scholarly journals You have to acknowledge the problem before you can address the problem: Audit looking at identification of co-existing substance misuse in a Liaison Psychiatry patient population

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S91-S91
Author(s):  
Emma McLean ◽  
Akash Kadiwar ◽  
Mariam Alexander
Keyword(s):  
Substance Use ◽  
Substance Misuse ◽  
Training Session ◽  
Care Pathways ◽  
Liaison Psychiatry ◽  
Nice Guidelines ◽  
Nice Guideline ◽  
Retrospective Audit ◽  
Objective Evidence ◽  
Drug And Alcohol

AimsTo evaluate if patients referred to Ealing Liaison Psychiatry Service (ELPS) with co-existing substance use are being appropriately identified as per NICE guidelines.Patients with co-existing substance misuse have greater morbidity and mortality and it is therefore important to identify these patients to optimise their management. NICE recommends that all patients are asked about their substance use.Anecdotally, our team felt we were doing a good job of identifying and managing such patients but we had no objective evidence of this.MethodCompleted a retrospective audit looking at a sample of patients referred to ELPS over two weeks in December 2019.A training session for ELPS was then held to highlight the initial audit results and NICE guideline recommendations.We then repeated the audit over two weeks in March 2020.ResultInitial audit (100 patients):Only 69% of patients asked about substance use. From those asked, 50-65.2% were using a substance, most commonly alcohol.None of the patients over the age of 80 were asked about substance use vs 79.5% of patients aged 20–40 years.55% of females vs 81% of males were asked about illicit substances.33.3% of ward referrals vs 74.2% of Emergency Department referrals asked about substance useRe-audit (53 patients):Significant improvement across all areas93% now asked about substance use60% of over 80s, 96% of females and 85% of ward referrals were now being correctly asked about substance useConclusionWe were surprised to find that we were initially not meeting NICE standards regarding asking patients about their substance use.Acknowledging this problem during our training session proved to be effective.This knowledge will help us develop our care pathways with our Acute colleagues and the Drug and Alcohol Liaison Service.

Community participation and mental health prior to treatment

2017 ◽  
Vol 10 (2) ◽  
pp. 57-70 ◽  
Author(s):  
Breanna McGaffin ◽  
Frank P. Deane ◽  
Peter J. Kelly
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Community Participation ◽  
Social Connectedness ◽  
Substance Misuse ◽  
Salvation Army ◽  
Social Emotional ◽  
Content Type ◽  
Population Norms ◽  
Drug And Alcohol

Purpose The purpose of this paper is to investigate Keyes’ (2007) model of mental health, the presence (flourishing) or absence (languishing) of social, emotional and psychological wellbeing, in the context of drug and alcohol misuse and the frequency and pattern of community participation (engaging in society). Design/methodology/approach Participants were 1,815 individuals (70 per cent male) who entered residential substance misuse treatment provided by The Salvation Army. Questionnaires were completed at intake assessments with The Salvation Army staff. The data were compared with population norms of community participation utilising t-tests, while multiple linear regression was used to examine continuous mental health. Findings Although participants have lower levels of community participation compared to Australian population norms, those participants who were experiencing flourishing mental health had higher rates of community participation than Australian norms. Keeping in touch with friends and family was the most common form of participation. Informal social connectedness and civic engagement were the strongest predictors of mental health over and above more traditional substance use outcomes such as cravings. Originality/value This is one of the first studies to describe the relationships between community participation, substance use and mental health in participants seeking treatment for substance misuse. Despite having a drug or alcohol addiction requiring treatment, those participants with flourishing mental health have higher levels of community participation than community norms. Furthermore, community participation predicts mental health. This offers promise for interventions that increase community participation but further research using longitudinal designs is needed to replicate and clarify the direction of these relationships.

scholarly journals Use of electronic health records in identifying drug and alcohol misuse among psychiatric in-patients

2013 ◽  
Vol 37 (1) ◽  
pp. 15-20 ◽  
Author(s):  
James Bell ◽  
Cise Kilic ◽  
Reena Prabakaran ◽  
Yuan Yuan Wang ◽  
Robin Wilson ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Substance Misuse ◽  
Health Staff ◽  
Mental Health Staff ◽  
Interactive Search ◽  
Progress Notes ◽  
Clinical Records ◽  
Drug And Alcohol ◽  
Acute Admissions

Aims and methodTo assess the usefulness of the electronic patient record, we used the search engine Clinical Record Interactive Search (CRIS) to scan all acute admissions during 2008 for possible substance use disorders. In addition, screening interviews were undertaken with 75 in-patients, and documentation in their files was compared with results of screening interviews.ResultsOf 839 acute admissions during 2008, 47% of males and 29% of females had reference to a substance misuse problem in their file. Documentation was unsystematic and inconsistent and mostly occurred in progress notes rather than in structured questionnaires. Screening interviews and manual review of files of 75 current in-patients confirmed that substance use disorders were common, but poorly documented.Clinical implicationsThe study highlights the power of search engines in scanning electronic clinical records, but also identified the limitations of unsystematic documentation in research and practice. Mental health staff were reluctant to diagnose or rate severity of substance misuse problems.

Application of the Non-adoption, Abandonment, Scale-up, Spread and, Sustainability (NASSS) Framework to evaluate the role of technology in the Pathways to Comorbidity Care (PCC) implementation project to improve management of comorbid substance use and mental disorders

2020 ◽  
Author(s):  
MariaGabriela Uribe Guajardo ◽  
Andrew James Baillie ◽  
Eva Louie ◽  
Vicki Giannopoulos ◽  
Katie Wood ◽  
...  
Keyword(s):  
Substance Use ◽  
Clinical Supervision ◽  
Mental Health Problems ◽  
Scale Up ◽  
Structured Interview ◽  
Barriers And Facilitators ◽  
Self Report ◽  
Evidence Based ◽  
Face To Face ◽  
Drug And Alcohol

Abstract (250 words)In substance use treatment settings, there is a high prevalence of comorbid mental health problems. Yet an integrated approach for managing comorbidity, implementation of evidence-based intervention in drug and alcohol settings remains problematic. Technology can help the adoption of evidence-based practice and successfully implement effective treatment health care pathways. This study sought to examine aspects of electronic resources utilisation (barriers and facilitators) by clinicians participating in the PCC training. MethodA self-report questionnaire and a semi-structured interview was designed to measure overall satisfaction with the PCC portal and e-resources available throughout the 9-month intervention for participating clinicians. An adapted version of the ‘Non-adoption, Abandonment, Scale-up, Spread and, Sustainability’ (NASSS) framework was used to facilitate discussion in regards to the study findings. ResultsA total of 20 clinicians from drug and alcohol services responded to all the measures. Facilitators of portal use included: i. clinician acceptance of the PCC portal; ii. guidance from the clinical supervisor or clinical champion that encouraged the use of e-resources. Some of the barriers included: i. complexity of the illness (condition), ii. clinicians’ preference (adopter system) for face-to-face resources and training modes (e.g. clinical supervision, clinical champion workshops), and iii. lack of face-to-face training on how to use the portal (technology and organisation).ConclusionBased on the NASSS framework, we were able to identify several barriers and facilitators including such as the complexity of the illness, lack of face-to-face training and clinician preference for training mediums. Recommendations include ongoing consultation of clinicians to assist in the development of tailored e-health resources and offering in-house training on how to operate and effectively utilise these resources.

Young Males Attending a Family-Planning Clinic: Some Ideas about Consequences of Child Abuse

1999 ◽  
Vol 85 (2) ◽  
pp. 529-532
Author(s):  
PEggy B. Smith ◽  
Maxine L. Weinman ◽  
Ruth S. Buzi
Keyword(s):  
Smoking Cessation ◽  
Child Abuse ◽  
Family Planning ◽  
Behavioral Problems ◽  
Substance Misuse ◽  
Alcohol Misuse ◽  
Family Planning Clinic ◽  
Young Males ◽  
Medical Needs ◽  
Drug And Alcohol

33 young males attending a family-planning clinic were asked about the consequences of child abuse as it affects behavioral problems of teens and their interest in programs that deal specifically with these problems. Nine reported they had been victims of abuse. Most believed that drug and alcohol misuse and suicide were the major consequences of child abuse. Fifteen were interested in programs for prevention of child abuse but not for specific problems such as substance misuse and smoking cessation. This study's findings suggest that family-planning clinics with services for males must address their behavioral as well as medical needs.

Epidemiological Associations of Asthma and Tobacco Use, Substance Use, and Substance Misuse among Adults in the United States

2022 ◽  
pp. 1-17
Author(s):  
Abdullah M. M. Alanazi ◽  
Mohammed M. Alqahtani ◽  
Maher M. Alquaimi ◽  
Tareq F. Alotaibi ◽  
Saleh S. Algarni ◽  
...  
Keyword(s):  
United States ◽  
Substance Use ◽  
Tobacco Use ◽  
Substance Misuse ◽  
The United States

scholarly journals Making Choices and Reducing Risk (MCARR): School Counseling Primary Prevention of Substance Use

2021 ◽  
Vol 11 (3) ◽  
pp. 352-369
Author(s):  
Louisa L. Foss-Kelly ◽  
Margaret M. Generali ◽  
Michael J. Crowley
Keyword(s):  
Substance Use ◽  
Alcohol Use ◽  
Student Attitudes ◽  
School Community ◽  
Longitudinal Impact ◽  
Addictive Behaviors ◽  
Making Choices ◽  
Drug And Alcohol Use ◽  
The Impact ◽  
Drug And Alcohol

The consequences of adolescent drug and alcohol use may be serious and far-reaching, forecasting problematic use or addictive behaviors into adulthood. School counselors are particularly well suited to understand the needs of the school community and to seamlessly deliver sustainable substance use prevention. This pilot study with 46 ninth-grade students investigates the impact of the Making Choices and Reducing Risk (MCARR) program, a drug and alcohol use prevention program for the school setting. The MCARR curriculum addresses general knowledge of substances and their related risks, methods for evaluating risk, and skills for avoiding or coping with drug and alcohol use. Using a motivational interviewing framework, MCARR empowers students to choose freely how they wish to behave in relation to drugs and alcohol and to contribute to the health of others in the school community. The authors hypothesized that the implementation of the MCARR curriculum would influence student attitudes, knowledge, and use of substances. Results suggest that the MCARR had a beneficial impact on student attitudes and knowledge. Further, no appreciable increases in substance use during the program were observed. Initial results point to the promise of program feasibility and further research with larger samples including assessment of longitudinal impact.

scholarly journals Improving the assessment of risk of violence: a clinical audit of case note documentation

2001 ◽  
Vol 25 (7) ◽  
pp. 250-252 ◽  
Author(s):  
Michael Campbell ◽  
Robert Chaplin
Keyword(s):  
Risk Assessment ◽  
Clinical Audit ◽  
Training Session ◽  
Clinical Implications ◽  
Community Mental Health Team ◽  
Mental Health Team ◽  
Health Team ◽  
Retrospective Audit ◽  
Changes In Risk ◽  
Made In

Aims and MethodsTo improve the rate of documentation of risk in new referrals to a community mental health team. A retrospective audit of 46 case notes was followed by a training session on risk of violence. The following 50 case notes were studied for changes in risk assessment.ResultsPrior to the study there were very low rates of documentation of risk of violence. Significant improvements were made in 45% of the items in the history and mental state although not in the formulation of a risk assessment statement.Clinical ImplicationsIt is possible to improve the risk of violence documentation with no extra time, resources or paperwork and with true multi-disciplinary involvement.

scholarly journals The NICE OECD countries’ geographic search filters: Part 2—validation of the MEDLINE and Embase (Ovid) filters

2021 ◽  
Vol 109 (4) ◽  
Author(s):  
Lynda Ayiku ◽  
Thomas Hudson ◽  
Ceri Williams ◽  
Paul Levay ◽  
Catherine Jacob
Keyword(s):  
Gold Standard ◽  
Oecd Country ◽  
Oecd Countries ◽  
Workplace Health ◽  
Nice Guidelines ◽  
Nice Guideline ◽  
Abortion Care ◽  
Flu Vaccination ◽  
Search Filters ◽  
Standard Sets

Objective: We previously developed draft MEDLINE and Embase (Ovid) geographic search filters for Organisation for Economic Co-operation and Development (OECD) countries to assess their feasibility for finding evidence about the countries. Here, we describe the validation of these search filters.Methods: We identified OECD country references from thirty National Institute for Health and Care Excellence (NICE) guidelines to generate gold standard sets for MEDLINE (n=2,065) and Embase (n=2,023). We validated the filters by calculating their recall against these sets. We then applied the filters to existing search strategies for three OECD-focused NICE guideline reviews (NG103 on flu vaccination, NG140 on abortion care, and NG146 on workplace health) to calculate the filters’ impact on the number needed to read (NNR) of the searches.Results: The filters both achieved 99.95% recall against the gold standard sets. Both filters achieved 100% recall for the three NICE guideline reviews. The MEDLINE filter reduced NNR from 256 to 232 for the NG103 review, from 38 to 27 for the NG140 review, and from 631 to 591 for the NG146 review. The Embase filter reduced NNR from 373 to 341 for the NG103 review, from 101 to 76 for the NG140 review, and from 989 to 925 for the NG146 review.Conclusion: The NICE OECD countries’ search filters are the first validated filters for the countries. They can save time for research topics about OECD countries by finding the majority of evidence about OECD countries while reducing search result volumes in comparison to no filter use.

scholarly journals Medication Adherence among Mentally Ill Patients with comorbid- Substance Use Disorder

KYAMC Journal ◽  
2017 ◽  
Vol 6 (2) ◽  
pp. 602-609
Author(s):  
Nasim Jahan ◽  
Mohammad Muntasir Maruf ◽  
Md Faruk Hossain ◽  
Md Waziul Alam Chowdhury ◽  
Anwara Begum
Keyword(s):  
Substance Use ◽  
Medication Adherence ◽  
Mentally Ill ◽  
Substance Misuse ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Psychiatric Medication ◽  
Cross Sectional ◽  
Care Givers

Substance misuse is usually associated with poorer psychiatric medication adherence among mentally ill patients. Identifying proportion & predictors of medication adherence among patients with dual psychiatric and substance misuse problems is important because poor adherence is associated with relapse and re-hospitalization. This study was a descriptive cross sectional study conducted among the patients dually diagnosed with psychiatric and substance use disorders attending OPD in a tertiary care hospital of Dhaka city, during the period from May 2013 to November 2013. The main objective of the study was to explore the proportion of psychotropic medication adherence among the respondents who were on such medication for at least last 6 months (N=151). Respondents were selected purposefully. An informed consent was taken from the patients or care givers and data were collected using the questionnaire designed by the researcher based on Factors Influencing Neuroleptic Medication Taking Scale (FNIMTS). Diagnoses were done previously according to DSM-IV TR by psychiatrist appointed in inpatient and outpatient department. Questionnaire was filled up by the researcher by interviewing the patients and attending care givers as needed. Over half of the respondents (57.0%) admitted they had missed taking their medications on more than one occasion in the week prior to the interview. Thus this study found the proportion of medication adherence to be 43% among the respondents.KYAMC Journal Vol. 6, No.-2, Jan 2016, Page 602-609

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