…Care for individuals with mental distress in primary care: an interdisciplinary and multiprofessional practice (18) Primary care PHC to Home Article Transitions of care in mental health (19) Hospital-based Hospital to PHC • Referrals;…”

“…In this light, studies have pointed to the emergence of RAS, strategies aimed at integrating services. They are crucial in overcoming care gaps and optimizing available resources (19)(20)(21)(22) .…”

“…Grounded in ensuring better reception to users, the coordination and assistance developed by the multiprofessional team is emphasized. It focuses on bonding between the team and service users, educating patients and families, and maintaining treatment regularity and continuity (12,15,(17)(18)(19) .…”

Transição do cuidado de pessoas com transtorno mental no Brasil: uma análise de contexto

“…Atuação dos Centros de Atenção Psicossocial em quatro centros urbanos no Brasil (17) Atenção secundária APS para CAPS e hospital Artigo O cuidado aos portadores de sofrimento mental na atenção primária: uma prática interdisciplinar e multiprofissional (18) Atenção primária APS para domicílio Artigo Transitions of care in mental health (19) Hospitalar Hospital para APS • Encaminhamentos;…”