Unnecessary psychotropic drug prescription in primary care for people with intellectual disability

Introduction 214 Promoting emotional well-being 216 Promoting assertiveness 218 Primary care 220 Secondary care 222 Tertiary care 224 Prevalence rates 226 Factors contributing to mental health 228 Anxiety disorders 230 Psychotic disorders 232 Organic disorders 234 Dementia (in people with intellectual disability) 236 Psychopathology 238...

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The Association Between Continuity of Primary Care and Preventive Cancer Screening in Women With Intellectual Disability

American Journal on Intellectual and Developmental Disabilities ◽

10.1352/1944-7558-123.6.499 ◽

2018 ◽

Vol 123 (6) ◽

pp. 499-513 ◽

Cited By ~ 2

Author(s):

Natasha Plourde ◽

Hilary K. Brown ◽

Simone Vigod ◽

Virginie Cobigo

Keyword(s):

Primary Care ◽

Cervical Cancer ◽

Intellectual Disability ◽

Cancer Screening ◽

Social Services ◽

Continuity Of Care ◽

Pap Test ◽

Population Based ◽

Breast And Cervical Cancer ◽

To Receive

Abstract Women with intellectual disability have low screening rates for breast and cervical cancer. This population-based cohort study examined the association between the level of primary care continuity and breast and cervical cancer screening rates in women with intellectual disability. Data were obtained from the Institute for Clinical Evaluative Sciences and the Ontario Ministry of Community and Social Services. Neither high (adjusted OR [aOR] = 1.06; 95% CI: 0.88-1.29) nor moderate (aOR = 1.11; 95% CI: 0.91-1.36) continuity of care were associated with mammography screening. Women were less likely to receive a Pap test with high (aOR = 0.70; 95% CI: 0.64-0.77) and moderate (aOR = 0.81, 95% CI 0.74-0.89) versus low continuity of care. Improving continuity of care may not be sufficient for increasing preventive screening rates.

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Evaluation of Psychotropic Drug Use in Adolescents Accessing a General Emergency Medical Department for Mental Disorders

Adolescents ◽

10.3390/adolescents1010001 ◽

2020 ◽

Vol 1 (1) ◽

pp. 1-9

Author(s):

Martina Buttera ◽

Antonio Clavenna ◽

Lucia Tansini ◽

Erica Maselli ◽

Alessandro Albizzati ◽

...

Keyword(s):

Drug Use ◽

Mental Disorders ◽

Mental Disorder ◽

Psychotropic Drug ◽

Pediatric Population ◽

Drug Prescription ◽

University Hospital ◽

Medical Department ◽

Off Label ◽

Psychotropic Drug Use

Background: Given the paucity of data concerning the care of adolescents attending an emergency department (ED) for mental disorders, we performed an observational study with the aim to describe psychotropic drug use in an Italian ED. Methods: A retrospective chart review of adolescents (13–17 years) visited in the ED of the San Paolo University Hospital in Milan for mental disorders between January and June 2018 was conducted. Information concerning age, gender, type of disorder, psychotropic drug use in the ED and outcome of the visit were analyzed, using an anonymous patient code. Results: A total of 1298 adolescents, 13–17 years old, were visited in the ED, 56 (4%) of whom had a diagnosis of mental disorder (34 females and 22 males). The most common disorder was anxiety (21 patients), followed by predominant psychomotor disorder (13 patients). In all, 30 adolescents received a psychotropic drug. Benzodiazepines were the most commonly used drugs (73% of the subjects), and delorazepam was administered/prescribed to 17 adolescents, despite the fact that evidence on its safety, efficacy, and its off-label use in the pediatric population is lacking. Conclusions: One out of two adolescents attending the ED for an acute episode of mental disorder received a psychotropic drug prescription, mainly in an off-label manner. More evidence is needed to guide the pharmacological management of acute episodes of mental disorders.

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Effectiveness of individual and group multicomponent interventions for smoking cessation in primary care: a quasi-experimental study

Family Practice ◽

10.1093/fampra/cmz005 ◽

2019 ◽

Vol 36 (5) ◽

pp. 627-633 ◽

Cited By ~ 1

Author(s):

Juan Fernando Suárez-Varela Úbeda ◽

Sara Rodríguez-Vázquez ◽

José Antonio Ordóñez Barranco ◽

Gilberto Vega Caldera ◽

Pedro Pablo Pérez Alvárez ◽

...

Keyword(s):

Higher Education ◽

Primary Care ◽

Smoking Cessation ◽

Group Intervention ◽

Drug Prescription ◽

Intervention Group ◽

Quasi Experimental ◽

Primary Care Practices ◽

Multicomponent Interventions

Abstract Background The efficacy of smoking cessation interventions can be quite diverse in day-to-day clinical practice. Objective To analyse the effectiveness in smoking cessation of multicomponent interventions carried out in groups or individually in primary care practices. Methods A quasi-experimental, multicentre study of 12-month follow-up of patients treated in multicomponent smoking cessation interventions was carried out in Urban health care centres in Sevilla, Spain. Two hundred and twenty smoking patients, ≥18 years of age, participated either in a multicomponent intervention group (n = 145; mean age 51.7 years; 53.1% women) or in individual interventions (n = 77; mean age 50.5 years; 61.0% women). The abstinence or relapse status was computed from patient self-reports, confirmed by relatives or companions when possible and supplemented by CO-oxymetry tests in 89 patients. Results The overall percentage of smoking cessation was 36.9% (37.9% with group and 35.1% with individual intervention, P = 0.398). Patients who quit smoking were younger (48.7 versus 52.9 years old, P < 0.01), with fewer years of smoking (32.9 versus 36.8 years, P < 0.05), with higher education (39.0% versus 25.0%, P < 0.05) and had received pharmacological treatment (91.5% versus 67.9%, P < 0.001). In the multivariate analysis, level of education [odds ratio (OR): 1.995; 95% confidence interval (CI): 1.065–3.735, P < 0.01], group intervention (OR: 1.743; 95% CI: 1.006–3.287, P < 0.05) and drug prescription (OR: 2.368; 95% CI: 1.126–4.980, P < 0.05) were significantly associated with smoking cessation. Conclusions Our study found that multicomponent group and individual interventions in primary care were associated with an overall quit rate of smoking of 36.9% at 12-month follow-up, with higher probability of success among patients with higher education and those who received the group intervention and drug treatment.

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