scholarly journals Psychotropic medication use at a private eating disorders treatment facility: A retrospective chart review and descriptive data analysis

2005 ◽  
Vol 66 (6) ◽  
pp. 572-588 ◽  
Author(s):  
Kelly N. Gable ◽  
Julie A. Dopheide
2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S558-S558
Author(s):  
Barbara Resnick ◽  
Elizabeth Galik

Abstract Understanding the factors that influence psychotropic can guide reduction in use of these medications. This study described predictors of psychotropics use among residents with moderate to severe cognitive impairment. This was a secondary data analysis using baseline data from the first 341 residents in the EIT-4-BPSD trial. Predictive measures included demographics, agitation, resistiveness to care, depression, cognition, pain, facility factors and state. Overall 63% (n=211) received at least one psychotropic medication, 16% (n=52) an anti-seizure medication, 23% (n=77) an anxiolytic, 30% (n=99) an antidepressant, 2% (n=8) a sedative hypnotic, 28% (n=93) an antipsychotic medication, and 9% (n=29) an opioid. Model testing explained 9 to 15% of psychotropic medication use. There were high rates of psychotropic medication use and a limited association between demographic factors, behavioral symptoms, and psychotropic medication use. Continued research is needed to explore additional factors associated with psychotropic medication use such as beliefs of providers.


2021 ◽  
Author(s):  
Jason Cha ◽  
Eamon Filan ◽  
Gary Stapolsky ◽  
Donna Kido ◽  
Nicole Sy ◽  
...  

ABSTRACT Introduction Disease non-battle injuries (DNBIs) are responsible for the majority of hospital admissions for soldiers in combat since the Vietnam War The U.S. Army prepares soldiers to deploy through a multistage process known as the Soldier Readiness Program (SRP). The current processes are reactive and address deployment-limiting health conditions (DLHCs) and the need for intervention and/or medical waivers late in the SRP process. This may compromise the quality and efficiency of pre-deployment medical clearance and result in DNBI medical evacuation from theater, which is costly and reduces the effectiveness of the unit. Implementation of a proactive and standardized screening process focused on behavioral health-related medical evacuations and psychotropic medication use will facilitate timely and effective interventions to improve readiness. Methodology The primary objective of this proof-of-concept (POC) study was to develop a standardized and sustainable process, known as the deployment-limiting medication (DLM) surveillance process, to screen soldiers for DLHCs that prevent mobilization. The A-3 performance improvement model was utilized to identify the root causes of limitations with the current medical SRP and to develop solutions. This process utilized the DLHC tool, a report created by the Defense Health Agency, as a basis to identify soldiers that require continued chart review based on prescription fill history. The results of the report were further assessed using published deployment eligibility standards and focused on psychotropic medications. Secondary measures [included] validation of the DLHC tool by assessing the accuracy of the DLHC report. This was determined by the proportion of soldiers screened who actually required intervention and/or waivers per deployment policy. This study took place within an Infantry Brigade Combat Team (IBCT). Results From August 2019 to March 2020, 959 soldiers in the IBCT were screened under the DLM surveillance process for DLHCs related to mental health and psychotropic medication use. The percentage of completed screenings of psychotropic-related DLHCs in the IBCT reached 100% after 3 months of implementing this POC study. After thorough chart review, a total of 421 soldiers met criteria for a medical intervention and/or waiver with 8% of these soldiers identified with a preexisting medical profile. The DLHC tool’s ability to use medication history to accurately predict the need for an intervention and/or medical waiver was 59% (654/1,112 medications). Soldiers identified using the DLM surveillance process that did not meet criteria predominately involved antidepressant, anticonvulsant, and central nervous system DLHC categories. If the psychotropic-related DLHC categories are optimized in future reports, the report’s accuracy may be increased to 90% while decreasing the time to complete the monthly review. Conclusion The DLM surveillance measures were successfully incorporated into the SRP process to proactively screen for DLHCs. Early identification of DLHCs allowed for proper identification of medical intervention and/or waiver needs and may decrease deployment complications. This process may help to improve a soldier’s deployability and improve overall readiness of the IBCT.


2021 ◽  
Author(s):  
Wendy Spettigue ◽  
Nicole Obeid ◽  
Madison Erbach ◽  
Stephen Feder ◽  
Natalie Finner ◽  
...  

Abstract Background: There is a noticeable lack of evidence regarding the impact of COVID-19 and the associated lockdown on young people with eating disorders. The goals of this study were 1) to examine characteristics of adolescents presenting for eating disorder (ED) assessment since the onset of the COVID-19 pandemic; 2) to compare adolescents presenting for ED assessment since the onset of the COVID-19 pandemic to those that presented for assessment one year previously; 3) to examine implications of the pandemic on the system of care. Methods: A retrospective chart review was completed on all patients assessed at a pediatric tertiary care ED program during the pandemic between April 1 and October 31, 2020, and on youth assessed during the same time frame one year previously. Data including body measurements and results of psychological measures was extracted from patients’ charts. Clinician reports were utilized for accounts of ED symptoms. Referrals to our program were also compared for the two time periods.Results: Of the 48 youth assessed between April and October 2020, average age was 14.6 years and average percentage of treatment goal weight was 77.7%. 40% cited the pandemic as a trigger for their ED; of these youth, 78.9% were medically unstable compared to 55.2% of those whose ED was not triggered by the pandemic. When comparing the 2020 cohort to those assessed in 2019, youth who presented for assessment during the pandemic trended towards having lower percentage of goal weights and higher rates of self-reported impairment, and were significantly more likely to be medically unstable and to require hospitalization. Higher rates of inpatient admissions, emergency room consultation requests and outpatient referrals deemed “urgent” were likewise associated with the pandemic period.


2020 ◽  
Vol 28 (6) ◽  
pp. 739-749 ◽  
Author(s):  
Sasha Gorrell ◽  
Jocelyn Lebow ◽  
Kathryn Kinasz ◽  
James E. Mitchell ◽  
Andrea B. Goldschmidt ◽  
...  

2016 ◽  
Vol 6 (2) ◽  
pp. 68-74
Author(s):  
Karen E Moeller ◽  
Amad Din ◽  
Macey Wolfe ◽  
Grant Holmes

Abstract Introduction: Use of medications to treat symptoms of borderline personality disorder (BPD) is controversial. The purpose of this study was to describe psychotropic medication use in hospitalized patients with BPD and compare with a control group. Methods: A retrospective chart review was conducted on hospitalized patients aged 18-65 years having a diagnosis of BPD and compared them with a control group of patients with a diagnosis of major depressive disorder (MDD) without a personality disorder. Patients were excluded from the BPD group if other personality disorders were recorded. Charts were reviewed for demographics and psychotropic medication usage both prior to admission and at discharge. Results: This study included 165 patients (85 in BPD; 80 in MDD). Prior to admission and upon discharge, patients in the BPD group were prescribed significantly more psychotropic medications than patients with MDD (3.21 vs 2.10; P < .001 and 2.87 vs 2.35; P < .05, respectively). Patients in the BPD group were significantly more likely to be prescribed antipsychotics, mood stabilizers, and miscellaneous agents compared with the MDD group. On admission, significantly more BPD patients were prescribed multiple sedative agents (37.6% vs 21.3%; P < .05), but because of the discontinuation of sedative agents, this difference was nonsignificant upon discharge. Discussion: This study found increased medication utilization among patients with BPD. Polypharmacy may increase the risk of side effects, drug interactions, and drug toxicity for BPD patients. Clinicians need to carefully evaluate the efficacy and risk of medications prescribed in patients with BPD.


2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Wendy Spettigue ◽  
Nicole Obeid ◽  
Madison Erbach ◽  
Stephen Feder ◽  
Natalie Finner ◽  
...  

Abstract Background There is a noticeable lack of evidence regarding the impact of COVID-19 and the associated lockdown on young people with eating disorders. The goals of this study were 1) to examine characteristics of adolescents presenting for eating disorder (ED) assessment since the onset of the COVID-19 pandemic; 2) to compare adolescents presenting for ED assessment since the onset of the COVID-19 pandemic to those that presented for assessment 1 year previously; 3) to examine implications of the pandemic on the system of care. Methods A retrospective chart review was completed on all patients assessed at a pediatric tertiary care ED program during the pandemic between April 1 and October 31, 2020, and on youth assessed during the same time frame 1 year previously. Data including body measurements and results of psychological measures was extracted from patients’ charts. Clinician reports were utilized for accounts of ED symptoms. Referrals to our program were also compared for the two time periods. Results Of the 48 youth assessed between April and October 2020, average age was 14.6 years and average percentage of treatment goal weight was 77.7%. 40% cited the pandemic as a trigger for their ED; of these youth, 78.9% were medically unstable compared to 55.2% of those whose ED was not triggered by the pandemic. When comparing the 2020 cohort to those assessed in 2019, youth who presented for assessment during the pandemic trended towards having lower percentage of goal weights and higher rates of self-reported impairment, and were significantly more likely to be medically unstable (p = 0.005) and to require hospitalization (p = 0.005). Higher rates of inpatient admissions, emergency room consultation requests and outpatient referrals deemed “urgent” were likewise associated with the pandemic period. Conclusions During the COVID-19 pandemic, youth assessed for an ED presented with high rates of medical instability and need for hospitalization. Caring for these youth may be more challenging during the pandemic, when access to services may be limited. Further research is required to better understand the impact of the pandemic on the clinical course and outcomes of EDs in adolescents.


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