Evaluation of insomnia management in the elderly by general practitioners

2017 ◽  
Vol 41 (S1) ◽  
pp. s856-s856
Author(s):  
M. Turki ◽  
J. Aloulou ◽  
N. Halouani ◽  
R. Ennaoui ◽  
O. Amami
Keyword(s):  
General Practice ◽  
General Practitioners ◽  
The Elderly ◽  
Descriptive Study ◽  
Accurate Diagnosis ◽  
Physiological Changes ◽  
Cross Sectional ◽  
Somatic Comorbidities ◽  
Hypnotic Drugs ◽  
Competing Interest

IntroductionInsomnia is the most common sleep disorder in the elderly. Its management must take into account the physiological changes associated with age, a higher frequency of comorbidities and polypharmacy.AimTo evaluate the management of insomnia in the elderly patients by general practitioners and to compare it with international recommendations.MethodsWe conducted a cross-sectional and descriptive study among general practitioners in Sfax over a period of two months (January and February 2016). We proposed to these doctors to participate in our study by sending to them a questionnaire in their emails, which they fill anonymously.ResultsA total of 32 doctors responded to the questionnaire. Among them, 62.5% reported that they often or very often receive elderly consulting for insomnia. Before prescribing hypnotic drugs, 65.6% of practitioners reported that they often advise lifestyle and dietary rules. The most prescribed hypnotic classes were: benzodiazepines (BZD) 59.37%; antihistamines 59.37% and homeopathic treatments 56.25%. In the last prescription, the treatment period exceeded 30 days in 18.75%. As for the prescription of BZD, molecules with long half-life were used in 37.48% of cases, and the dosage was identical to adult in 34.4% of cases.ConclusionThe prescription of hypnotic treatment in the elderly meets a logical approach to care, after an accurate diagnosis, taking into account psychiatric and somatic comorbidities, the precautions and contraindications. In this context, we have identified several shortcomings in the management of insomnia in the elderly in general practice. A multiplication of training on this subject is needed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Hypnotic Drug Use in Spain: A Cross-Sectional Study Based on a Network of Community Pharmacies

1996 ◽  
Vol 30 (10) ◽  
pp. 1092-1100 ◽  
Author(s):  
Pilar Rayón ◽  
Mariantonia Serrano-Castro ◽  
Horacio del Barrio ◽  
Carmen Alvarez ◽  
Dolores Montero ◽  
...  
Keyword(s):  
Drug Use ◽  
Sleep Disorder ◽  
General Practitioners ◽  
The Elderly ◽  
Community Pharmacies ◽  
Cross Sectional ◽  
Hypnotic Drug ◽  
Hypnotic Drugs ◽  
Long Action

OBJECTIVE: To investigate how hypnotic drugs are used in Spain, specifically, (1) to characterize the user population in some simple demographic (e.g., sex, age) and clinical (e.g., type of insomnia, type of physician who prescribed the drug) variables; (2) to estimate the proportion of long-term users (>3 mo); (3) to determine the frequency of different administration schedules; (4) to determine whether the kind of hypnotic drug prescribed according to the duration of its effect correlates with the type of sleep disorder or patient age; and (5) to compare the dosage used by the elderly with that used by adults. DESIGN: Cross-sectional pharmacy-based study. SETTING: A network of 318 community pharmacies throughout Spain. SUBJECTS: Patients (n = 5324) requesting a hypnotic drug for insomnia who agreed to take part in the study. MAIN OUTCOME MEASURES: Distribution of the use of hypnotic drugs by age, sex, type of insomnia, type of physician, specific hypnotic drug, daily dosage, treatment schedule, and duration of treatment. RESULTS: Women (67%) and the elderly (58%) constituted the largest subgroups in the sample. Difficulties in sleep onset and in sleep maintenance as single disorders were reported by 38% and 37% of users, respectively. Prescriptions were written by general practitioners in 80% of cases. Daily use was reported by 88% and long-term use (>3 mo) by 72% of the users. Long-term treatment was two- to threefold more frequent in the elderly than in middle-aged subjects. Intermediate-action hypnotic drugs were used by 59% of subjects, short-action drugs by 24%, and long-action drugs by 17%. The type of hypnotic drug prescribed was not related to the kind of sleep disorder or the age of patients. Specialists prescribed long-action hypnotic drugs more often than did general practitioners. No relevant differences were observed between dosages used by the elderly and those used by adults. In both groups the dosage taken by most patients, regardless of the drug, corresponded to the available strength. Substitution drugs for triazolam belonged to the intermediate-action class in 53% of the cases. CONCLUSIONS: Recommendations on hypnotic drug use are largely not followed in Spain. Most patients are taking hypnotic drugs daily, over long time periods, and without an adequate dosage titration according to age. Measures should be taken to correct this situation.

Consultation liaison psychiatry in Talavera's hospital during the year 2014

2016 ◽  
Vol 33 (S1) ◽  
pp. S394-S394
Author(s):  
M. Palomo Monge ◽  
D.C. Sandra ◽  
A.L. Maria Fernanda ◽  
G.M. David ◽  
T.G. Maria Fernanda ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Psychiatric Disorders ◽  
Descriptive Study ◽  
Liaison Psychiatry ◽  
Consultation Service ◽  
Cross Sectional ◽  
Consultation Liaison Psychiatry ◽  
Competing Interest

IntroductionAnalyze the number of interdepartmental consultations carried out at Department of Psychiatry, Hospital Nuestra Señora del Prado from other areas of hospitalization during 2014.ObjectivesThe goal is to evaluate the prevalence of psychiatric disorders in patients who are hospitalized for other reasons, and which services are needed the most.MethodsRetrospective cross-sectional descriptive study. A record of consultations carried out by the psychiatry service in 2014 was collected. The data were analyzed according to the origin of the consultation service, the month when it was performed and the sex of the patient. The monthly percentage of interconsultations and the percentage represented by each interconsultation service were calculated. They classified according to sex.ResultsIn 2014, 211 interconsultations were carried out, 104 men and 86 women. Surgery 16, 11%, pneumology 13, 74%, internal medicine 12, 32%, traumatology 8, 06%, digestive 7, 11%), I.C.U. 6, 64%, cardiology 6, 16%, hematology 5, 69%, oncology 5, 21%, pediatrics 4, 27%, gynecology 2, 84%, emergency 1, 90%, palliative1, 90%, endocrinology 1, 42%, urology 1, 42, nephrology 0, 95%, E.N.T. 0, 95%, obstetrics 0, 47%, dermatology 0%, ophthalmology 0%, rheumatology 0%. January 12, 8%, February 13%, March 9, 5%, April 6, 2%, May 5, 7%, June 8, 1%, July 6, 2%, August 4, 3%, September 8, 1%, October 12%, November 7, 6%, December 6, 2%.ConclusionsMost of the interconsultations were carried out in January, February and October. However, August was the least busy month. The busiest service was the Surgery service, followed by the Pneumology and Internal Medicine one. There were no interconsultations of the Ophthalmology, Rheumatology and Dermatology services. The consults were in demand mainly by men rather than women.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Nurses Knowledge on Management of Patient Receiving Spinal Anaesthesia in a Government Hospital

2019 ◽  
Vol 2 (2) ◽  
pp. 126-132
Author(s):  
Elisha Rijal ◽  
Suvekshya Silwal ◽  
Sheela Thapa ◽  
Saraswati Basnet ◽  
Subhadra Bhagat
Keyword(s):  
Nursing Care ◽  
Spinal Anaesthesia ◽  
Sampling Method ◽  
Descriptive Study ◽  
Age Group ◽  
Physiological Changes ◽  
Government Hospital ◽  
Cross Sectional ◽  
Competence Level ◽  
Self Administered Questionnaire

Introduction: Spinal Anaesthesia (SA) is a form of regional anaesthesia involving injection of a local anaesthetic into the subarachnoid space. SA is directly related to nervous system, so its mismanagement may cause various complications hence, prevention and management of complication is a vital and complex aspect of critical nursing care. Therefore, the objective of this study was to assess the nurse’s knowledge on the management of patient receiving spinal anaesthesia. Methodology: A cross-sectional descriptive study was conducted among nurses of Koshi Zonal Hospital of Province no. 1, Biratnagar, Nepal from May to June 2017. Non-probability purposive sampling method was used where self-administered questionnaire was administered among 67 working nurses in the hospital. Results: The majority of the respondents (77.6%) belonged to 20-30 years of age group, nearly half (44.8%) of the respondents had completed PCL nursing. Only 67.2% explained the meaning of anaesthesia, and 58.2% had knowledge on physiological changes after SA. Regarding ambulation and cause of backache, 29.9% had knowledge whereas only 20.9% had knowledge about management of post spinal backache. Respondents facing problem to manage the complication after SA was 13.4%. This study also found that the overall knowledge regarding SA was adequate among 80.6% respondents. Conclusion: Nurses as the key personnel in management and prevention of complication, the obtained result was below the desired competence level among working nurses as it is the vital aspect of critical nursing care.

scholarly journals Cross-sectional analysis of coding, patient characteristics, consultation frequency and pharmacological treatment of adults with severe mental disorders in Irish general practice

2021 ◽  
Author(s):  
James Larkin ◽  
Ivana Pericin ◽  
Brian Osborne ◽  
Philip Dodd ◽  
Claire Collins
Keyword(s):  
General Practice ◽  
Mental Disorders ◽  
Depressive Disorder ◽  
General Practitioners ◽  
Pharmacological Treatment ◽  
Mental Health Problems ◽  
Patient Characteristics ◽  
Severe Mental Disorders ◽  
Consultation Rate ◽  
Cross Sectional

Abstract Background General practitioners are the gatekeepers of Irish healthcare and they offer continuity of care to patients. Irish general practice is therefore considered appropriate for preventing, diagnosing and managing most mental health problems. Aims This study sought to establish the coding frequency, consultation frequency, patient characteristics and pharmacological treatment of patients with severe mental disorders (SMDs) in Irish general practice. Methods A cross-sectional design was used. A finder tool embedded in the practice software assisted general practitioners (GPs) coding adult patients with SMDs. Eleven practices uploaded anonymous data on 2,203 patients. Variables analysed included disease code, consultations, prescriptions, sex, patient status and age. Results Overall, 2.9% (n = 2,337) of patients had ever been coded with a SMD, 2.4% (n = 1,964) coded with depressive disorder ever and 0.26% (n = 209) and 0.3% (n = 233) with bipolar disorder and schizophrenia, respectively. Overall, 68.0% (n = 1,336) of patients with depressive disorder were female, and 74.0% (n = 171) of patients with schizophrenia were public patients. The median consultation rate in the previous 3 years was highest for schizophrenia patients at 24.5 visits. Conclusions Coding of SMDs in Irish general practice appears incomplete. Patients with SMDs have high consultation rates. Patients with depressive disorder are more likely to be female and public patients. This research suggests that the improvement of coding in Irish general practice is the first practical step required to detecting prevalence rates.

First episode schizophrenia in general practice: a national survey

2006 ◽  
Vol 23 (1) ◽  
pp. 6-9 ◽  
Author(s):  
Blanaid Gavin ◽  
Walter Cullen ◽  
Brian O'Donoghue ◽  
Juan Carlos Ascencio-Lane ◽  
Gerard Bury ◽  
...  
Keyword(s):  
General Practice ◽  
General Practitioners ◽  
Postal Survey ◽  
Psychiatric Services ◽  
First Episode ◽  
Cross Sectional ◽  
Intervention Service ◽  
Almost All ◽  
First Episode Schizophrenia ◽  
First Episode Of Schizophrenia

AbstractObjective: We sought to establish the views of general practitioners about detecting and managing patients with a first episode of schizophrenia in Ireland.Method: Twenty per cent of GPs were invited to participate in a cross-sectional postal survey.Results: Sixty-two per cent (n = 261) participated. Almost all (99.2%) see at least one case of suspected first episode schizophrenia annually. The most commonly (80.7%) encountered symptom is ‘bizarre behaviour’. Many (47.7%) rarely or never prescribe antipsychotics to patients whom they suspect have a first episode of schizophrenia. However, 80.6% of GPs reported that they ‘always’ refer this group of patients to psychiatric services. Over half (57.8%) advised patients with schizophrenia to continue medication for less than a year. A large number of respondents reported that it is difficult to obtain a rapid psychiatric assessment.Conclusions: GPs want more information about identifying early psychosis, a closer liaison with psychiatric services and a rapid intervention service.

Prescription of hearing aids for the elderly: The views of general practitioners

1992 ◽  
Vol 106 (11) ◽  
pp. 963-966 ◽  
Author(s):  
V. E. Newton ◽  
V. F. Hillier ◽  
S. D. G. Stephens
Keyword(s):  
General Practice ◽  
General Practitioners ◽  
Hearing Aids ◽  
Questionnaire Survey ◽  
Hearing Aid ◽  
The Elderly ◽  
Health Centres ◽  
Northern City ◽  
And Training ◽  
Do So

AbstractA questionnaire survey was carried out to examine the views of general practitioners in one Northern city regarding whether or not they thought that hearing aids should be prescribed from general practice, who they thought should prescribe them and whether or not additional resources and training would be needed if the responsibility for hearing aid prescription for the elderly was placed upon general practitioners.The survey indicated that whereas many general practitioners would be in favour of prescribing hearing aids from Health Centres, many would need extra training and resources to enable them to do so.

scholarly journals Monitoring the introduction of universal influenza vaccination for the elderly people in the Netherlands

1998 ◽  
Vol 3 (3) ◽  
pp. 32-32
Author(s):  
G. A. van Essen
Keyword(s):  
General Practice ◽  
Information Systems ◽  
The Netherlands ◽  
Influenza Vaccination ◽  
Elderly People ◽  
General Practitioners ◽  
The Elderly

For many years, influenza vaccination in the Netherlands has been administered by general practitioners (GPs), with whom every person is registered. Nine out of ten practices use one of six approved general practice information systems (GPIS). The exponen

scholarly journals Factors related to rural general practitioners supervising general practice registrars in Australia: A national cross-sectional study

2019 ◽  
Vol 48 (1-2) ◽  
pp. 66-71 ◽  
Author(s):  
Belinda O'Sullivan ◽  
Deborah Russell ◽  
Matthew McGrail ◽  
Marisa Sampson ◽  
Allyson Warrington ◽  
...  
Keyword(s):  
General Practice ◽  
General Practitioners ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional
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