Drug prescriptions associated with long acting. Pharmaco-economic aspects

2017 ◽  
Vol 41 (S1) ◽  
pp. S759-S759
Author(s):  
A. Riolo ◽  
F. Babici ◽  
F. Tassi
Keyword(s):  
Mental Health ◽  
Mental Health Center ◽  
Unit Price ◽  
Economic Aspects ◽  
Adherence To Treatment ◽  
Controversial Subject ◽  
Economic Profile ◽  
Competing Interest ◽  
Long Acting ◽  
Interaction Between Drugs

IntroductionThe polypharmacy is a very controversial subject; it brings together problems of interaction between drugs, side effects, and rationality of co-prescriptions, pharmaco-economic aspects. The long acting is useful to solve adherence to treatment but they are often prescribed in polytherapy.MethodThe aim of this studies is to compare long-acting haloperidol, fluphenazine, risperidone and paliperidone regard to prescribing associations and pharmaco-economy. Also we want to consider for each long-acting which and how many drugs are associated and the implications in terms of pharmaco-economics. We examined all prescriptions (126 patients) over a period of 12 months in a mental health center, identifying which long acting had the best pharmaco-economic profile.ResultsDespite being the less prescribed and not being associated with other psychiatric drugs, paliperidone palmitate shows the best pharmaco-economic profile.ConclusionsThe costs of a drug are in relationship not only with unit price but also with the question of safety in order to oppose the overmedication.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Long-acting injectable aripiprazole. Clinical experience in a case series

2016 ◽  
Vol 33 (S1) ◽  
pp. S614-S614
Author(s):  
J.M. Hernández Sánchez ◽  
M.C. Cancino Botello ◽  
M.F. Molina López ◽  
D. Peña Serrano ◽  
M. Machado Vera
Keyword(s):  
Mental Health ◽  
Health Center ◽  
Mental Health Center ◽  
Case Series ◽  
Antipsychotic Agent ◽  
Clinical History ◽  
Concomitant Treatment ◽  
Patient Profile ◽  
Competing Interest ◽  
Long Acting

IntroductionThe use of long-acting injectable antipsychotics is useful in patients with low therapeutic compliance.ObjectiveTo present the demographic and clinical data of a case series in which long-acting injectable aripiprazole has been prescribed in an ambulatory Mental Health Center.MethodsSystematic review of the related literature and clinical history of patients in which long-acting injectable aripiprazole had been prescribed from January to March 2015 in a Mental Health Center.ResultsWe found 10 patients, whose diagnosis were schizophrenia (4), non-specified psychosis (2), personality disorder (1), bipolar disorder (1), schizoaffective disorder (2), of whom 7 were men and 3 women, with a mean age of 43.8 years old. The mean of years since diagnosis was 15.1 years. In 7 patients, we found concomitant treatment with another antipsychotic agent (low dose quetiapine in all of them); antidepressants in 1 patient, benzodiazepines in 6; mood stabiliser in 5 and biperidene in 1. In relation to previous antipsychotic drugs, we found: aripiprazole 15 mg/day oral (4); long-acting injectable paliperdidone 150 mg/28 days (2) paliperdone 6 mg/day oral (1); combination of paliperidone 6 mg/day oral plus olanzapine 5 mg/day oral (1). Only 4 patients had used long-acting injectable drugs previously in their lifetime. The reason of having initiated treatment with long-acting injectable aripiprazole was sexual disturbance (3); lack of compliance (4); clinical inestability (2) and motor side effects (1).ConclusionsIn our series, we can observe a chronic patient profile, predominantly men with diagnosis of psychotic spectrum.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Folie à Deux: Shared or “Infected” Madness? About a Case Report

2016 ◽  
Vol 33 (S1) ◽  
pp. S529-S530
Author(s):  
M.Á. Soriano ◽  
C. Garcia
Keyword(s):  
Mental Health ◽  
Mental Health Center ◽  
Psychiatric Condition ◽  
Psychotic Experience ◽  
Environmental Features ◽  
The Family ◽  
Folie À Deux ◽  
Delusional System ◽  
Competing Interest ◽  
Folie A Deux

The shared madness or Folie à deux was described in France in the nineteenth century by Charles Lasage and Pierre Falret, as a condition where a person (the primary) builds a delusional system, sharing it with another (the secondary), who must be very close to the first affected, becoming delirious with the same subject. Several theories attempt to explain the phenomenon that challenges theories of personality structures, rooted in relational and/or environmental features of psychosis. Theoretically, there are many attempts to classify this psychotic experien in some manuals they distinguish various types of partners: the simultaneous psychosis, where the two people start to became delirious at once; imposed psychosis, in which the disorder arises first with one, then going on to “healthy” individual and symptomatology disappears after being separated; and communicated psychosis, where the first transmitted the psychotic experience to the second, and he or she develops his or her own delusion not interrupted even while separated. Other classifications about shared madness not only between two people, but three, and four, even a whole family show us how complicated the delirium systems can become. In our paper, we will discuss the different theories explaining this rare psychiatric condition based on a case about two brothers of 35 and 37, who live together with the rest of the family, and also come together to the same mental health center, although with different psychiatrists.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Psychiatrists’ opinion on treatment adherence in Delusional Disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S570-S570
Author(s):  
B. Girela Serrano ◽  
L. Aguado Bailón ◽  
P. Calvo ◽  
J.E. Muñoz Negro ◽  
J. Cervilla Ballesteros
Keyword(s):  
Treatment Adherence ◽  
Health Care Services ◽  
Delusional Disorder ◽  
Poor Adherence ◽  
Adherence To Treatment ◽  
Care Services ◽  
Active Compliance ◽  
Competing Interest ◽  
Long Acting ◽  
High Level

IntroductionDelusional Disorder (DD) F22 is a disease with low prevalence, probably underdiagnosed by clinical specialists due to the high level of functionality, low awareness of disease, low deterioration of patients and poor adherence to prescribed treatment. Adherence to treatment is considered to be one of the major difficulties that stand in the way of the treatment of DD. The present paper assessed psychiatrists’ opinion of the adherence to treatment of patients with DD.Material and methodsA self-administered survey was conducted on a sample of psychiatrists proceeding on a wide array of mental health care services. Participants provided their opinions regarding adherence to treatment. Descriptive statistics were subsequently calculated with SPSS.ResultsIn the opinion of our participants none of the patients have an active compliance of the treatment, 36% consider that the participation is partial or passive. It is also estimated that 57.5% reject the treatment but not totally and 6.5% believe that rejection is absolute.ConclusionsLiterature informs of the association of poor adherence to treatment and little or no improvement of patients, suggesting the need to address the lack of compliance and adherence to treatment as a crucial aspect to improve the prognosis of DD. To address this problem Long Acting Injections (LAIs) of Atypical Antipsychotics are postulated to be a plausible solution as a good treatment strategy. In order to improve the clinical practice in DD and obtain information for further effectiveness we emphasize the need of implementing clinical studies.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.

Group therapy based on mindfulness in a mental health center

2016 ◽  
Vol 33 (S1) ◽  
pp. S642-S642
Author(s):  
A. Uría de los Ojos ◽  
J. Ballesteros López ◽  
P. Rico García ◽  
A.B. González Palacios ◽  
C. Domínguez García
Keyword(s):  
Mental Health ◽  
Group Therapy ◽  
Health Center ◽  
Mental Health Center ◽  
Present Moment ◽  
Meditation Practice ◽  
Final Session ◽  
Before And After ◽  
Competing Interest

IntroductionMindfulness is defined as the ability of paying attention to the present moment with intentionality, moment to moment without making judgments of value.ObjectivesTo describe the effectiveness of group therapy performed in our mental health center according to the results in the SOFI scale of patients. This scale is designed to assess different qualities, which evolve through training in meditation practice based on mindfulness.MethodsGroup therapy consisted of 12 weekly sessions of an hour and a half. A total of 11 patients, 7 of which having completed therapy. The questionnaires were answered in the first and final session of therapy.ResultsThe questionnaire items were divided before and after treatment, into four categories with the following results: positive (friendly, happy, acceptance, compassion) to himself: 1.86 (0.54)/2.75 (0.78) and to others 3.57 (0.86)/3.89 (0.54); negative (hate, angry, cruel, bad) to himself: 2.92 (0.54)/2 (0.23); and to others: 2.28 (0.41)/1.96 (0.36)ConclusionsIn keeping with similar studies, the scale shows effectiveness of therapy in all sets of items, highlighting the variation of the aspects related to himself.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Time to relapse monotherapy and acquisition in a sample of schizophrenic patients over 3 years of follow-up

2016 ◽  
Vol 33 (S1) ◽  
pp. s261-s261
Author(s):  
P. González Rivera ◽  
A.J. Benito Ruiz ◽  
J. Prados Gomez ◽  
A. Hidalgo Borreguero ◽  
M. Soto Laguna ◽  
...  
Keyword(s):  
Concomitant Medication ◽  
Hospital Admissions ◽  
Clinical Sample ◽  
Psychiatric Patients ◽  
Clinical Relapse ◽  
Adherence To Treatment ◽  
Schizophrenic Patients ◽  
Competing Interest ◽  
Long Acting ◽  
Time To Relapse

IntroductionPoor adherence to treatment is one of the main problems in health care to psychiatric patients. The second-generation antipsychotics, and the subsequent emergence of the depot forms (long acting formulations) have facilitated this aspect, increasing the time to clinical relapse in patients with schizophrenia.GoalsDetermine the time to relapse in a clinical sample of patients diagnosed with schizophrenia treated with paliperidone palmitate over 3 years. Other objectives include the possible reduction in hospital admissions, as well as the possible reduction of psychiatric emergency visits, concomitant medication (benzodiazepines and Biperiden) and the possible increase in drug monotherapy.MethodologyThis is a study with a sample of 101 patients with schizophrenia who had started treatment with PP (consecutive sampling). Quantified variables in the 12 months prior to the change of PP treatment with variables at 6, 12, 24 and 36 months after initiation of treatment with PP were compared.Results and conclusionsAt the end of the tracking, 72.22% (73 patients) remained clinically stable, with adequate adherence to treatment and there have been no clinical relapses. It has obtained a statistically significant reduction in the use of concomitant medication, emergency room visits and the average duration of revenues, with no clinical relapse should occur in patients of the sample in the second and third year.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Does community care works? Evaluate the effectiveness of mental health services

2016 ◽  
Vol 33 (S1) ◽  
pp. S631-S631
Author(s):  
M. Giacomin
Keyword(s):  
Mental Health ◽  
Rating Scale ◽  
Personal Autonomy ◽  
Mental Health Center ◽  
Health Centre ◽  
Residential Community ◽  
Starting Point ◽  
Time Utilization ◽  
Competing Interest ◽  
Treatment Package

IntroductionImproving quality require the capability to evaluate clinical and operational processes and improve patients outcomes. Just in the view of evidence-based practise (EBP) it's used HONOS rating Scale, adopted since May 2012, by Mental Health Center of Villorba (Treviso-Italy) There are 3 package treatments: rehabilitative, territorial and clinical.ObjectivesTo identify which variables are positively correlated to HONOS improvement in patients group who frequented Mental Health Centre along 36 months. All patients present severe mental illness.AimsEvaluate the effectiveness of interventions and correlate to treatment package and individual feature. Analyze treatment process for quality improvement.MethodA psychiatric team (4 nurses, 1 psychiatrist) administered Honos Rating Scale along 3 years: on starting point and 6, 12 and 36 months later: T 0,1,2,3,4. Patients are also described by diagnosis, mental, social and autonomy skill, time, utilization of MHC and anagraphic information.ResultsAll 15 groups’ patients realize lower scoring, after 36 months’ treatment. Seven have got reliable improvement (i.e. = > 8-point lowering T3–T4) and positively correlate with: (1) 36 months’ treatment, at 12 months in rehabilitative Package; (2) days in residential/semi-residential community from 82 to 311 days. Related tables are included in paper.Discussion and conclusionHONOS score correlates directly with clinical and riabilitation improvement, i.e. mental, social capacity, and personal autonomy. It needs more investigation to clear which other factors are involved with improvement.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Non-Attendance at Initial Appointments in an Outpatient Mental Health Centre

2016 ◽  
Vol 33 (S1) ◽  
pp. S485-S485
Author(s):  
S. Ramos Perdigues ◽  
S. Gasque Llopis ◽  
S. Castillo Magaña ◽  
Y. Suesta Abad ◽  
M. Forner Martínez ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Social Services ◽  
Mental Health Problems ◽  
Mental Health Center ◽  
Health Centre ◽  
Outpatient Mental Health ◽  
Use Of Resources ◽  
Mental Health Centre ◽  
Competing Interest

IntroductionNon-attendance at initial appointments is an important problem in outpatient settings and has consequences, such as decreased efficient use of resources and delayed attention to patients who attend their visits, and that compromises quality of care.ObjectivesTo identify and describe the characteristics of patients who do not attend the first appointment in an adult outpatient mental health center, located in Barcelona.MethodRetrospective study. The sample was made up from all patients who had a first appointment during 2014 in our outpatient mental health centre. Socio-demographic and clinical data (type of first appointment, reason for consultation, origin of derivation, priority, history of mental health problems) were described. The results were analyzed using the SPSS statistical package.ResultsA total of 272 patients were included. Twenty-six per cent did not attend their first appointment; with mean age 39.75 years and 51.4% were male. Most frequent problems were anxiety (41.7%), depression (26.4%) and psycosis and behavioural problems (11.2%). The origin was primary care (83.3%), social services (4.2%) and emergencies (2.8%). Most of them were not preferent or urgent (86.1%). The 51.4% of non-attendees had history or psychiatric problems and 13.9% nowadays are patients of our mental health centre.ConclusionsIt is important to develop mechanisms that can reduce the incidence of first non-attended appointments. In our case, most of them are attended by primary care so we can establish better communication with our colleagues and try to contact to the patients prior to the date of the appointment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Ekbom syndrome in a visually impaired patient with alcohol abuse and OCD: A case report

2017 ◽  
Vol 41 (S1) ◽  
pp. s829-s829
Author(s):  
A. Portilla Fernandez ◽  
L. Montes Reula ◽  
H. Saiz García ◽  
R. Ortigosa Aguilar ◽  
A.S. Rosero Enriquez ◽  
...  
Keyword(s):  
Mental Health ◽  
Case Report ◽  
Alcohol Abuse ◽  
Visually Impaired ◽  
Compulsive Behavior ◽  
Impaired Patient ◽  
The Family ◽  
Ekbom Syndrome ◽  
Competing Interest ◽  
Long Acting

This is a case report of a 63-year-old patient with no previous attentions in mental health. He is referred by his general practitioner because he presents wounds all over his body. He reports that there is a plague of bugs at his place that bite him everywhere. Therefore, he scratches continuously, trying to remove the stingers, and injuring himself all over. The family ensures there are no bugs at all, but the patient threatens to set fire to the house in order to extinguish the plague or even kill himself. An OCD with cleaning compulsive behavior was also present since many years, as well as an alcohol abuse. The patient required hospitalization in the psychiatry service. Organic cause for the disorder was discarded. Long-acting injectable aripiprazol was introduced and the patient stopped drinking. Progressively, the delusional symptoms began to subside. Now he maintains no awareness of illness but he says the bugs are disappearing and, at least, they do not bite him anymore.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Improving use of resources-health care in patients with psychiatric pathology after introduction of risperidone long-acting injection (RLAI)

2011 ◽  
Vol 26 (S2) ◽  
pp. 1288-1288
Author(s):  
F. Valdivia ◽  
M. Asensio ◽  
A. Soler ◽  
L. López
Keyword(s):  
Mental Health Center ◽  
Psychiatric Inpatient ◽  
Ambulatory Monitoring ◽  
Adherence To Treatment ◽  
Use Of Resources ◽  
Psychiatric Inpatient Unit ◽  
Qualitative Variables ◽  
Oral Antipsychotic ◽  
One Year ◽  
Long Acting

Enhance adherence to treatment is one of the main objectives in psychiatric clinical practice. The aim of this study is to evaluate changes in the use of oral antipsychotic medication, the use of rehabilitation resources and the number and duration of income in Psychiatric Inpatient Unit, comparing one year before and one year after RLAI's introduction, in patients with different psychiatric disorders, followed up by Mental Health Center and have maintained adherence to treatment for a defined period. We performed an observational, retrospective study by reviewing medical records of patients in ambulatory monitoring. The sample consisted of all patients (112) who had maintained RLAI treatment for a year, excluding those who did not fulfill the guideline correctly (14), remaining n = 98. We included patients of various pathologies, establishing groups as qualitative variables (F.20 = 56; F.25 = 12; F.22–28 = 20; F.60 = 10); of both sexes (V = 71; M = 27) and all ages. The preliminary results obtained showed a greater use of rehabilitation resources and decreased use of oral antipsychotics.

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