RESUMEN
OBJECTIVE: The aim of this study was to test the proposition that adoption of a dose titration protocol may be associated with better patient outcomes, at lower treatment dose, and with comparable cumulative dose to that in patients treated using an age-based stimulus dosing protocol. METHODS: This was an analysis of data assembled from archived records and based on cohorts of patients treated respectively on an age-based stimulus dosing protocol and on a dose titration protocol in the National Health Service in England. RESULTS: We demonstrated a significantly better response in the patient cohort treated with dose titration than with age-based stimulus dosing. Peak doses were less and the total cumulative dose was less in the dose titration group than in the age-based stimulus dosing group. CONCLUSIONS: Our findings are consistent with superior outcomes in patients treated using a dose titration protocol when compared with age-based stimulus dosing in a similar cohort of patients.
Asunto(s)
Envejecimiento , Terapia Electroconvulsiva/métodos , Adulto , Anciano , Estudios de Cohortes , Bases de Datos Factuales , Trastorno Depresivo Resistente al Tratamiento/psicología , Trastorno Depresivo Resistente al Tratamiento/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Estudios Retrospectivos , Convulsiones , Resultado del TratamientoRESUMEN
In England, electroconvulsive therapy (ECT) has been traditionally administered by trainee or consultant psychiatrists with support from nurses. We believe that providing senior nurses, who specialize in ECT, with the appropriate training support to administer ECT will increase the capacity and capability of the team and improve the service for patients.
Asunto(s)
Terapia Electroconvulsiva/normas , Enfermeras y Enfermeros , Terapia Electroconvulsiva/tendencias , Inglaterra , Humanos , Psiquiatría , Encuestas y CuestionariosRESUMEN
The World Health Organization checklist is proven to reduce morbidity and mortality and is mandatory in operating theater settings, but not for electroconvulsive therapy (ECT) in the UK. We believe that such a checklist is especially relevant in an ECT setting because of the high turnover of short cases and for specific checks particularly pertinent to ECT patients. Our ECT team has developed a checklist with the headings Sign In, Psychiatric Concerns, Anesthetic Concerns, and Recovery, which we have found efficacious. We recommend that all centers offering ECT develop their own World Health Organization checklist to improve patient safety.