scholarly journals Antipsychotic medication adherence and preventive diabetes screening in Medicaid enrollees with serious mental illness: an analysis of real-world administrative data

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Erica L. Stockbridge ◽  
Nathaniel J. Webb ◽  
Eleena Dhakal ◽  
Manasa Garg ◽  
Abiah D. Loethen ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Medication Adherence ◽  
Serious Mental Illness ◽  
Antipsychotic Medication ◽  
Clinical Characteristics ◽  
Care Quality ◽  
System Reform ◽  
Diabetes Screening

Abstract Background There is excess amenable mortality risk and evidence of healthcare quality deficits for persons with serious mental illness (SMI). We sought to identify sociodemographic and clinical characteristics associated with variations in two 2015 Healthcare Effectiveness Data and Information Set (HEDIS) measures, antipsychotic medication adherence and preventive diabetes screening, among Medicaid enrollees with serious mental illness (SMI). Methods We retrospectively analyzed claims data from September 2014 to December 2015 from enrollees in a Medicaid specialty health plan in Florida. All plan enrollees had SMI; analyses included continuously enrolled adults with antipsychotic medication prescriptions and schizophrenia or bipolar disorder. Associations were identified using mixed effects logistic regression models. Results Data for 5502 enrollees were analyzed. Substance use disorders, depression, and having both schizophrenia and bipolar disorder diagnoses were associated with both HEDIS measures but the direction of the associations differed; each was significantly associated with antipsychotic medication non-adherence (a marker of suboptimal care quality) but an increased likelihood of diabetes screening (a marker of quality care). Compared to whites, blacks and Hispanics had a significantly greater risk of medication non-adherence. Increasing age was significantly associated with increasing medication adherence, but the association between age and diabetes screening varied by sex. Other characteristics significantly associated with quality variations according to one or both measures were education (associated with antipsychotic medication adherence), urbanization (relative to urban locales, residing in suburban areas was associated with both adherence and diabetes screening), obesity (associated with both adherence and diabetes screening), language (non-English speakers had a greater likelihood of diabetes screening), and anxiety, asthma, and hypertension (each positively associated with diabetes screening). Conclusions The characteristics associated with variations in the quality of care provided to Medicaid enrollees with SMI as gauged by two HEDIS measures often differed, and at times associations were directionally opposite. The variations in the quality of healthcare received by persons with SMI that were identified in this study can guide quality improvement and delivery system reform efforts; however, given the sociodemographic and clinical characteristics’ differing associations with different measures of care quality, multidimensional approaches are warranted.

Quality of Care for Florida Nursing Home Residents With Serious Mental Illness

2006 ◽  
Author(s):  
Kathy Hyer ◽  
Christopher Johnson ◽  
Victor A. Molinari ◽  
Marion Becker
Keyword(s):  
Mental Illness ◽  
Nursing Home ◽  
Quality Of Care ◽  
Serious Mental Illness ◽  
Nursing Home Residents

Quality of Life, Physical Activity Level and Psychological Profile of Nigerians with Serious Mental Illness and Healthy Psychotropic Naive Subjects (Preprint)

2020 ◽  
Author(s):  
Christian Arinze Okonkwo ◽  
Peter Olarenwaju Ibikunle ◽  
Izuchukwu Nwafor ◽  
Andrew Orovwigho
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Mental Illness ◽  
Serious Mental Illness ◽  
Activity Level ◽  
Psychological Profile ◽  
Cross Sectional Survey ◽  
Significant Difference ◽  
Apparently Healthy

BACKGROUND Quality of life (QoL), physical activity (PA) level and psychological profile (PF) of patients with serious mental illness have been neglected during patient’s management OBJECTIVE The purpose of this study was to determine the effect of selected psychotropic drugs on the QoL, PA level and PF of patients with serious mental illness METHODS A cross sectional survey involving one hundred and twenty-four subject [62 Serious Mental Illness (SMI) and 62 apparently healthy subjects as control] using purposive and consecutive sampling respectively .Questionnaires for each of the constructs were administered to the participants for data collation. Analysis of the data was done using non parametric inferential statistics of Mann-Whitney U independent test and Spearman’s rho correlation with alpha level set as 0.05. RESULTS Significant difference was recorded in the QoL (p<0.05) of patient with SMI and apparently healthy psychotropic naive participants. There was a significant correlation between the QoL (p<0.05) and PF of participants with SMI. Participants with SMI had significantly lower QoL than apparently healthy psychotropic naive subject. QoL of the healthy psychotropic naive group was better than those of the participants with SMI. Female participants with SMI had higher PA than their male counterparts CONCLUSIONS Psychological profiles of male participants with SMI were lower than male healthy psychotropic naive participants. Clinicians should take precaution to monitor the QoL, PA level and PF because the constructs are relevant in evaluation of treatment outcome.

scholarly journals Creating a ‘reverse’ integrated primary and mental healthcare clinic for those with serious mental illness

2015 ◽  
Vol 17 (05) ◽  
pp. 421-427 ◽  
Author(s):  
Alexandros Maragakis ◽  
Ragavan Siddharthan ◽  
Jill RachBeisel ◽  
Cassandra Snipes
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Illness ◽  
Quality Of Care ◽  
Serious Mental Illness ◽  
Mental Healthcare ◽  
Policy Reforms ◽  
Mental Health Settings ◽  
Primary Care Practitioners

Individuals with serious mental illness (SMI) are more likely to experience preventable medical health issues, such as diabetes, hyperlipidemia, obesity, and cardiovascular disease, than the general population. To further compound this issue, these individuals are less likely to seek preventative medical care. These factors result in higher usage of expensive emergency care, lower quality of care, and lower life expectancy. This manuscript presents literature that examines the health disparities this population experiences, and barriers to accessing primary care. Through the identification of these barriers, we recommend that the field of family medicine work in collaboration with the field of mental health to implement ‘reverse’ integrated care (RIC) systems, and provide primary care services in the mental health settings. By embedding primary care practitioners in mental health settings, where individuals with SMI are more likely to present for treatment, this population may receive treatment for somatic care by experts. This not only would improve the quality of care received by patients, but would also remove the burden of managing complex somatic care from providers trained in mental health. The rationale for this RIC system, as well as training and policy reforms, are discussed.

Surgical Adverse Outcomes in Patients with Serious Mental Illnes

2021 ◽  
Vol 1 (4) ◽  
pp. 71-75
Author(s):  
Gerry Armando
Keyword(s):  
Mental Illness ◽  
Quality Of Care ◽  
Serious Mental Illness ◽  
Adverse Outcomes ◽  
Medical Procedure ◽  
Key Factor ◽  
Comorbidity Status

Serious mental illness (SMI) influences 3 % of the populace and incorporates handicapping types of despondency and uneasiness, just as maniacal issues, for example, bipolar and schizophrenia. Patients with schizophrenia were known to have a higher risk of complications during hospitalization. Quality of care has become the key factor in reducing their potential mortality afterwards. Patients with SMI were substantially less liable to have significant medical procedure, in the wake of controlling for age, other segment measures, and illness trouble. For patients of a similar age, sex, race and comorbidity status, having a previous genuine psychological instability passed on a significantly diminished probability of careful mediation. Clinical and careful hospitalizations for people with schizophrenia had in some measure double the chances of a few kinds of unfriendly occasions than those for people without schizophrenia. These antagonistic occasions were related with poor clinical and financial results during the emergency clinic confirmation. Endeavors to decrease these unfriendly occasions should turn into an examination need.

Body dysmorphic disorder

2020 ◽  
pp. 1031-1042
Author(s):  
Megan M. Kelly ◽  
Katharine A. Phillips
Keyword(s):  
Quality Of Life ◽  
Mental Illness ◽  
Suicidal Ideation ◽  
Functional Impairment ◽  
Clinical Characteristics ◽  
Body Dysmorphic Disorder ◽  
Psychosocial Interventions ◽  
Poor Quality ◽  
Clinical Settings

Body dysmorphic disorder (BDD) is a common and unusually severe mental illness, characterized by distressing or impairing preoccupations with non-existent or slight defects in one’s physical appearance, as well as compulsive behaviours, that aim to examine, improve, hide, or obtain reassurance about the perceived defects. BDD is associated with poor quality of life and marked functional impairment, as well as high rates of suicidal ideation and behaviours. Although BDD is often under-recognized in clinical settings, both pharmacotherapy and psychosocial interventions are effective at reducing BDD symptoms and distress. This chapter presents information on the phenomenology, clinical characteristics, diagnosis, epidemiology, pathogenesis, course, and treatment of BDD.

T40PSYCHIATRIC GENETIC COUNSELING: IMPACT ON PSYCHOTROPIC MEDICATION ADHERENCE IN PEOPLE WITH SERIOUS MENTAL ILLNESS

2019 ◽  
Vol 29 ◽  
pp. S237-S238
Author(s):  
Emily Morris ◽  
Rolan Batallones ◽  
Jane Ryan ◽  
Caitlin Slomp ◽  
Prescilla Carrion ◽  
...  
Keyword(s):  
Mental Illness ◽  
Genetic Counseling ◽  
Medication Adherence ◽  
Serious Mental Illness ◽  
Psychotropic Medication

scholarly journals Changes to the Psychiatric Chatbot Landscape: A Systematic Review of Conversational Agents in Serious Mental Illness: Changements du paysage psychiatrique des chatbots: une revue systématique des agents conversationnels dans la maladie mentale sérieuse

2020 ◽  
pp. 070674372096642
Author(s):  
Aditya Nrusimha Vaidyam ◽  
Danny Linggonegoro ◽  
John Torous
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Bipolar Disorder ◽  
Mental Illness ◽  
Serious Mental Illness ◽  
Therapeutic Efficacy ◽  
Digital Tools ◽  
Conversational Agent ◽  
Conversational Agents ◽  
Diagnostic Quality

Objective: The need for digital tools in mental health is clear, with insufficient access to mental health services. Conversational agents, also known as chatbots or voice assistants, are digital tools capable of holding natural language conversations. Since our last review in 2018, many new conversational agents and research have emerged, and we aimed to reassess the conversational agent landscape in this updated systematic review. Methods: A systematic literature search was conducted in January 2020 using the PubMed, Embase, PsychINFO, and Cochrane databases. Studies included were those that involved a conversational agent assessing serious mental illness: major depressive disorder, schizophrenia spectrum disorders, bipolar disorder, or anxiety disorder. Results: Of the 247 references identified from selected databases, 7 studies met inclusion criteria. Overall, there were generally positive experiences with conversational agents in regard to diagnostic quality, therapeutic efficacy, or acceptability. There continues to be, however, a lack of standard measures that allow ease of comparison of studies in this space. There were several populations that lacked representation such as the pediatric population and those with schizophrenia or bipolar disorder. While comparing 2018 to 2020 research offers useful insight into changes and growth, the high degree of heterogeneity between all studies in this space makes direct comparison challenging. Conclusions: This review revealed few but generally positive outcomes regarding conversational agents’ diagnostic quality, therapeutic efficacy, and acceptability, which may augment mental health care. Despite this increase in research activity, there continues to be a lack of standard measures for evaluating conversational agents as well as several neglected populations. We recommend that the standardization of conversational agent studies should include patient adherence and engagement, therapeutic efficacy, and clinician perspectives.

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