RESUMO
The authors examined the feasibility and impact of a therapist-driven outreach program on depression outcomes in a primary care clinic. Patients with a diagnosis of depression but missing a 1-year follow-up Patient Health Questionnaire-9 (PHQ-9) screening were rescreened via telephone. Eligible patients (N=241) were contacted, and implementation rates and outcomes, along with feasibility, were assessed. Of the patients contacted, 47% indicated a depression response (reduction in PHQ-9 score of ≥50%), and 33% met remission criteria (PHQ-9 score <5). PHQ-9 scores decreased by approximately 7 points (p<0.001). This project may have helped to improve depression symptoms and remission rates for patients of the clinic and to facilitate patient reengagement with treatment.
RESUMO
A quality improvement project was delivered by a federally qualified health center to improve patient access to psychiatric services. The effort was supported by training and technical assistance provided by the American Psychiatric Association Support and Alignment Network. Over a 3-year period, the collaborative care model (CoCM) and other integrated consultative strategies were implemented. As a result, the waitlist was reduced from 350 patients to 1 patient. The use of the CoCM and other integrated care strategies was successful in eliminating a psychiatric service waitlist in this primary care setting.
Assuntos
Centros Comunitários de Saúde/organização & administração , Acessibilidade aos Serviços de Saúde , Atenção Primária à Saúde/organização & administração , Psiquiatria/organização & administração , Listas de Espera , Humanos , Modelos Organizacionais , Melhoria de Qualidade/organização & administração , Estados UnidosAssuntos
Transtorno Bipolar/induzido quimicamente , Hipnóticos e Sedativos/efeitos adversos , Transtornos Psicóticos/complicações , Piridinas/efeitos adversos , Adulto , Humanos , Hipnóticos e Sedativos/uso terapêutico , Masculino , Transtornos Psicóticos/psicologia , Piridinas/uso terapêutico , Distúrbios do Início e da Manutenção do Sono/tratamento farmacológico , ZolpidemAssuntos
Antipsicóticos/administração & dosagem , Antipsicóticos/efeitos adversos , Cloridrato de Lurasidona/administração & dosagem , Cloridrato de Lurasidona/efeitos adversos , Refeições , Náusea/prevenção & controle , Adulto , Transtorno Bipolar/tratamento farmacológico , Ingestão de Alimentos , Feminino , Humanos , Náusea/induzido quimicamenteRESUMO
Initiatives to develop better-tolerated, more efficacious pharmacological agents with improved drug delivery systems have driven recent research in attention-deficit hyperactivity disorder (ADHD). While stimulants are the primary pharmacotherapy for ADHD, these drugs have a limited duration of action and a subset of patients will either fail to respond to these medications or have side effects that preclude their use. The development of atomoxetine, the first nonstimulant approved for ADHD, has been followed by additional innovative research, such as the methylphenidate transdermal system, modafinil, NRP-104 and cholinergic agents. This review highlights some of the recent trends in ADHD treatment and the current status of promising treatment options that may help to shape the future of ADHD treatment.