Usage of clozapine and the new neuroleptics

1999 ◽  
Vol 23 (8) ◽  
pp. 478-480
Author(s):  
M. F. Bristow
Keyword(s):  
General Practitioner ◽  
General Practitioners ◽  
Atypical Antipsychotic ◽  
Response Rate ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
England And Wales

Aims and methodTo explore clozapine and atypical antipsychotic usage in England and Wales, particularly availability, restrictions on use and shifting of prescribing to general practitioners. To examine the hypothesis that respondents in acute trusts would encounter more restrictions. Method used – postal questionnaire sent to general psychiatrists derived from the 1996 Medical Directory.ResultsThere was an 80% response rate and over 90% of respondents used clozapine, with only 9% reporting any difficulty in obtaining it. Difficulty was not associated with any particular type of trust. Only about 4% of respondents suggested that general practitioners regularly took over the prescribing costs of the drug.Clinical implicationsOptimistic, with widespread usage and few difficulties in obtaining clozapine. General practitioner prescribing is still very low and needs to increase.

scholarly journals Drug services in England and Wales: a survey of treatment providers and their medical leads

2006 ◽  
Vol 30 (4) ◽  
pp. 140-142
Author(s):  
Nick Airey ◽  
Stuart McLaren
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Social Services ◽  
General Practitioners ◽  
Questionnaire Survey ◽  
Drug Action ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
England And Wales ◽  
Treatment Providers

Aims and MethodWe undertook a postal questionnaire survey of drug action teams in England and Wales with the aim of clarifying the nature of statutory specialist drug services.ResultsOf 159 drug action teams, 110 (69%) responded; 64 (58%) reported that mental health trusts exclusively provided their specialist drug services. Other providers were primary care and acute trusts, the non-statutory sector and social services. The majority of medical leads were psychiatrists (123 senior posts with 20% vacant/occupied by a locum), then general practitioners (GPs) (42) and other specialists (4).Clinical ImplicationsSpecialist drug services are offered by a range of treatment providers, with the medical lead being taken by GPs and other specialists in some areas. In view of the current difficulty in recruiting psychiatrists, we propose that alternative training pathways are considered for addiction specialists.

scholarly journals Cognitive therapy training for psychiatrists: impact on individual clinical practice

2004 ◽  
Vol 28 (4) ◽  
pp. 117-119 ◽  
Author(s):  
G. Swift ◽  
I. Durkin ◽  
C. Beuster
Keyword(s):  
Clinical Practice ◽  
Cognitive Therapy ◽  
Response Rate ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
Previous Survey ◽  
Therapy Training ◽  
Training And Supervision ◽  
Improved Outcomes ◽  
Therapy Sessions

Aims and MethodWe aimed to survey how psychiatrists with in-depth training in cognitive therapy use these skills. A postal questionnaire based on a previous survey was sent to all psychiatrists who are accredited members of the British Association for Behavioural and Cognitive Psychotherapies.ResultsThere was a 94% response rate. Psychiatrists in non-psychotherapy posts used formal cognitive therapy, with an average of 20% of new patients compared with 65% for those in psychotherapy posts, and were less satisfied with the extent to which they were able to use their skills (20%v. 80%). A total of 85% of respondents described themselves as being involved in teaching, training and supervision of cognitive therapy.Clinical ImplicationsUnless psychiatrists are planning on working in specialised psychotherapy posts, they are unlikely to use cognitive therapy training in formal therapy sessions. Further research is needed to determine whether cognitive therapy training for psychiatrists translates into improved outcomes for patients.

scholarly journals Attitudes of psychiatrists to evidence-based guidelines

2002 ◽  
Vol 26 (11) ◽  
pp. 421-424 ◽  
Author(s):  
Harvey Rees ◽  
Attila Sipos ◽  
Matthew Spence ◽  
Glynn Harrison
Keyword(s):  
Response Rate ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
Evidence Based ◽  
Previous Survey ◽  
Health Partnership ◽  
Improved Outcomes ◽  
Actual Use ◽  
Evidence Based Guidelines ◽  
Improving Patient Care

Aims and MethodWe aimed to survey clinicians' attitudes on using evidence-based guidelines. A postal questionnaire based on a previous survey of general practitioners was sent to 105 psychiatrists working within Avon and Western Wiltshire Mental Health Partnership NHS Trust.ResultsThere was a 91% response rate. Respondents were generally in favour of clinical guidelines, with scores indicating a positive attitude to guidelines in 13 of the 18 statements. The majority felt that guidelines were effective in improving patient care, could be used flexibly to suit individual patients and did not impinge on their clinical judgement.Clinical ImplicationsPsychiatrists welcomed the increasing use of guidelines. Further research is needed to determine whether this will translate into actual use and improved outcomes for patients.

scholarly journals Medical records: Doctors' and patients' experiences of copying letters to patients

2004 ◽  
Vol 28 (2) ◽  
pp. 40-42 ◽  
Author(s):  
Harpal Nandhra ◽  
Graham Murray ◽  
Nigel Hymas ◽  
Neil Hunt
Keyword(s):  
General Practitioner ◽  
Pilot Study ◽  
General Practitioners ◽  
Medical Records ◽  
Letter Writing ◽  
Initial Assessment ◽  
Clinical Implications ◽  
Usual Practice ◽  
To Receive ◽  
Writing Practice

Aims and MethodWe conducted a pilot study to determine patients' views on receiving a copy of the assessment letter sent to their general practitioner and to determine how psychiatrists' letter writing practice would be altered in the knowledge that patients would receive copies of such letters. Seventy-six consecutive new outpatients received copies of the initial assessment letter sent to general practitioners. Patients were asked to complete a short questionnaire on how the practice affected them. For each letter, psychiatrists were asked to provide details of anything of importance that had been omitted from the letter that in their normal practice they would have included.ResultsThere was a broad range of responses on how patients felt about the letters. Only two patients found the letters unhelpful, and 83% expressed a positive desire to continue receiving letters, even though initially 18% found the letter distressing. For 56 out of 76 patients, psychiatrists stated that they composed and sent out the letter to the GP in accordance with their usual practice and copied the letter to the patient in an unaltered form. For 17 patients, the psychiatrist stated that some information he/she would usually have included in the GP letter was omitted in the copy the patient received. In a further 3 cases, the psychiatrist sent no letter to the patient.Clinical ImplicationsPatients found it helpful to receive copies of their assessment letters. Psychiatrists might require training and reassurance about this policy before implementation.

scholarly journals Psychotherapy training experience in an inner-city psychiatry rotation

2003 ◽  
Vol 27 (5) ◽  
pp. 179-182
Author(s):  
Maria Podlejska-Eyres ◽  
Julian Stern
Keyword(s):  
Inner City ◽  
Response Rate ◽  
Psychotherapy Training ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
Basic Training ◽  
Specialist Training ◽  
Training Experience ◽  
Training Scheme ◽  
Royal London Hospital

Aims and MethodA postal questionnaire was circulated to all psychiatrists who had completed their basic specialist training on the Royal London Hospital training scheme within the last 7.5 years. The aim of the questionnaire was to explore their psychotherapy experience while on the rotation.ResultsThe response rate was 95%. The respondents had a broad experience of both didactic and case work that they valued highly. Over half of them wished for an even greater exposure to psychotherapy during their basic training.Clinical ImplicationsThe results of our survey suggest that with the dedication of both the trainees and trainers, it is possible to have a comprehensive psychotherapy experience while working on a busy inner-city rotation.

General Practitioners' Knowledge and Use of a Disabled Living Centre

1996 ◽  
Vol 59 (2) ◽  
pp. 79-83
Author(s):  
Anna V Phillips
Keyword(s):  
Monitoring System ◽  
General Practitioners ◽  
Telephone Interview ◽  
Response Rate ◽  
Postal Questionnaire ◽  
Professional Group ◽  
Second Stage ◽  
Set Up ◽  
Two Stages ◽  
To Receive

In March 1994, 141 Aberdeen general practitioners (GPs) were surveyed to clarify why Hillylands Disabled Living Centre (DLC) appeared to receive few direct referrals from this professional group. This was carried out in two stages. The first consisted of a postal questionnaire which received a 77% response rate. This identified that 90% of the 108 respondents knew of Hillylands' existence but only 24% were fully aware of the services it offered. Forty-six per cent had advised someone to visit Hillylands DLC, although only 17% of GPs had visited the centre themselves. The second stage, a telephone interview of 46 volunteer GPs, indicated that some GPs recognised a need to increase their awareness. Some felt that it was not appropriate that they visit Hillylands DLC, although those who had done so had found their visit useful. Recommendations are made to extend the mailing list at Hillylands and to set up a monitoring system to ensure regular liaison and supply of publicity material. It is also suggested that the feasibility of developing a comprehensive publicity initiative be investigated.

scholarly journals The role of the educational supervisor

2000 ◽  
Vol 24 (6) ◽  
pp. 216-218 ◽  
Author(s):  
Edward Day ◽  
Nick Brown
Keyword(s):  
Response Rate ◽  
Educational Development ◽  
Postal Questionnaire ◽  
Clinical Implications ◽  
The West ◽  
Educational Plan ◽  
West Midlands ◽  
Educational Supervision ◽  
Educational Supervisor

Aims and MethodsA postal questionnaire of all pre-membership psychiatric trainees in the West Midlands was used to investigate the role of the educational supervisor. The trainees were asked about their experience of educational supervision, and also asked to rank a number of possible roles for their supervisor in order of importance.ResultsA response rate of 70% was achieved. Trainees rated regular appraisal and assessment of skills and deficits as the most important role of the educational supervisor, but had only experienced this in 55% of their training posts thus far. Less than half of the respondents had developed a written educational plan with their educational supervisors, and trainees rated this the least important task of good educational supervision.Clinical ImplicationsThe results of this survey inform the training agenda for trainers, and emphasise the need to equip consultants with the skills to appraise their trainee's educational development.

scholarly journals Survey of clozapine use by consultant old age psychiatrists

2006 ◽  
Vol 30 (11) ◽  
pp. 410-412 ◽  
Author(s):  
Raghupathy Paranthaman ◽  
Robert C. Baldwin
Keyword(s):  
Elderly Patients ◽  
Old Age ◽  
Random Sample ◽  
Older Patients ◽  
Response Rate ◽  
Postal Questionnaire ◽  
Published Data ◽  
Clinical Implications ◽  
Old Age Psychiatry

Aims and MethodThe aim of the survey was to assess the attitudes of specialists in old age psychiatry towards the use of clozapine in elderly patients. A postal questionnaire was sent to a random sample of 155 consultant old age psychiatrists in England.ResultsThe response rate was 87%. A majority of respondents felt that clozapine had a useful place in the treatment of elderly patients, although they expressed concerns about the lack of published data and about safety and practical difficulties in monitoring. Prescribers of clozapine (n=45) were significantly more positive about its role in treating older patients than those who had not used it.Clinical ImplicationsThe findings suggest that familiarity with and confidence in clozapine and practical difficulties in monitoring are important determinants of its use in older patients.

Consultant Orthodontic Services for Cleft Patients in England and Wales

1996 ◽  
Vol 23 (2) ◽  
pp. 165-171 ◽  
Author(s):  
A. C. Williams ◽  
J. R. Sandy ◽  
W. C. Shaw ◽  
H. B. Devlin
Keyword(s):  
Questionnaire Survey ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Response Rate ◽  
Postal Questionnaire ◽  
National Audit ◽  
Regional Data ◽  
Data Bases ◽  
England And Wales ◽  
Record Keeping

A postal questionnaire survey of consultant orthodontists in England and Wales was undertaken as part of a national audit of the care of children horn with cleft lip/and or cleft palate. A 100% response rate was achieved. The majority of respondents stated that they provide orthodontic treatment for cleft patients hut only 78% of these attend multi-disciplinary cleft clinics. Consultant orthodontists provide treatment not only in the form of appliances for patients born with clefts hut are also involved in the counseling of parents and coordination of regional data bases. Only 24% of hospital orthodontists are involved in the provision of presurgical appliances for cleft babies on a regular basis. The lack of rationalisation of orthodontic services and a low uptake of standardised record keeping protocols for cleft patients by consultant orthodontists gives cause for concern.

scholarly journals Psychiatric out-patient clinics for older adults: highly regarded by users and carers, but irreplaceable?

2009 ◽  
Vol 33 (4) ◽  
pp. 127-129 ◽  
Author(s):  
Rashi Negi ◽  
Jeremy Seymour ◽  
Christopher Flemons ◽  
Matthew Impey ◽  
Nicola Thomas ◽  
...  
Keyword(s):  
Older Adults ◽  
General Practitioner ◽  
Response Rate ◽  
Clinical Implications ◽  
Older Users ◽  
At Home

Aims and MethodThe aim of this study was to explore older users' and carers' views of attending out-patient clinics for older adults. A questionnaire was designed to be distributed to all patients attending out-patient clinics for a period of 1 month in January 2007.ResultsThe response rate for returning the completed questionnaire was 71%, and 95% of these respondents were satisfied with their overall experience of attending out-patient clinics. Although satisfaction levels were high with every aspect of out-patient clinics, 49% preferred the hypothetical option of being seen at home.Clinical ImplicationsThe role of psychiatric out-patient departments for older adults merits further research, comparing cost and user/carer acceptability with home or general practitioner surgery-based treatment.

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