预防精神病复发和改善精神病患者功能的移动交付计划。

IF 1.3 4区 医学 Q3 PSYCHIATRY Journal of Psychiatric Practice Pub Date : 2024-09-01 DOI:10.1097/PRA.0000000000000807
Erin M Sanzone, Olivia Kam, Kaitlin E Sanzone, Michael Bai, Nicole Rodecker, Mujeeb U Shad, Sajoy P Varghese, Stefano Barlati, Matthias Kirschner, Pavan Kooner, Dawn I Velligan, Rohit Aiyer, Napoleon Waszkiewicz, David J Castle, Ronald L Cowan, Maju Mathew Koola
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引用次数: 0

摘要

所谓 "旋转门病人",是指那些经常因复发而再次入院的病人。造成这种现象的原因很多,包括缺乏医疗和/或社会支持。在对长效注射剂、辅助门诊治疗和远程医疗等各种精神病治疗模式进行回顾的基础上,我们清楚地认识到,对自己的身心健康缺乏洞察力的精神病患者的一个主要潜在问题是不坚持用药。因此,我们提出了一项移动送药计划(MDP),由专业医护人员在精神病患者家中为其提供药物和护理服务。移动送药计划的目标人群是不坚持服药、经常去急诊室就诊和错过预约的患者。精神病患者,尤其是精神分裂症患者,在无家可归者和被监禁者中的比例过高。通过实施 MDP,我们可以帮助打破精神疾病患者和无家可归者的监禁循环。此外,与每年因复发、急诊就诊、住院和犯罪而导致长期滞留在惩教机构所花费的数十亿美元相比,移动医疗团队的交通和工资成本要低得多。这种模式有可能减少复发、改善功能、降低过高的发病率和死亡率。反过来,也可望节省大量的医疗服务费用。
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Mobile Delivery Program to Prevent Relapse and Improve Functioning in Patients With Psychiatric Diseases.

The term "revolving door patients" refers to those who are frequently rehospitalized for relapse. This phenomenon can be explained by a multitude of factors, including a lack of medical and/or social support. On the basis of a review of various modalities of psychiatric treatment, such as long-acting injectables, assisted outpatient treatment, and telehealth, it is clear that a major underlying issue among people with psychiatric diseases who lack insight into their mental and physical health is medication nonadherence. Therefore, we propose a mobile delivery program (MDP) in which health care professionals deliver medications and care to psychiatric patients in their own homes. The target patient population for MDP is patients with medication nonadherence, frequent emergency department visits, and missed appointments. Patients with mental illnesses, especially schizophrenia, are disproportionately represented among the homeless and incarcerated populations. By implementing MDP, we can help break the cycle of incarceration for patients with mental illnesses and homelessness. In addition, the cost of transportation and salaries for the mobile delivery team would be considerably lower than the billions of dollars spent each year due to relapses, emergency department visits, inpatient admissions, and crime leading to long-term stays in correctional facilities. This model has the potential to reduce relapse, improve functioning, and reduce excess morbidity and mortality. Substantial cost savings for health services can, in turn, be expected.

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来源期刊
CiteScore
2.30
自引率
10.50%
发文量
159
审稿时长
>12 weeks
期刊介绍: Journal of Psychiatric Practice® seizes the day with its emphasis on the three Rs — readability, reliability, and relevance. Featuring an eye-catching style, the journal combines clinically applicable reviews, case studies, and articles on treatment advances with practical and informative tips for treating patients. Mental health professionals will want access to this review journal — for sharpening their clinical skills, discovering the best in treatment, and navigating this rapidly changing field. Journal of Psychiatric Practice combines clinically applicable reviews, case studies, and articles on treatment advances with informative "how to" tips for surviving in a managed care environment.
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