The Mental Health Clinician最新文献

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Moving beyond first-line treatment options for OCD. 超越强迫症的一线治疗选择。
The Mental Health Clinician Pub Date : 2022-10-01 DOI: 10.9740/mhc.2022.10.300
Chris Paxos
{"title":"Moving beyond first-line treatment options for OCD.","authors":"Chris Paxos","doi":"10.9740/mhc.2022.10.300","DOIUrl":"https://doi.org/10.9740/mhc.2022.10.300","url":null,"abstract":"<p><p>OCD is characterized by obsessions and compulsions that cause distress, are time-consuming, and interfere with a patient's social, occupational, or other areas of functioning. SSRIs are first-line pharmacologic treatment options and produce response rates of up to 60% in patients with OCD. Several potential strategies have been evaluated for enhancing patient response, including high-dose SSRI therapy, antipsychotic augmentation, and memantine augmentation. Three patient cases are used to explore treatment guidelines, evaluate existing literature, and provide pharmacotherapy recommendations for the management of patients with OCD when first-line therapy fails.</p>","PeriodicalId":22710,"journal":{"name":"The Mental Health Clinician","volume":"12 5","pages":"300-308"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b1/bf/i2168-9709-12-5-300.PMC9645290.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9915477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Opioid antagonists to prevent olanzapine-induced weight gain: A systematic review. 阿片类拮抗剂预防奥氮平诱导的体重增加:一项系统综述。
The Mental Health Clinician Pub Date : 2022-08-23 eCollection Date: 2022-08-01 DOI: 10.9740/mhc.2022.08.254
S Andrea Laguado, Stephen R Saklad
{"title":"Opioid antagonists to prevent olanzapine-induced weight gain: A systematic review.","authors":"S Andrea Laguado,&nbsp;Stephen R Saklad","doi":"10.9740/mhc.2022.08.254","DOIUrl":"https://doi.org/10.9740/mhc.2022.08.254","url":null,"abstract":"<p><strong>Introduction: </strong>Olanzapine (OLZ) is a second generation antipsychotic that is approved for the treatment of schizophrenia, bipolar disorder type 1 as monotherapy (acute manic or mixed episodes, maintenance), or as an add-on to lithium or valproate (manic or mixed episodes). It is one of the most effective antipsychotics for the treatment of schizophrenia, but concerns remain due to its significant metabolic adverse effects. Notably, OLZ has one of the highest rates of weight gain among all antipsychotic drugs. Previous studies report on potential mitigation of weight gain with opioid antagonists. A systematic review was conducted to summarize the impact of these agents on weight and BMI when used as adjuncts to OLZ.</p><p><strong>Methods: </strong>A systematic review of randomized controlled trials was conducted with 3 searches between March 2, 2021 and March 27, 2022.</p><p><strong>Results: </strong>Six studies met inclusion criteria, 5 of which assessed OLZ and samidorphan (SAM) and 1 of which assessed OLZ and naltrexone compared with OLZ monotherapy. A total of 1752 patients were included with 952 receiving SAM and 14 receiving naltrexone as an adjunct to OLZ. SAM was shown to mitigate OLZ-induced weight gain by 1.0 kg. Only 1 study assessed naltrexone with no statistically significant results for weight gain.</p><p><strong>Discussion: </strong>SAM is effective at reducing OLZ-induced weight gain. Naltrexone did not reduce OLZ-induced increases in weight or BMI. However, there is a paucity of data on other opioid antagonists as adjuncts to OLZ treatment to prevent increases in weight or BMI.</p>","PeriodicalId":22710,"journal":{"name":"The Mental Health Clinician","volume":"12 4","pages":"254-262"},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4b/d4/i2168-9709-12-4-254.PMC9405627.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33447434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Do buprenorphine doses and ratios matter in medication assisted treatment adherence. 丁丙诺啡的剂量和比例对药物辅助治疗依从性有影响吗?
The Mental Health Clinician Pub Date : 2022-08-23 eCollection Date: 2022-08-01 DOI: 10.9740/mhc.2022.08.241
Kevin Kavanagh, Kimberly Tallian, Joe A Sepulveda, Sarah Rojas, Shedrick Martin, Harminder Sikand
{"title":"Do buprenorphine doses and ratios matter in medication assisted treatment adherence.","authors":"Kevin Kavanagh,&nbsp;Kimberly Tallian,&nbsp;Joe A Sepulveda,&nbsp;Sarah Rojas,&nbsp;Shedrick Martin,&nbsp;Harminder Sikand","doi":"10.9740/mhc.2022.08.241","DOIUrl":"https://doi.org/10.9740/mhc.2022.08.241","url":null,"abstract":"<p><strong>Introduction: </strong>Buprenorphine (BUP), generally prescribed as buprenorphine/naloxone, is a key component of medication-assisted treatment (MAT) to manage opioid use disorder. Studies suggest higher doses of BUP increase treatment adherence. Routine urine drug screens (UDS) assist in monitoring MAT adherence via measurement of excreted BUP and its metabolite, norbuprenorphine (NBP). The clinical significance between BUP/NBP concentrations and their ratios for assessing adherence and substance use is not well-described.</p><p><strong>Methods: </strong>We conducted a single-center, retrospective chart review of 195 clients age ≥18 years enrolled in a local MAT program from August 2017 to February 2021. Demographics, BUP doses, prescription history, and UDS results were collected. Participants were divided based on MAT adherence (<80% vs ≥80%) and median total daily dose (TDD) of BUP (≥16 mg vs <16 mg) in addition to pre- and post-COVID-19 cohorts.</p><p><strong>Results: </strong>Median BUP/NBP urinary concentrations were significantly correlated with MAT adherence (<i>P</i> < .0001 for each) and a reduced percentage of positive UDS for opioids (<i>P</i> = .0004 and <i>P</i> < .0001, respectively) but not their ratios. Median TDD of BUP ≥16 mg (n = 126) vs <16 mg (n = 68) was not correlated with MAT adherence (<i>P</i> = .107) or incidence of nonprescription use (<i>P</i> = .117). A significantly higher incidence of UDS positive for opiates (<i>P</i> = .049) and alcohol (<i>P</i> = .035) was observed post-COVID-19.</p><p><strong>Discussion: </strong>Clients appearing adherent to MAT who had higher concentrations of urinary BUP/NBP demonstrated a reduced incidence of opioid-positive UDS independent of the BUP dose prescribed. An increase in opioid- and alcohol-positive UDSs were observed during the COVID-19 pandemic.</p>","PeriodicalId":22710,"journal":{"name":"The Mental Health Clinician","volume":"12 4","pages":"241-246"},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5a/1c/i2168-9709-12-4-241.PMC9405633.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33447431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Postinjection delirium/sedation syndrome in a transgender man undergoing hormone therapy. 注射后谵妄/镇静综合征变性人接受激素治疗。
The Mental Health Clinician Pub Date : 2022-08-23 eCollection Date: 2022-08-01 DOI: 10.9740/mhc.2022.08.263
Joshua Gerving, Heather Walser, Anne C Kelly
{"title":"Postinjection delirium/sedation syndrome in a transgender man undergoing hormone therapy.","authors":"Joshua Gerving,&nbsp;Heather Walser,&nbsp;Anne C Kelly","doi":"10.9740/mhc.2022.08.263","DOIUrl":"https://doi.org/10.9740/mhc.2022.08.263","url":null,"abstract":"<p><strong>Background: </strong>Long-acting injectable medications have become an important tool in the treatment of schizophrenia and schizoaffective disorder due to the high rates of medication nonadherence. Olanzapine long-acting injection (OLAI) is a useful therapeutic option for patients who have good tolerability and efficacy to oral olanzapine. Postinjection delirium/sedation syndrome (PDSS) is a rare but potentially serious event with the proposed mechanism of inadvertent intravascular injection of OLAI. This concern necessitates the requirement of a 3-hour monitoring period postinjection. Based on a literature review, there are no clearly defined risk factors for developing PDSS.</p><p><strong>Case report: </strong>A case is presented that describes PDSS in a transgender man undergoing hormone therapy with testosterone. The patient received OLAI for more than 3 years and developed PDSS 9 months after the initiation of injectable testosterone.</p><p><strong>Discussion: </strong>There are published case reports of PDSS with the use of OLAI; however, there are no documented cases in a patient undergoing concurrent testosterone therapy. The effect that testosterone has on the vascular system and how it may alter the pharmacokinetics of OLAI has not been studied.</p><p><strong>Conclusion: </strong>Despite proper injection technique, PDSS can occur after injection with OLAI. Further research is necessary to identify specific risk factors for the development of PDSS, including the potential effect that hormone therapy may have.</p>","PeriodicalId":22710,"journal":{"name":"The Mental Health Clinician","volume":"12 4","pages":"263-266"},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c3/b2/i2168-9709-12-4-263.PMC9405634.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33447992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Addition of a clinical pharmacist practitioner to an inpatient addiction triage team and related medication outcomes. 增加临床药剂师执业住院成瘾分诊小组和相关的药物治疗结果。
The Mental Health Clinician Pub Date : 2022-08-23 eCollection Date: 2022-08-01 DOI: 10.9740/mhc.2022.08.219
Kim Ehrhard, Michelle Colvard, Jennifer Brabson
{"title":"Addition of a clinical pharmacist practitioner to an inpatient addiction triage team and related medication outcomes.","authors":"Kim Ehrhard,&nbsp;Michelle Colvard,&nbsp;Jennifer Brabson","doi":"10.9740/mhc.2022.08.219","DOIUrl":"https://doi.org/10.9740/mhc.2022.08.219","url":null,"abstract":"<p><strong>Introduction: </strong>At a Veterans Affairs Medical Center (VAMC), a clinical pharmacist practitioner (CPP) was added to an inpatient addiction triage team in August 2019 to provide education and recommendations regarding medications for alcohol use disorder (MAUD) and opioid use disorder (MOUD). Before the addition of the CPP, missed opportunities for MAUD and MOUD education and prescribing prior to discharge on non-psychiatric units were observed.</p><p><strong>Methods: </strong>This was a single-center, single-site, retrospective, observational cohort study with a primary objective to compare initiation rates of MAUD/MOUD 12 months before and after the addition of the CPP to the addiction triage team. Secondary end points included 90-day medication possession ratio, 1- and 3-month emergency department visit rates, 1- and 3-month hospital readmission rates, and opioid education and naloxone distribution interventions for eligible patients with a diagnosis of opioid use disorder.</p><p><strong>Results: </strong>Both statistically and clinically significant improvements in MAUD/MOUD initiation rates were found in the CPP intervention group compared with the historical control group (26.3% vs 4%, <i>P</i> < .0001). Although secondary end points within this review were not found to be statistically significant, improvements were seen in the CPP intervention group compared with the historical control group related to medication possession ratio, and emergency department and hospital readmission rates.</p><p><strong>Discussion: </strong>This study highlights the potential utility of a CPP to an inpatient addiction triage team to improve MAUD/MOUD prescribing rates in appropriate patients prior to discharge. Overall, the introduction of a CPP to an inpatient addiction triage team was feasible, well received by interprofessional team members, and required limited additional resources.</p>","PeriodicalId":22710,"journal":{"name":"The Mental Health Clinician","volume":"12 4","pages":"219-224"},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c0/ec/i2168-9709-12-4-219.PMC9405629.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33447435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Attitudes and perceptions about the use of long-acting injectable antipsychotics among behavioral health practitioners. 行为健康从业人员对使用长效注射抗精神病药物的态度和看法。
The Mental Health Clinician Pub Date : 2022-08-23 eCollection Date: 2022-08-01 DOI: 10.9740/mhc.2022.08.232
Shaina Schwartz, Christina Carilli, Taimur Mian, Laura Ruekert, Archana Kumar
{"title":"Attitudes and perceptions about the use of long-acting injectable antipsychotics among behavioral health practitioners.","authors":"Shaina Schwartz,&nbsp;Christina Carilli,&nbsp;Taimur Mian,&nbsp;Laura Ruekert,&nbsp;Archana Kumar","doi":"10.9740/mhc.2022.08.232","DOIUrl":"https://doi.org/10.9740/mhc.2022.08.232","url":null,"abstract":"<p><strong>Introduction: </strong>Long-acting injectable antipsychotics (LAI-As) are important tools for the treatment of schizophrenia, yet they appear to be underutilized. This study will assess practitioner perceptions of LAI-As to elucidate reasons for underuse and uncover new avenues to increase appropriate use.</p><p><strong>Methods: </strong>An anonymous electronic survey was developed and actively distributed to behavioral health care practitioners (MD, DO, PA, NP, PharmD, RN, LCSW). Independent <i>t</i> testing and linear regression analysis was used to assess for interactions between survey responses and individual factors.</p><p><strong>Results: </strong>A total of 146 survey responses were collected from September 3, 2020 to March 17, 2021. On average, participants thought that LAI-As were slightly underutilized in practice. The mean estimated patient acceptance rate for LAI-A therapy was 38.6% ± 29.5% (range = 0%-100%). Participants who were <40 years of age and those with a psychiatric pharmacist at their practice site had significantly higher estimated acceptance rates. The highest-rated barriers to LAI-A use were related to negative patient attitudes, lack of patient education, and access issues (eg, transportation, cost). Respondent characteristics including age, gender identity, geographic location, practice setting, and the presence of a psychiatric pharmacist significantly influenced the perceived impact of these barriers.</p><p><strong>Discussion: </strong>Behavioral health practitioners generally believed that LAI-As were underused, and only one-third of their patients would be accepting of the therapy. Several barriers were perceived as frequently impacting LAI-A use, but these were reduced by the presence of a psychiatric pharmacist. Understanding practitioner perceptions can assist with increasing the use of LAI-As.</p>","PeriodicalId":22710,"journal":{"name":"The Mental Health Clinician","volume":"12 4","pages":"232-240"},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d1/41/i2168-9709-12-4-232.PMC9405628.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33447437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Perceptions and barriers of adverse drug reaction reporting within inpatient state psychiatric facilities. 州立精神病院住院病人对药物不良反应报告的看法和障碍。
The Mental Health Clinician Pub Date : 2022-08-23 eCollection Date: 2022-08-01 DOI: 10.9740/mhc.2022.08.247
Carolyn O'Donnell, Tammie Lee Demler, Charisse Dzierba
{"title":"Perceptions and barriers of adverse drug reaction reporting within inpatient state psychiatric facilities.","authors":"Carolyn O'Donnell, Tammie Lee Demler, Charisse Dzierba","doi":"10.9740/mhc.2022.08.247","DOIUrl":"10.9740/mhc.2022.08.247","url":null,"abstract":"<p><strong>Introduction: </strong>Adverse drug reactions (ADRs) are a leading cause of morbidity and mortality for hospitalized patients. Health care organizations track ADRs to reduce patient mortality, reduce hospital readmissions, decrease costs, and improve patient care. Differing definitions of ADRs cause confusion among providers, leading to hesitation with ADR reporting. The objective of this study was to understand health care professionals' perspectives of ADR reporting within inpatient state psychiatric facilities.</p><p><strong>Methods: </strong>A survey was sent to 143 health care professionals throughout 25 inpatient state psychiatric facilities within 1 state. The survey assessed the definition of an ADR, confidence in reporting, barriers to reporting, the role of reporting, who should report and review ADRs, and strategies for process improvement.</p><p><strong>Results: </strong>The survey had a 75.5% response rate with 108 respondents. Most respondents could identify the definition of an ADR, were moderately confident in reporting ADRs, and understood the importance of ADR reporting. Barriers to ADR reporting included the reaction not being serious, a lack of information about the ADR, or not enough clarity on how to report an ADR. Fear of retaliation was an additional barrier to ADR reporting. Training and direction on ADR reporting, education on real versus perceived consequences, a designated point person to aid in reporting, and better access to reporting technology were suggested improvements for ADR reporting.</p><p><strong>Discussion: </strong>From this survey, it is evident that respondents believe improved education and training, improved communication regarding reporting consequences, and consensus on the definition of an ADR would encourage reporting.</p>","PeriodicalId":22710,"journal":{"name":"The Mental Health Clinician","volume":"12 4","pages":"247-253"},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/96/53/i2168-9709-12-4-247.PMC9405632.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33447433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prazosin dosed 3 times a day to treat flashbacks related to PTSD: A case report. 每天服用三次哌唑嗪治疗与PTSD相关的闪回:一例报告。
The Mental Health Clinician Pub Date : 2022-08-23 eCollection Date: 2022-08-01 DOI: 10.9740/mhc.2022.08.267
Christie Richardson, Alexander Swartz, Martin Forsberg
{"title":"Prazosin dosed 3 times a day to treat flashbacks related to PTSD: A case report.","authors":"Christie Richardson,&nbsp;Alexander Swartz,&nbsp;Martin Forsberg","doi":"10.9740/mhc.2022.08.267","DOIUrl":"https://doi.org/10.9740/mhc.2022.08.267","url":null,"abstract":"<p><p>Prazosin is an alpha-1 adrenergic receptor antagonist widely known by mental health providers for its off-label use for nightmares in patients with PTSD. Prazosin is lipophilic and crosses the blood-brain barrier to antagonize alpha-1 receptors in the central nervous system, potentially reducing autonomic arousal caused by PTSD. There have been numerous case reports describing the reduction of nightmares and daytime flashbacks due to PTSD with prazosin dosed at night and during the day, respectively. This case report illustrates the resolution of flashbacks related to chronic PTSD with prazosin dosed 3 times a day. As the half-life of prazosin is only 2 to 3 hours, even a twice daily dosing regimen may lead to breakthrough symptoms between doses. This case proposes a unique dosing strategy for prazosin and need for further research utilizing multiple daily doses of prazosin in the treatment of PTSD.</p>","PeriodicalId":22710,"journal":{"name":"The Mental Health Clinician","volume":"12 4","pages":"267-269"},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/23/52/i2168-9709-12-4-267.PMC9405631.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33447436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
An innovative approach to teaching depression and anxiety medication management: Virtual choose your own adventure, psychiatry edition. 一个创新的方法来教学抑郁和焦虑药物管理:虚拟选择你自己的冒险,精神病学版。
The Mental Health Clinician Pub Date : 2022-08-23 eCollection Date: 2022-08-01 DOI: 10.9740/mhc.2022.08.225
Nina Vadiei, Jeannie K Lee
{"title":"An innovative approach to teaching depression and anxiety medication management: Virtual choose your own adventure, psychiatry edition.","authors":"Nina Vadiei,&nbsp;Jeannie K Lee","doi":"10.9740/mhc.2022.08.225","DOIUrl":"https://doi.org/10.9740/mhc.2022.08.225","url":null,"abstract":"<p><strong>Introduction: </strong>Rates of depression and anxiety continue to increase in the United States. It's important for pharmacy students to graduate knowledgeable and confident in treating these disorders. The purpose of this study was to evaluate whether a virtual active-learning exercise (choose your own adventure) is helpful in teaching students how to manage medications for depression and anxiety.</p><p><strong>Methods: </strong>Third-year pharmacy students responded to preactivity questions and then worked on a single patient case in which the presenting problem is worsening depression and anxiety. Students worked in virtual groups of 4 to 5 to select 1 treatment among 5 multiple-choice options and documented the rationale for their choice. Each multiple-choice option led to a different follow-up case. After writing their assessment and plan, the instructor debriefed on therapeutic concepts from each follow-up case. Students then answered postactivity questions and participated in a voluntary survey consisting of 10 retrospective questions.</p><p><strong>Results: </strong>Of 106 participants, 85 completed the survey (80.2% response rate). Most agreed that their understanding of treatment of depression and anxiety disorders increased following participation (92.9% <i>strongly</i>/<i>somewhat agreed</i>). This was supported by an increase in the percentage of correct responses on the knowledge questions (preactivity: 67.2%, n = 91; postactivity: 83.5%, n = 97; <i>P</i> = .01). Additionally, students reported their confidence in their understanding of depression and anxiety management increased following activity participation (93.0% <i>strongly</i>/<i>somewhat agreed</i>).</p><p><strong>Discussion: </strong>The virtual active-learning exercise improved student knowledge and confidence in managing depression and anxiety treatments. Educators teaching depression and anxiety pharmacotherapy may consider implementing such activity into their lecture(s).</p>","PeriodicalId":22710,"journal":{"name":"The Mental Health Clinician","volume":"12 4","pages":"225-231"},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fe/cc/i2168-9709-12-4-225.PMC9405630.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33447432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessment of hepatitis C monitoring adherence after viral eradication in veterans with substance use to improve care and surveil reinfection. 使用药物改善护理和监测再次感染的退伍军人在病毒根除后丙型肝炎监测依从性的评估。
The Mental Health Clinician Pub Date : 2022-06-10 eCollection Date: 2022-06-01 DOI: 10.9740/mhc.2022.06.181
Miranda L Stratton, Elayne D Ansara, Amanda P Ifeachor, Kelly K Houck, Suthat Liangpunsakul, Katie J Binger
{"title":"Assessment of hepatitis C monitoring adherence after viral eradication in veterans with substance use to improve care and surveil reinfection.","authors":"Miranda L Stratton,&nbsp;Elayne D Ansara,&nbsp;Amanda P Ifeachor,&nbsp;Kelly K Houck,&nbsp;Suthat Liangpunsakul,&nbsp;Katie J Binger","doi":"10.9740/mhc.2022.06.181","DOIUrl":"https://doi.org/10.9740/mhc.2022.06.181","url":null,"abstract":"<p><strong>Introduction: </strong>Hepatitis C virus (HCV) incidence rates are rising for patients with substance use and/or SUDs. Guidelines provide monitoring recommendations to ensure remission after successful treatment. The study's objective was to identify gaps in follow-up for patients with documented substance use and/or SUD through assessment of adherence to guideline-recommended HCV RNA lab 12 months post-treatment.</p><p><strong>Methods: </strong>Patients treated for HCV through the Veteran Health Indiana Hepatitis C Pharmacy Clinic were retrospectively evaluated. Subjects were categorized based on the provider assigned for follow-up care after 12-week sustained virologic response (SVR12) labs (primary care provider [PCP] or HCV provider). The primary outcome was HCV RNA obtained 11 to 13 months post-treatment. Secondary outcomes were HCV RNA detected post-treatment, substance use, engagement in substance use treatment, and engagement with social work.</p><p><strong>Results: </strong>Two hundred forty-one patients were included in the HCV provider cohort and 139 in the PCP cohort. Forty-one patients did not have a specified clinic for follow-up treatment, and 20 patients did not achieve SVR12. Sixty-one patients (28%) in the HCV provider cohort completed a 12-month HCV RNA within 11 to 13 months post-treatment vs 15 patients (11%) in the PCP cohort (<i>P</i> ≤ .01). One patient had HCV RNA detected post-treatment.</p><p><strong>Discussion: </strong>This study reveals inadequate HCV post-treatment follow-up for patients with substance use and/or SUD. SUD is a chronic disease that requires continued monitoring to prevent complications. Further studies are needed to identify reinfection rates and improvements of care in this population.</p>","PeriodicalId":22710,"journal":{"name":"The Mental Health Clinician","volume":"12 3","pages":"181-186"},"PeriodicalIF":0.0,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/98/3e/i2168-9709-12-3-181.PMC9190266.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40572083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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