Patient experience with telehealth service in a mental health setting.

The purpose of the quality improvement project is to explore the patient experience of telehealth services in a mental health setting during the COVID-19 pandemic. A cross-sectional survey design was deployed in an outpatient psychiatric setting. Forty-five participants completed the survey, and the smartphone was the most frequently used and preferred device for their telehealth service. Participants exhibited a high level of usability for telehealth services (Mean = 5.82, SD = 1.21). Telehealth can be a way to solve the problem of not having enough mental health services available, even though there are potential barriers such as digital literacy and human engagement.

Buprenorphine Program Evaluation in a Private Psychiatric Office-Based Practice.

PURPOSE: The opioid crisis has contributed to the mortality, morbidity, and rising healthcare costs in the United States. Buprenorphine (BUP) is an effective medication for opioid use disorder. The aims of this quality assurance evaluation of a BUP program were to (a) evaluate the clinic's performance in illicit opioid abstinence and (b) identify patient risk and resilience characteristics to improve patient success in recovery with BUP. METHODS: A retrospective chart review of open (n = 35) and closed (n = 21) cases and a cross-sectional survey in open cases were completed. Adults (aged ≥18 years) who completed 6 months of BUP treatment at a psychiatric clinic were included. Clinical performance was measured with percentages of opioid-negative urine and completed monthly urine drug tests (UDTs) for the first 6 months. Open cases were surveyed regarding risk and resilience characteristics (frequency of opioid cravings and triggers, therapy participation, and coping skills). Descriptive statistics, t test, and chi-square test were used to analyze data. RESULTS: Average opioid-negative urine was significantly higher in open cases than closed cases (88.57% vs. 74.82%; t = 2.885, p = .004). There was no significant association between open cases (61.4%) and closed cases (73.8%) in completed monthly UDT. Opening and closing of cases stabilized with mandatory monthly UDT. Most individuals reported therapy participation, minimal opioid cravings, and use of distraction to cope with chronic-pain-induced cravings. CONCLUSIONS/IMPLICATIONS: This clinic met benchmarks leading to improved substance recovery. Recommendations include regular evaluations of UDT, cravings, and chronic pain; therapy participation; and continuous quality assurance activities.

A Buprenorphine Program Evaluation Before and During the COVID-19 Pandemic.

This project evaluated the service delivery (ie, attendance rate) of a buprenorphine management treatment program and compared patient recovery-related information between service methods. This was a medical record review and cross-sectional comparison of pre-COVID-19 vs post onset of COVID-19 data. In the sample of 28 adults, mean attendance rates did not differ significantly before (99.46%) vs during the pandemic (96.13%; t = 1.92, P = .07). Patient participation in therapy before and during the pandemic did differ significantly (χ2 = 1.98, P = .03). The use of telemental health services within a BMT program may be a viable option when normal in-person services are disrupted.

Examining patient outcomes of receiving long-acting injectable antipsychotics.

PURPOSE: The purpose of this project was to evaluate a long-acting injectable (LAI) antipsychotics program regarding the quality of care and outcomes of individuals with schizophrenia. DESIGN AND METHODS: Observational design with retrospective chart review and survey was utilized in an outpatient clinic. FINDINGS: Individuals on LAIs receive the quality of care by exhibiting favorable knowledge about LAIs, positive attitude toward medications, and satisfaction with care. They take higher dosages of medications than those who take oral antipsychotics and report decreases in hospitalizations/emergency room visits after LAIs. PRACTICE IMPLICATIONS: Reducing reservations about LAIs may provide awareness of the positive effects of treatment leading to viable management options and patient satisfaction.

Learned lessons from patients who take clozapine: A case study.

PURPOSE: The purpose of this report is to provide clinical strategies to manage patients with schizophrenia taking clozapine. CONCLUSIONS: Serious side effects and required blood monitoring impede the use of clozapine, despite the benefits of clozapine for managing psychiatric symptoms. Well-managed patients receiving evidence-based interventions exhibit reduced symptoms, improved functioning, and better adherence to treatment. PRACTICE IMPLICATIONS: Preexisting medical conditions should be considered before prescribing clozapine. Ongoing education on medication and mental illness for patients and family members is essential to prepare them for adherence to management plans. Healthcare providers are responsible for monitoring the side effects of clozapine.