A pharmacologic option to reduce hospital admissions and relapses of patients with severe mental illness

2017 ◽  
Vol 41 (S1) ◽  
pp. S753-S753
Author(s):  
N. Gomez-Coronado ◽  
P. Blanco ◽  
I. Martinez
Keyword(s):  
Mental Health ◽  
Hospital Admissions ◽  
Descriptive Analysis ◽  
Psychotic Episode ◽  
Anti Psychotic ◽  
Before And After ◽  
Previously Treated ◽  
Competing Interest ◽  
One Year ◽  
Long Acting

IntroductionSome diseases relapses involve functional impairment that sometimes takes years to recover. We present our experience using long-acting aripiprazole as maintenance therapy in patients diagnosed with psychotic episode, acute mania (bipolar disorder) or personality disorder, who were previously treated with another anti-psychotic.AimsAnalyze what treatment were they taking before aripiprazole depot. Determine the number of hospital admissions and relapses before and after long-acting aripiprazole treatment.MethodsDescriptive analysis based on a sample of 37 patients, aged 18–65 years, treated during one year with anti-psychotics at two community mental health units.ResultsReduction of hospitalization average: 0.59/year with non-long-acting-aripiprazol anti-psychotic, 0.18/year with long-acting aripiprazol (66.6%).ConclusionLong-acting aripiprazole appears to reduce the number of hospitalizations and relapses compared to other anti-psychotics. However, the sample size is small and more studies are needed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Effects of switching antipsychotics in 80 outpatients: A descriptive analysis from a mental health community

2017 ◽  
Vol 41 (S1) ◽  
pp. S332-S332
Author(s):  
R. Medina Blanco ◽  
R. Martín Gutiérrez ◽  
M.J. Cuesta Nuñez ◽  
D. Sierra Biddle ◽  
P. Suárez Pinilla
Keyword(s):  
Mental Health ◽  
Gender Differences ◽  
Behavioral Disorders ◽  
Descriptive Analysis ◽  
Health Clinic ◽  
Final Treatment ◽  
Before And After ◽  
Competing Interest ◽  
Long Acting ◽  
Gender Groups

IntroductionIn the general practice, psychiatrists widely prescribe antipsychotics for several conditions as schizophrenia, bipolar disorder and behavioral disorders among others.Aim and objectivesThe aim of this study is to describe the clinical and sociodemographic features of typical patients receiving antipsychotics and their effects after switching to long-acting treatment.MethodsA descriptive analysis of 80 outpatients collected from a mental health clinic in Santander (Spain) was performed. All patients were taking antipsychotics at baseline, both oral and intramuscular, and were switched to a different long-acting antipsychotic drug.ResultsAt baseline, 24 patients were taking oral medication and 56 intramuscular. There were 37 females and 43 males. There were no gender differences in the final treatment, but Palmitate Paliperidone (71.3%) was the most prescribed drug, followed by intramuscular risperidone (16.3%) and long-acting aripiprazole (11.3%). We found gender differences regarding cannabis (P = 0.002), alcohol (P = 0.004) and tobacco (P = 0.043) consumption, being their use more common in males. In regard to diagnosis, schizophrenia was predominant in both gender groups, whereas delusional and behavioral disorders were more frequent in females. There were no significant differences in the reason of switching, but the inefficacy was more common in males and the side effects in females. At the switching, females were significantly older than males (P = 0.003). We found significant differences before and after switching regarding the number of admissions, emergency visits and length of stay.ConclusionsAntipsychotic benefits are individual and unpredictable. When switching, some other different factors should be taking in account, not only regarding medication.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Reasons to choose a long acting antipsychotic and tolerability

2017 ◽  
Vol 41 (S1) ◽  
pp. s822-s822
Author(s):  
I. Martínez Molina ◽  
N. Gómez-Coronado Suárez de Venegas ◽  
P. Blanco Ramón
Keyword(s):  
Side Effects ◽  
Sexual Dysfunction ◽  
Negative Symptoms ◽  
Descriptive Analysis ◽  
Hypertensive Crisis ◽  
Antipsychotic Treatment ◽  
Competing Interest ◽  
One Year ◽  
Long Acting ◽  
Positive And Negative Symptoms

IntroductionAripiprazole depot is an atypical antipshycotic used to treat positive and negative symptoms of psychosis or acute mania.AimDescribe the reason why psychiatrists switch the current antipsychotic treatment on to aripiprazol depot, its tolerability and the reasons to stop aripiprazol depot treatment.MethodsDescriptive analysis based on a sample of 37 patients, aged 18–65 years, treated during one year with antipsychotics at two community mental health units.ResultsSwitching on to aripiprazole depot principal reasons: promote adherence (25%), persistence of symptoms (25%) and high levels of prolactin or sexual dysfunction (16.66%):– side effects of aripiprazole depot: insomnia (11.11%), inquietude (8.33%), sexual dysfunction (2.77%) and hypertensive crisis during administration (2.77%);– 83.33% of the patients are still taking it after one year. The most common reasons to stop or change it were the presence of secondaries (11.11%) and clinical exacerbation (5.55%).ConclusionsAripiprazole depot is well tolerated (even better than other antipsychotics). Common side effects are not severe and appear in a small percent of patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Effective doses of paliperidone palmitate (PAP): Retrospective analysis from three years of treatment

2016 ◽  
Vol 33 (S1) ◽  
pp. S540-S540
Author(s):  
S. Galiano Rus ◽  
A. Soler Iborte ◽  
C. Quesada González
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Hospital Admissions ◽  
Average Length ◽  
Average Hospital ◽  
Icd 10 ◽  
Effective Doses ◽  
Technical Specifications ◽  
Competing Interest ◽  
Long Acting

IntroductionThe use of PAP is already much extended in general. The recommended doses in the technical specifications of the drugs, as the result of trial studies, differ from the doses administered in habitual clinical practice. Therefore, the justification of this study is to monitor the average doses prescribed, to be able to reach an agreement on the best doses. To retrospectively analyze the first 32 patients in our area of healthcare, who were prescribed PAP, the doses used at the start of treatment and after 3 years.Materials and methodsTwo initial doses of PAP were analyzed, maximum and current (outpatient) in 32 patients attended in the area of mental health of North Jaen, who started the treatment with PAP between 2012 and 2013, with an average length of time of 2.55 years (SD 2.02). We evaluated the diagnosis (schizophrenia and related disorders, ICD-10 F20), the number of hospital admissions previous and posterior to the start of the treatment and change in weight.ResultsAverage doses: initial: 110.15 mg (SD 32.83), maximum: 165.51 mg (SD 29.76) and maintenance: 146.81 mg (SD 29.59). Average hospital admissions: prior and posterior to the start of treatment: 1.5 and 0.83. An average reduction of 44.06% in admissions was observed.ConclusionsThe data obtained suggests that a dose of 75–200 mg could be effective in the maintenance of patients with schizophrenia and for decreasing the number of new hospital admissions. Fifty percent of the cases can be compensated with long acting peliperidone as a monotherapy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Effect of Long-acting Injectable Aripiprazole in Glucose and Lipids: A 1 Year Study

2017 ◽  
Vol 41 (S1) ◽  
pp. S268-S268
Author(s):  
M. Juncal Ruiz ◽  
O. Porta Olivares ◽  
B. Fernández-Abascal Puente ◽  
M. Gómez Revuelta ◽  
R. Landera Rodríguez ◽  
...  
Keyword(s):  
Beneficial Effect ◽  
Ldl Cholesterol ◽  
Hdl Cholesterol ◽  
Anti Psychotic ◽  
Glucose Levels ◽  
Cholesterol Levels ◽  
Low Levels ◽  
Competing Interest ◽  
One Year ◽  
Long Acting

IntroductionAtypical anti-psychotics are associated with an impaired in glucose and lipids homeostasis.AimsTo evaluate, the effect in lipids and glucose levels after switching to long-acting injectable (LAI) aripiprazole.MethodsThis was a prospective, observational, 1 year study carried out in 125 outpatients with schizophrenia who were clinically stabilized but a switching to another anti-psychotic was indicated. We measured basal levels of glucose and lipids at the time to start the study and 1 year after switching to LAI-aripiprazole.ResultsIn basal analytic we observed these abnormalities: hyperglycemia (16.7%), high-levels of LDL-cholesterol (33.3%), low-levels of HDL-cholesterol (39%) and hypertrygliceridemia (22.2%). One year after switching to LAI-aripiprazole we found: glucose levels were normalized in all patients; levels of LDL-cholesterol were lower in 66.7% (in 33.3% levels were normalized) and they were higher in 16.7% (in 11% marked a change from normal to abnormal parameters); levels of HDL-cholesterol were lower in 23.3% and higher in 32.2% (in 11% levels were normalized); and finally, levels of tryglicerides were higher in 66.7% (in 8% marked a change from normal to abnormal parameters) and in 16.7% they were lower (in 7.3% levels were normalized).ConclusionsLAI-aripiprazole has a beneficial effect in glucose and cholesterol levels. Although, it usually increases tryglicerides levels, only in seven cases there was a change from normal to abnormal parameters. Our study suggests that LAI-aripiprazol could be an alternative in patients with schizophrenia who have high levels of glucose and lipids related with atypical anti-psychotics treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Recent Critical Trends in Mental Hospital Admissions in the Oxford Region

1962 ◽  
Vol 108 (452) ◽  
pp. 59-67 ◽  
Author(s):  
A. Barr ◽  
D. Golding ◽  
R. W. Parnell
Keyword(s):  
Mental Health ◽  
Length Of Stay ◽  
Mental Hospital ◽  
Hospital Admissions ◽  
Average Length ◽  
Time Study ◽  
Ministry Of Health ◽  
Mental Hospitals ◽  
Average Length Of Stay ◽  
One Year

The statistics on mental hospitals published by the Ministry of Health (1957) show that the average length of stay for admissions to mental hospitals decreased in the period 1952–1956. According to the Registrar-General's Mental Health Supplement (1961) there was an average saving, between 1951 and 1958, of sixteen days for men and thirteen days for women, among patients staying less than one year. But these figures for stay only relate to the patients discharged each year, irrespective of the year of their admission, and furthermore we do not know what happens to particular groups such, for example, as schizophrenics. Although remarkable changes are occurring at the present time, study of them is hampered by lack of appropriate and up-to-date information.

scholarly journals Is paliperidone palmitate more effective than other long-acting injectable antipsychotics?

2017 ◽  
Vol 48 (10) ◽  
pp. 1616-1623 ◽  
Author(s):  
R. Patel ◽  
E. Chesney ◽  
M. Taylor ◽  
D. Taylor ◽  
P. McGuire
Keyword(s):  
Rate Ratio ◽  
Hospital Admissions ◽  
Incidence Rate Ratio ◽  
Psychiatric Inpatient ◽  
The Other ◽  
Paliperidone Palmitate ◽  
Before And After ◽  
Long Acting ◽  
Few Data ◽  
The Uk

AbstractBackgroundPaliperidone palmitate is one of the most widely prescribed long-acting injectable (LAI) antipsychotics in the UK. However, it is relatively expensive and there are few data comparing its effectiveness to that of other LAI antipsychotics. We sought to address this issue by analyzing a large anonymized electronic health record (EHR) dataset from patients treated with LAI antipsychotics.MethodsEHR data were obtained from 1281 patients in the South London and Maudsley NHS Foundation Trust (SLaM) who started treatment with a LAI antipsychotic between 1 April 2011 and 31 January 2015. The number of days spent as a psychiatric inpatient and the number of admissions to a psychiatric hospital were analyzed in each of the 3 years before and after LAI prescription.ResultsPatients treated with paliperidone palmitate (n = 430; 33.6%) had a greater number of inpatient days and a greater number of admissions in the year prior to treatment than those treated with other LAI antipsychotics. Nevertheless, in the 3 years after initiation there were no significant differences between paliperidone and the other LAI antipsychotics in the number of days as an inpatient (B coefficient 5.4 days, 95% confidence interval (CI) −57.3 to 68.2, p = 0.86) or number of hospital admissions (Incidence rate ratio 1.07, 95% CI 0.62 to 1.83, p = 0.82).ConclusionPaliperidone palmitate was more likely to be prescribed in patients with more frequent and lengthy hospital admissions prior to initiation. However, the absence of differences in outcomes after initiation indicates that paliperidone palmitate was not more effective than other cheaper LAI antipsychotics.

Describing the assistance, the basis for improvement

2017 ◽  
Vol 41 (S1) ◽  
pp. s505-s505
Author(s):  
E.J. Pérez Sánchez ◽  
J.M. Ginés Miranda ◽  
V. Chavarría Romero ◽  
J. Moreno ◽  
A. Palma ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Psychiatric Diagnosis ◽  
Clinical Characteristics ◽  
Descriptive Analysis ◽  
Adjustment Disorder ◽  
Competing Interest ◽  
Care Assistance ◽  
Surgical Conditions ◽  
Made In

IntroductionConsultation-liaison (CL) psychiatry is a branch of psychiatry that study and treat mental health of patients with other medical or surgical conditions. The assistance between hospitals and health services is heterogeneous.Aims and objectivesFor this reason, the objective of our research is to define the clinical characteristics from our CL service and check out the quality relationship with the applicant service, for improving future assistance.MethodsWe made a descriptive analysis of clinical variables from the patients who received assistance during 2 months by the CL service from the hospital del Mar, Barcelona. We got the frequencies and we used the Chi2 test for the comparison between variables: Diagnosis, appearance in the report and treatment in the report.ResultsTotal of the sample: 42 patients, 61.9% women. Mean age: 55.1 years. Psychiatric diagnosis was present before the assistance on 57.1% of the patients. The most frequent diagnosis was Adjustment Disorder (47.6%) and more than one diagnosis was made in the 14.3%. Near the half of the patients required only primary care assistance after the discharge from the hospital. In the 68.3% of the reports appeared information about CL assistance and the indicated treatment didn’t appear in all the reports. Statistically significant differences weren’t found in the comparisons.ConclusionsAdjustment Disorder is supposed to be the most common psychiatric diagnosis in our CL psychiatry service, as we found in the reviewed literature. The results reveal that relationships between services can be improved. More studies must be done for completing information in this issue.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Paliperidone palmitate: Experience in a community mental health unit

2017 ◽  
Vol 41 (S1) ◽  
pp. s804-s805
Author(s):  
L. Carrión Expósito ◽  
G.M. Chauca Chauca ◽  
E.L. Guadalupe
Keyword(s):  
Mental Health ◽  
Retrospective Study ◽  
Maintenance Dose ◽  
Lower Number ◽  
Paliperidone Palmitate ◽  
Health Unit ◽  
Dose Number ◽  
Competing Interest ◽  
Long Acting ◽  
Mental Health Unit

IntroductionThere are many jobs that offer advantages of treatment with long-acting injectable in psychosis.ObjectiveTo know the changes in the different variables after the start of paliperidone palmitate (PP).Material and methodWe performed a descriptive and retrospective study. Were evaluated patients who received maintenance therapy with PP during 48 months.ResultsThe sample was composed of 29 patients: 72.4% men and 27.6% women. Average age of 46.21 years. In Figures 1, 2 and 3 show data obtained in relation to compliance with treatment, relapse, maintenance dose, number of admissions and visits to emergency departments respectively.ConclusionsThe administration of PP is associated with a higher level of compliance with treatment. The patients presented a lower number of relapses, hospitalizations and visits to the emergency room. The maintenance dose more used is 150 mg.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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