RISK FACTORS FOR REHOSPITALIZATION OF PATIENTS WITH MENTAL DISORDERS A CASE CONTROL STUDY Margaret Eliphy Nkangala, Bsc Health Science Education, Malawi.

Slides:



Advertisements
Similar presentations
TRI science addiction Lost Opportunity? SBI for Substance Abuse In ERs and Trauma Centers Academy Health Mady Chalk, Ph.D. Treatment Research Institute.
Advertisements

A comparison of the profiles of people discharged from Russell Clinic in the periods from October 2002 to October 2004, October 2004 to October 2006 and.
National Confidential Inquiry into Suicide and Homicide by People with Mental Illness Homicide data for Scotland ( ) © National Confidential Inquiry.
A Pilot Study of Satisfaction and Adherence with Antipsychotic Medication Amongst Prisoners Dr Alice Mills Mr Dan Bressington Dr Richard Gray Professor.
Forensic Mental Health Services at Zomba Prison & ZMH Harry Kawiya & Owen Mwale.
Factors Associated with Living Setting of Patients at Discharge from Inpatient Rehabilitation after Acquired Brain Injury in Ontario Vincy Chan, Amy Chen,
Aftercare Attendance Partially Moderated by History of Physical Abuse and Gender Louise F. Haynes 1 ; Amy E. Herrin 1 ; Rickey E. Carter 1 ; Sudie E. Back.
Standards of Electroconvulsive Therapy (ECT) Services at Zomba Mental Hospital (ZMH) Michael M. M. Udedi.
Health service utilization by patients with common mental disorder identified by the Self Reporting Questionnaire in a primary care setting in Zomba, Malawi.
Rapid Access to Psychiatric Care Creating a “Safety Net” for High Risk Patients while decreasing Emergency Department Visits and Inpatient Admissions Oakville.
Impact of the Community Mental Health System Sthrengthening Project in Aceh, Indonesia ( ) Hervita Diatri, Harry Minas.
 More than 2 million men and women have been deployed to Afghanistan and Iraq for Operations Enduring Freedom/Iraqi Freedom (OEF/OIF).  ~21% of men and.
Prevalence of current substance misuse in psychiatric in-patients: Results of a survey in a University Teaching Hospital, Ireland. Brief report: Dr Ajay.
Dr. Elaine Dunnea, Dr. Maura Dugganb, Dr. Julie O’Mahonyc
1 Lauren E. Finn, 2 Seth Sheffler-Collins, MPH, 2 Marcelo Fernandez-Viña, MPH, 2 Claire Newbern, PhD, 1 Dr. Alison Evans, ScD., 1 Drexel University School.
Michelle Denton Manager: Forensic MHS Southern and Central Qld PhD Candidate Uni of Qld Andrew Hockey Project Officer “Back on Track”: Transition from.
Impact of Side Effects of Antipsychotics on Attitude and Adherence to Treatment among Adult Psychiatric Outpatients at Mathari Hospital in Kenya Defense.
® Introduction Mental Health Predictors of Pain and Function in Patients with Chronic Low Back Pain Olivia D. Lara, K. Ashok Kumar MD FRCS Sandra Burge,
Youth Empowerment Services (YES) A Medicaid Waiver Program for Children with Severe Emotional Disturbances Clinical Eligibility Determination Texas Department.
報 告 者 王瓊琦. postpartum depression : identification of women at risk.
Factors that Associated with Stress in Nursing Faculty in Thailand
Psychotropic medication use and obesity among IDD service recipients in 15 states AAIDD 2012, 6/19/2012.
In Crisis: Clinical Solutions for the Revolving Door Mary Ruiz MBA, CEO Melissa Larkin Skinner LMHC, CCO Florida's Premier Behavioral Health Annual Conference.
Priority Groups for Choose Life Overview. Children (especially looked after children): Deaths of children aged 0-14: < 5 per year (GROS) Highest in males.
GP Perspectives on the Home Based Crisis Team. City North Sectors, Cork. Muller Neff, D., O’Brien S.M. ABSTRACT: OBJECTIVES: The introduction of crisis.
It’s Possible to prevent social exclusion among mentally ill?: IPSE Project, " Clinical Case Management " in Schizophrenic Patients in two catchment areas.
Characteristics of Patients Using Extreme Opioid Dosages in the Treatment of Chronic Low Back Pain In this sample of 204 participants, 70% were female,
Socioeconomic Status and Health Care Outcomes Jianhui Hu, Ph.D., Research Associate Center for Health Policy & Health Services Research Henry Ford Health.
Slide 1 Crisis in the Mental Health Care Workforce Are Advanced Practice Nurses Part of the Solution? Nancy P. Hanrahan, PhD, RN, CS Assistant Professor.
Specific Aim 1: Determine the impact of psychiatric disorders on the hospital length of stay (LOS) in pediatric patients diagnosed with SCD admitted for.
The Organization of Mental Health Services in Ulss – 9 Treviso.
Recovery Support Services and Client Outcomes: What do the Data Tell Us? Recovery Community Services Program Grantee Meeting December 14, 2007.
Sex Differences in Profiles and Outcomes of Patients with Traumatic Brain Injury in a National Rehabilitation Sample Dr. Angela Colantonio PhD, OT Reg.
LENGTH OF FIRST HOSPITALIZATION AND OTHER PREDICTORS FOR RE-HOSPITALIZATION IN PSYCHOSES Jouko Miettunen, PhD Department of Psychiatry University of Oulu,
Louis Appleby Professor of Psychiatry University of Manchester Chair, National Suicide Prevention Advisory Group Department of Health.
+ Terrell Preventable Readmission Project Jeylan Buyukdura & Natalie Davies.
Introduction Introduction Alcohol Abuse Characteristics Results and Conclusions Results and Conclusions Analyses comparing primary substance of abuse indicated.
Introduction Results and Conclusions Categorical group comparisons revealed no differences on demographic or social variables. At admission to treatment,
Introduction Results and Conclusions On demographic variables, analyses revealed that ATR clients were more likely to be Hispanic and employed, whereas.
Predictors of non-compliance in primary care of patients with chronic disease Roger Zoorob, MD, MPH, FAAFP; Mohamad Sidani, MD, MS; Medhat Kalliny, MD,
Relational Discord at Conclusion of Treatment Predicts Future Substance Use for Partnered Patients Wayne H. Denton, MD, PhD; Paul A. Nakonezny, PhD; Bryon.
WANDSWORTH ASSERTIVE OUTREACH & RECOVERY TEAM Dr Gunam Kanagaratnam, Associate Specialist & Dave Ramkhelawon Team Manager.
1 The Effect of Primary Health Care Orientation on Chronic Illness Care Management Julie Schmittdiel, Ph.D., Stephen M. Shortell, Ph.D., Thomas Rundall,
Introduction Results and Conclusions On counselor background variables, no differences were found between the MH and SA COSPD specialists on race/ethnicity,
A joint Australian, State and Territory Government Initiative Experiences and lessons from benchmarking Older Persons Mental Health Services Dr Rod McKay.
1 Is the ACT model effective in a contemporary Danish psychiatric setting? Preliminary Results from a Danish Multi-centre Trial of Assertive Community.
Jack Stanley, Dr Daniel Mogford, Dr Rebecca Lawrence and Prof
Medical and Emergency Medical Use by People Experiencing Homelessness before and after Placement in Supportive Housing James Petrovich, PhD, LMSW TCU Department.
Smoking and Mental Health Problems in Treatment-Seeking University Students Eric Heiligenstein, M.D. University of Wisconsin-Madison Health Services Stevens.
© National Confidential Inquiry into Suicide and Homicide by People with Mental Illness. All rights reserved. Not to be reproduced in whole or in part.
Ready (or not) to graduate: Mental and physical health characteristics associated with completing public housing-based, substance abuse treatment in Key.
“SEVERE MENTAL ILLNESS & CONGESTIVE HEART FAILURE OUTCOMES AMONG VETERANS” by Jim Banta UCLA Committee members: Alexander Young, Gerald Kominksi, William.
The authors would like to acknowledge the families at the Children’s Hospital of Wisconsin Jane P. Pettit Pain and Palliative Care Center. For more information,
Printed by A Follow-Up Study of Patterns of Service Use and Cost of Care for Discharged State Hospital Clients in Community-Based.
Introduction Results and Conclusions Numerous demographic variables were found to be associated with treatment completion. Completers were more likely.
March 2004 HIGH COST MEDICAID PATIENTS An Analysis of New York City Medicaid High Cost Patients Robert F. Wagner Graduate School of Public Service Center.
1 JANE MARLOW SERVICE MANAGER CITY ADULT MENTAL HEALTH SERVICE COMMUNITY AND RESIDENTAL SERVICES.
Community Treatment Orders use in Assertive Outreach Dr Mohammed Al-Uzri Consultant Psychiatrist & Honorary Professor (University of Leicester)
Medication Adherence and Substance Abuse Predict 18-Month Recidivism among Mental Health Jail Diversion Program Clients Elizabeth N. Burris 1, Evan M.
Persons with Serious Mental Illness Michael B. Blank, PhD Center for Mental Health Policy and Services Research University of Pennsylvania HIV Screening.
A comprehensive evaluation of post- mortem findings and psychiatric case records of individuals who died by probable suicide. A van Laar, J Kielty, M Davoren,
Background The occurrence of bedside teaching rounds has declined over the decades, with various barriers. One barrier sited is patient discomfort with.
Clare Meernik, MPH 1 ; Anna McCullough, MSW, MSPH, CTTS 1 ; Leah Ranney, PhD 1 ; Barbara Walsh 2 ; Adam O. Goldstein, MD, MPH 1 Predictors of Quit for.
Introduction  Schizophrenia ↓ Neuro-developmental Disorder ↕ Pathogenesis in gestation and early childhood ↕ Further research is needed.
Ready to Use, Basic Psychopharmacology Didactic Curriculum 2014 Behavioral Sciences in Family Medicine Conference Yvonne Murphy, MD Associate Program Director.
REINHARD HEUN PROFESSOR OF PSYCHIATRY RADBOURNE UNIT RDH DERBYSHIRE HEALTHCARE FT KEGWORTH, 1 APRIL 2014 What works well in the treatment of psychosis.
Mental and Behavioral Health Services
CRISIS RESOLUTION / HOME TREATMENT - DEFINITION
Community Care Teams Carl Schiessl, Director, Regulatory Advocacy
Developing an Effective Assisted Outpatient Treatment Program
Presentation transcript:

RISK FACTORS FOR REHOSPITALIZATION OF PATIENTS WITH MENTAL DISORDERS A CASE CONTROL STUDY Margaret Eliphy Nkangala, Bsc Health Science Education, Malawi College of Health Sciences, Dr Robert Start and Dr Felix Kauye 10/31/2015 1

INTRODUCTION  Studies from other parts of the world indicate that severe mental disorders can be treated and the affected individuals can lead a normal life again [WHO 2008].  However, Zomba Mental Hospital, Malawi, is experiencing a lot of rehospitalization some of which take place in less than a year after discharge. 2

Aim of study To find out the factors that lead to rehospitalization of patients at the mental hospital in Malawi. To assist policy makers to utilize the findings to come up with measures to minimize relapses and hence improve community integration of patients discharged from the psychiatric hospital. 10/31/2015 3

Specific Objectives To compare persons who have been readmitted within one year of discharge and those who have not been readmitted on a number of variables including: ▫ demographic characteristics ▫ illness characteristics ▫ family support ▫ substance abuse ▫ compliance to medication 10/31/2015 4

Method The study used an unmatched case control design Cases were: Current inpatient in ZMH Having a severe mental disorder Readmitted in less than a year after last discharge Controls were: Currently attending outpatient clinic at ZMH Previously admitted with a severe mental disorder Discharged at least 1 year before recruitment to the study. 10/31/2015 5

Data collection Data was collected by the researcher through the use of a structured questionnaire. This took place in the month of July 2011 for a period of 4 weeks. 10/31/2015 6

7 DEMOGRAPHICS VariableCases (n=75)Controls(n=71) Subjects N=146NpercentageN p- valu e Males Employed * Married * Primary or no education * Residence: Rural * MeanSD Mea n SD Age

DIAGNOSIS (CASENOTE) 46 (61.3%) of the cases and 41 (57.7%) of the controls were diagnosed as schizophrenia. The next common condition was Mania/bipolar disorder. There were 14 (18.7%) cases with this diagnosis and 12 (16.9%) controls The third diagnosis was drug-induced psychosis. Eight of the cases (10.7%) and 14.1% of the controls were diagnosed as having this condition No significant differences between cases/controls 10/31/2015 8

ILLNESS CHARACTERISTICS Mean admission number for the cases was 3.84(SD 1.748) while the controls had a mean admission number of 2.46 (SD1.43). Independent 2 tailed T-test p-value of < % 0f the cases and 25% of the controls had been violent (p value of 0.005). 74.7% of the cases and 94.4% of the controls believed that they had a mental disorder (p value of 0.001). 10/31/2015 9

FAMILY SUPPORT 10/31/

SUBSTANCE MISUSE 10/31/

MEDICATION COMPLIANCE 53% of the cases and 83.1% of the controls were compliant with medication following discharge (p value of 0.005) 10/31/

Multivariate Analysis (logistic regression) The factors significantly associated with being a case vs. control were: primary or no education living in rural area having a history of violence to others Lack of insight non compliant with medication after discharge not receiving financial and practical support from family not getting help with medication 10/31/

DISCUSSION From the findings we conclude that the nature of the illness is associated with rehospitalization due to: ▫having a history of violence to others ▫not believing that has a mental illness We did not find an association with marijuana misuse (but this was self-report) Those who are not rehospitalized are getting less support from the family: ▫receiving financial support from family ▫getting help with medication. 10/31/

DISCUSSION Several modifiable factors are associated with rehospitalization of patients: ▫not receiving practical support from family not compliant with medication after discharge residing in rural areas These could be improved by improving community outreach services particularly in rural areas. Home visiting to include psychoeducation, support with medication compliance, and rehabilitation 10/31/

Limitations of the study  We depended on cases to give information which may not be reliable.  The study only looked at cases and controls from Zomba which may not be representative for Malawi 10/31/

Recommendations for practice and future research  For future research involve other districts and health centers.  A prospective cohort study can also be done to recruit patients on discharge and follow them up. 10/31/

Acknowledgements Dr Robert Stewart Dr Felix Kauye Professor Linda Kalilani The executive Director MCHS Colleagues Students 10/31/

ct 10/31/