RESUMO
OBJECTIVE: This study examined whether outpatients with a psychotic disorder who are at risk of hospitalization can be identified by using data from electronic medical records (EMRs). METHODS: Data from EMRs of outpatients enrolled in two clinics for treatment of psychotic disorders were abstracted. Monthly data were collected for 75 patients over two years. The study examined the association of medication nonadherence, substance use, participation in psychiatric rehabilitation, and long-acting injectable antipsychotic use in any given month with the risk of hospitalization in the subsequent month by using generalized estimating equations. RESULTS: The only variable found to increase the relative risk of future hospitalization was recorded medication nonadherence (adjusted relative risk=7.19, p<.001). CONCLUSIONS: Results suggest that recording medication nonadherence in EMRs is feasible and that these data may be used to identify patients at high risk of future hospitalization, who may require more intensive intervention.
Assuntos
Antipsicóticos/uso terapêutico , Registros Eletrônicos de Saúde/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Adesão à Medicação/estatística & dados numéricos , Transtornos Psicóticos/terapia , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Psicóticos/tratamento farmacológico , Risco , Adulto JovemRESUMO
The use of seclusion and restraints (SR) in acute hospital settings remains a controversial practice. Despite the focus on SR in the psychiatric services literature, data on SR use in pediatric day hospital settings is lacking. A case-control retrospective analysis for children admitted into a pediatric psychiatry day hospital in a 2-year span examined predictors of SR use. Demographic and clinical descriptors were examined in relation to SR events using univariate and multivariate regression models. Significant univariate risk factors for SR use were psychiatric morbidity, history of physical abuse, post-traumatic stress disorder, having any anxiety disorder, and younger age. Knowledge of risk factors for SR use in pediatric psychiatric day hospitals can avert use of SR and lead to improved safety in a trauma-informed care model.
