scholarly journals The impact of the National Institute of Clinical Excellence guidance on the use of electroconvulsive therapy in England

2009 ◽  
Vol 22 (1) ◽  
pp. 164-166 ◽  
Author(s):  
Ajit Shah
Keyword(s):  
Clinical Practice ◽  
Electroconvulsive Therapy ◽  
Royal College ◽  
Clinical Excellence ◽  
Depressive Illness ◽  
Review Group ◽  
The Impact ◽  
Technical Appraisal

Electroconvulsive therapy (ECT) has been reported to have efficacy in the treatment of depressive illness, mania and catatonia (U.K. ECT Review Group, 2003; National Institute for Clinical Excellence, 2003; Scott, 2004). The Royal College of Psychiatrists in the U.K. continues to support the use of ECT within the framework of its guidance on the use of ECT (Scott, 2004) and has developed an ECT accreditation service for clincal services that use ECT. In May 2003, the National Institute of Clinical Excellence (NICE) issued a technical appraisal on the use of ECT in England (NICE, 2003). This is essentially guidance on the use of ECT which clinicians are required to follow in their clinical practice.

scholarly journals The Defeat Depression Campaign

1997 ◽  
Vol 21 (3) ◽  
pp. 148-150 ◽  
Author(s):  
Ann Macaskill ◽  
Norman Macaskill ◽  
A. Nicol
Keyword(s):  
Clinical Practice ◽  
Royal College ◽  
Questionnaire Survey ◽  
Clinical Management ◽  
The Public ◽  
Health Practitioners ◽  
The Impact

The Royal College of Psychiatrists launched a five year campaign in 1992 to better inform health practitioners and the public about depression. A questionnaire survey of Sheffield general practitoners (GPs) to assess the impact of the Defeat Depression Campaign on their knowledge and clinical management of depression was carried out in May 1994, half way through the campaign. Overall, 75% of GPs who responded indicated that the Defeat Depression Campaign had had little or no impact on their clinical practice. It would appear that at its mid-point the Defeat Depression Campaign failed to achieve its main goals in relation to educating GPs about depression and its management.

scholarly journals Electroconvulsive therapy – attitudes and practice in New Zealand

2001 ◽  
Vol 25 (12) ◽  
pp. 467-470 ◽  
Author(s):  
John A. Strachan
Keyword(s):  
Clinical Practice ◽  
New Zealand ◽  
Great Britain ◽  
Electroconvulsive Therapy ◽  
Royal College ◽  
Clinical Implications ◽  
Medical Conditions ◽  
Therapy Attitudes ◽  
Zealand College ◽  
Source Of Information

Aims and MethodThe clinical practice of electroconvulsive therapy (ECT) by New Zealand psychiatrists was surveyed by questionnaire. This paper compares the findings with national and regional surveys conducted in Great Britain, and considers the influence on clinical practice in New Zealand of the Royal College of Psychiatrists' ECT Handbook.ResultsECT has the same level of support from psychiatrists in New Zealand as in Britain, but is less frequently used. Modern brief pulse machines are used by 16 of 19 (84%) services from which data were received. The ECT Handbook was the most nominated source of information on ECT. Most (87%) respondents were aware of at least one set of ECT guidelines. However, these have apparently failed to influence some important aspects of practice. In particular, many medical conditions are still perceived as absolute contraindications.Clinical ImplicationsThe Royal College of Psychiatrists and the Royal Australian and New Zealand College of Psychiatrists need to place even greater emphasis on the importance of training in ECT for both trainees and qualified psychiatrists, and on the promotion of approved guidelines.

scholarly journals Improving electroconvulsive therapy practice through audit

1995 ◽  
Vol 19 (8) ◽  
pp. 480-481 ◽  
Author(s):  
C. Robertson ◽  
T. Wheeldon ◽  
J. M. Eagles ◽  
I. C. Reid
Keyword(s):  
Clinical Practice ◽  
Service Delivery ◽  
Electroconvulsive Therapy ◽  
Royal College ◽  
Marked Improvement ◽  
Psychiatric Service ◽  
Education Programme ◽  
Set Up ◽  
Audit Information

Recent studies have highlighted deficiencies in ECT service delivery. This audit was set up to monitor and improve the ECT administered in a large psychiatric service. In the first phase of the audit Information was collected regarding stimulus adjustment in response to brief seizures. This highlighted inconsistencies In clinical practice and an education programme was instigated to correct these deficiencies and to bring practice into line with the Royal College of Psychiatrists guidelines. A repeat audit was performed and a marked improvement in the quality of stimulus adjustment was shown.

scholarly journals Implementing the Royal College of Psychiatrists' guidelines for the practice of electroconvulsive therapy

2000 ◽  
Vol 24 (9) ◽  
pp. 329-330 ◽  
Author(s):  
Guy Brookes ◽  
John Rigby ◽  
Richard Barnes
Keyword(s):  
Electroconvulsive Therapy ◽  
Royal College ◽  
Slight Improvement ◽  
Considerable Effort ◽  
Quality Of Treatment ◽  
Before And After ◽  
The Impact

Aims and MethodTo implement the Royal College of Psychiatrists' guidelines for the practice of electroconvulsive therapy (ECT) and measure the impact of such implementation on the quality of treatment. Treatment of ECT for periods of six months before and after implementation of the guidelines were studied. The effect on producing adequate treatments and the actions taken by the administrating doctor were noted.ResultsOnce the guidelines were in place there was a slight improvement in the proportion of treatments considered therapeutic and the doctor was more likely to take appropriate action following an inadequate treatment. However, it was also clear that despite the guidelines being available they were not followed in a significant number of instances.ConclusionsImplementation of the guidelines is not easy and there needs to be considerable effort to ensure they are used. When they are followed there is an improvement in the practice of ECT.

scholarly journals A re-audit of ECT training and practice

1999 ◽  
Vol 23 (7) ◽  
pp. 419-421 ◽  
Author(s):  
Farida Yousaf ◽  
Martin Lee ◽  
Jose King
Keyword(s):  
Clinical Practice ◽  
Electroconvulsive Therapy ◽  
Royal College ◽  
Current Practice ◽  
Dose Titration ◽  
Clinical Implications ◽  
Junior Doctors ◽  
Information Recording ◽  
Training And Supervision ◽  
New Guidelines

Aims and methodsA re-audit of the current practice of electroconvulsive therapy (ECT) was carried out over a period of five months using the new guidelines produced by the Royal College of Psychiatrists. The areas audited included obtaining consent from the patients, information recording, training and supervision of the junior doctors and the practical aspects of ECT administration, including dose titration.ResultsAn improvement in the training and supervision of junior doctors was seen since the last audit but shortcomings were identified in areas of pre- and post-ECT preparation, information recording and correct use of stimulus-dosing policy.Clinical implicationsRecommendations include the need to improve clinical practice and recording of information.

Translating Principles of Speech Science to Clinical Practice: Current and Future Trends in Craniofacial Disorders

2008 ◽  
Vol 18 (1) ◽  
pp. 31-40 ◽  
Author(s):  
David J. Zajac
Keyword(s):  
Clinical Practice ◽  
Speech Intelligibility ◽  
Current Practice ◽  
Computer Assisted ◽  
Behavioral Management ◽  
Single Word ◽  
Future Directions ◽  
Speech Science ◽  
The Impact ◽  
Opinion Article

Abstract The purpose of this opinion article is to review the impact of the principles and technology of speech science on clinical practice in the area of craniofacial disorders. Current practice relative to (a) speech aerodynamic assessment, (b) computer-assisted single-word speech intelligibility testing, and (c) behavioral management of hypernasal resonance are reviewed. Future directions and/or refinement of each area are also identified. It is suggested that both challenging and rewarding times are in store for clinical researchers in craniofacial disorders.

17. Boundaries or overlap: An examination of the community-oriented clinical practice of community medicine specialists and family/general practitioners

2007 ◽  
Vol 30 (4) ◽  
pp. 36
Author(s):  
M. L. Russell ◽  
L. McIntyre
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Clinical Practice ◽  
Community Health ◽  
Royal College ◽  
Community Medicine ◽  
Work Setting ◽  
Public Health Medicine ◽  
Work Settings ◽  
Main Work

We compared the work settings and “community-oriented clinical practice” of Community Medicine (CM) specialists and family physicians/general practitioners (FP). We conducted secondary data analysis of the 2004 National Physician Survey (NPS) to examine main work setting and clinical activity reported by 154 CM (40% of eligible CM in Canada) and 11,041 FP (36% of eligible FP in Canada). Text data from the specialist questionnaire related to “most common conditions that you treat” were extracted from the Master database for CM specialists, and subjected to thematic analysis and coded. CM specialists were more likely than FP to engage in “community medicine/public health” (59.7% vs 15.3%); while the opposite was found for primary care (13% vs. 78.2%). CM specialists were less likely to indicate a main work setting of private office/clinic/community health centre/community hospital than were FP (13.6% vs. 75.6%). Forty-five percent of CM provided a response to “most common conditions treated” with the remainder either leaving the item blank or indicating that they did not treat individual patients. The most frequently named conditions in rank order were: psychiatric disorders; public health program/activity; respiratory problems; hypertension; and metabolic disorders (diabetes). There is some overlap in the professional activities and work settings of CM specialists and FP. The “most commonly treated conditions” suggest that some CM specialists may be practicing primary care as part of the Royal College career path of “community-oriented clinical practice.” However the “most commonly treated conditions” do not specifically indicate an orientation of that practice towards “an emphasis on health promotion and disease prevention” as also specified by the Royal College for that CM career path. This raises questions about the appropriateness of the current training requirements and career paths as delineated for CM specialists by the Royal College of Physicians & Surgeons of Canada. Bhopal R. Public health medicine and primary health care: convergent, divergent, or parallel paths? J Epidemiol Community Health 1995; 49:113-6. Pettersen BJ, Johnsen R. More physicians in public health: less public health work? Scan J Public Health 2005; 33:91-8. Stanwell-Smith R. Public health medicine in transition. J Royal Society of Medicine 2001; 94(7):319-21.

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