The Psychiatric quarterly最新文献_第8页

Structured Evaluation of Rehabilitation Programs Outcomes in Psychiatry: Application of a Recovery-Centered Model. 精神病学康复项目结果的结构化评估:以康复为中心模型的应用。

IF 3.5

The Psychiatric quarterly Pub Date : 2021-12-01 Epub Date: 2021-05-25 DOI: 10.1007/s11126-021-09884-0

Simone Vanzetto, Matteo Zabotto, Federica Fasciana, Alberto Varinelli, Giovanna Cirnigliaro, Luca Ferrara, Bernardo Dell'Osso, Caterina Viganò

{"title":"Structured Evaluation of Rehabilitation Programs Outcomes in Psychiatry: Application of a Recovery-Centered Model.","authors":"Simone Vanzetto, Matteo Zabotto, Federica Fasciana, Alberto Varinelli, Giovanna Cirnigliaro, Luca Ferrara, Bernardo Dell'Osso, Caterina Viganò","doi":"10.1007/s11126-021-09884-0","DOIUrl":"https://doi.org/10.1007/s11126-021-09884-0","url":null,"abstract":"Rehabilitation is oriented to psychiatric patients' recovery through specific techniques and structured projects, not yet fully standardized, carried out in territorial services. This study aims to apply an operational structured outcome indicator model (hospitalizations, continuity of care, LAI treatment adherence, working support) through a recovery-centered model in a rehabilitation community in Milan. This observational-retrospective study included 111 patients from a University High Assistance Rehabilitation Community (C.R.A.) based in Milan. Psychopathological and psychosocial functioning was evaluated with Kennedy Axis V, Brief Psychiatric Rating Scale (BPRS), Life Skills Profile (LSP), AR module of the VADO scale. Statistical analyses were performed using SPSS software version 19. Student t test and Wilcoxon Test were used to analyze quantitative variables, while McNemar test for qualitative variables. The minimum level of significance was set at 0.05 (p <0.05). The results showed that CRA rehabilitation program led to significant improvement in global functioning in terms of hospitalization reduction; improved continuity of care; stable adherence to psychopharmacological treatment with Long Acting Injectable (LAI) antipsychotics; stable employment maintenance during the year following discharge from the CRA. This study confirmed the utility of a structured outcome indicator model and highlighted its feasibility in daily clinical context of a rehabilitative community. Our results supported the effectiveness of a community-based rehabilitation program to improve individual functioning and clinical stability. However, further studies are required to better achieve the development of a recovery-oriented rehabilitation model and rigorously define an outcomes evaluation model.","PeriodicalId":520814,"journal":{"name":"The Psychiatric quarterly","volume":" ","pages":"1513-1530"},"PeriodicalIF":3.5,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11126-021-09884-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39030242","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

Utilization of Electroconvulsive Therapy for Older Homeless Adults Covered by Medicare. 医疗保险覆盖的无家可归的老年人电休克疗法的应用。

IF 3.5

The Psychiatric quarterly Pub Date : 2021-12-01 Epub Date: 2021-09-01 DOI: 10.1007/s11126-021-09946-3

Samuel T Wilkinson, Taeho Greg Rhee, Jack Tsai

{"title":"Utilization of Electroconvulsive Therapy for Older Homeless Adults Covered by Medicare.","authors":"Samuel T Wilkinson, Taeho Greg Rhee, Jack Tsai","doi":"10.1007/s11126-021-09946-3","DOIUrl":"https://doi.org/10.1007/s11126-021-09946-3","url":null,"abstract":"This study sought to examine the association between homelessness and receipt of electroconvulsive therapy (ECT) among older Medicare beneficiaries with homelessness. Among individuals with major depressive disorder who were older (age 65+) Medicare beneficiaries (2014-2015 data), we compared clinical and sociodemographic characteristics among those who were homeless and received ECT, those who were not homeless and received ECT, those who were homeless and did not receive ECT, and those who were domiciled and did not receive ECT. The unadjusted rate of ECT use among older homeless individuals with depression (1.46%) was higher than the rate of ECT use among older non-homeless individuals with depression (0.41%). Among all individuals receiving ECT, homeless individuals started as inpatients at a greater rate (94.0% v. 72.6%) and transitioned to outpatient ECT at a lower rate (23.8% v. 44.5%) compared to their domiciled counterparts. The individuals in the ECT/homeless group had more psychiatric comorbidities compared to all other groups. After adjusting for significant covariates, homelessness was associated with a lower odds ratio (0.74, 95% CI 0.55-0.99) of receiving ECT. Our data suggest that ECT can be provided to homeless individuals at rates comparable to domiciled individuals. The psychosocial support typically required for an ECT course may prove difficult for homeless patients in the outpatient setting, which may be an area for further development.","PeriodicalId":520814,"journal":{"name":"The Psychiatric quarterly","volume":" ","pages":"1825-1837"},"PeriodicalIF":3.5,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39373834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

The Power of Perception: Lived Experiences with Diagnostic Labeling in Mental Health Recovery without Ongoing Medication Use. 感知的力量:在没有持续药物使用的情况下，心理健康恢复中诊断标签的生活经验。

IF 3.5

The Psychiatric quarterly Pub Date : 2021-09-01 Epub Date: 2020-11-25 DOI: 10.1007/s11126-020-09866-8

Ray Eads, Mo Yee Lee, Chang Liu, Nancy Yates

{"title":"The Power of Perception: Lived Experiences with Diagnostic Labeling in Mental Health Recovery without Ongoing Medication Use.","authors":"Ray Eads, Mo Yee Lee, Chang Liu, Nancy Yates","doi":"10.1007/s11126-020-09866-8","DOIUrl":"https://doi.org/10.1007/s11126-020-09866-8","url":null,"abstract":"The recovery movement in mental health emphasizes holistic and individualized treatment through many pathways to recovery, though the majority of mental health treatment and existing literature emphasize pharmacotherapy and medication adherence for major mental health conditions. The reimbursement system and research literature are oriented around formal diagnostic categories based in a biomedical perspective of mental health problems, but diagnostic labels also carry stigma and influence how clients perceive themselves and their mental health problems. To investigate the influence of labeling and perception in alternate pathways to recovery, this qualitative study explores the lived experience of diagnostic labeling and self-perception among persons in sustained recovery without ongoing medication use. The study used a grounded theory approach to analyze data from in-depth interviews with 19 participants. Participants had previously received diagnoses of schizophrenia, bipolar disorder, and/or major depression, met criteria for functional recovery, and were no longer taking psychotropic medications for 12 months. The participants identified positive perceptions-externalization of the problem and hope for an external \"cure\"-and negative perceptions-stigma and powerlessness-following a diagnostic label. Notably, the theme of powerlessness related to the initially positive themes as the diagnosis placed the problem outside their control and some participants experienced treatments as unhelpful. Participants succeeded in overcoming powerlessness by finding internalized solutions and redefining their mental health experience as transformative. Rather than pressing clients to accept their diagnosis or \"illness,\" mental health providers can support multiple pathways to recovery by emphasizing empowerment and personal meaning-making in the recovery process.","PeriodicalId":520814,"journal":{"name":"The Psychiatric quarterly","volume":" ","pages":"889-904"},"PeriodicalIF":3.5,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11126-020-09866-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38640934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Association of Adverse Family Experiences with School Engagement and Performance in US Adolescents: Do Behavioral Health Conditions Mediate the Relationship? 不良家庭经历与美国青少年学业投入和表现的关系:行为健康状况是否起到中介作用?

IF 3.5

The Psychiatric quarterly Pub Date : 2021-09-01 Epub Date: 2021-03-03 DOI: 10.1007/s11126-021-09900-3

Adekemi O Suleiman, Damion J Grasso, Amy A Hunter, Robert A Rosenheck, Taeho Greg Rhee

{"title":"Association of Adverse Family Experiences with School Engagement and Performance in US Adolescents: Do Behavioral Health Conditions Mediate the Relationship?","authors":"Adekemi O Suleiman, Damion J Grasso, Amy A Hunter, Robert A Rosenheck, Taeho Greg Rhee","doi":"10.1007/s11126-021-09900-3","DOIUrl":"https://doi.org/10.1007/s11126-021-09900-3","url":null,"abstract":"To examine the prevalence of adverse family experiences (AFEs), their association with poor school engagement and performance, and whether behavioral health conditions mediate the association among US adolescents. We conducted a cross-sectional analysis of data from adolescents aged 12-17 years from the 2016-2018 National Survey of Children's Health (n = 41,648 unweighted). We first estimated the prevalence of AFEs, investigated the association of AFEs with school engagement and performance, and whether behavioral health conditions mediate such relationships, using multivariable-adjusted Poisson regression models. A mediation analysis was used and covariates included socio-demographic characteristics and co-morbid medical conditions. A total of 52.9% of US adolescents (nationally representative of 12.9 million adolescents nationwide) reported experiencing at least one form of AFE, the most common of which included parental divorce/separation (33.1%), economic hardship (22.0%) and living with a person with substance misuse problems (11.5%). Adolescents with ≥4 AFEs had poorer outcomes in school engagement and performance (p < 0.001 each) when compared to those with no AFEs. Behavioral health conditions (e.g., anxiety, depression, and conduct problems) partially mediated these relationships (p < 0.01 each). The indirect effect of behavioral health conditions accounted for 20.4% of the total effect in the association between AFEs and school performance (p < 0.001). AFEs are common among US adolescents, and cumulative AFEs are associated with behavioral health conditions, which may in turn reduce school engagement and performance. While reducing AFEs is important in children and adolescents, addressing potentially resultant behavioral health conditions is equally important in improving school engagement and performance.","PeriodicalId":520814,"journal":{"name":"The Psychiatric quarterly","volume":" ","pages":"1201-1215"},"PeriodicalIF":3.5,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11126-021-09900-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25427784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Psychiatrists' Experience of Vocational Rehabilitation for Patients with Mental Illness. 精神科医生对精神病患者职业康复的体会。

IF 3.5

The Psychiatric quarterly Pub Date : 2021-09-01 Epub Date: 2021-03-04 DOI: 10.1007/s11126-021-09896-w

Åsa Wallentin, Emelie Kinberg, Jennifer Strand, Peter Sand

{"title":"Psychiatrists' Experience of Vocational Rehabilitation for Patients with Mental Illness.","authors":"Åsa Wallentin, Emelie Kinberg, Jennifer Strand, Peter Sand","doi":"10.1007/s11126-021-09896-w","DOIUrl":"https://doi.org/10.1007/s11126-021-09896-w","url":null,"abstract":"The aim of this study was to explore psychiatrists' experience of vocational rehabilitation for patients with mental illness. The study employed a qualitative design to explore psychiatrists' experience of vocational rehabilitation. Ten psychiatrists, five women and five men, 33-62 years of age (median 40), were interviewed. All of them worked with patients at Sahlgrenska University Hospital. The interviews were analyzed using inductive thematic analysis. All participants considered vocational rehabilitation to be of great importance for patients' well-being and health. The results were characterized by two opposite experiences: frustration and agency, these were the two main themes in the analysis. All narratives embraced both experiences, but some reflected more frustration and others more agency. In order for the psychiatrist to master the assignment, there is a need for further training and supervision. The psychiatrist's role, as well as other professional roles within the team, requires clarification, and the support from rehabilitation coordinators and occupational therapists should be enhanced. There is a need for improved cooperation with external actors.","PeriodicalId":520814,"journal":{"name":"The Psychiatric quarterly","volume":" ","pages":"1217-1229"},"PeriodicalIF":3.5,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11126-021-09896-w","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25431763","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

Occurence of Post-Traumatic Stress Symptoms, Anxiety and Depression in the Acute Phase of Transient Ischemic Attack and Stroke. 短暂性脑缺血发作和脑卒中急性期创伤后应激症状、焦虑和抑郁的发生

IF 3.5

The Psychiatric quarterly Pub Date : 2021-09-01 Epub Date: 2021-01-02 DOI: 10.1007/s11126-020-09873-9

Helge H O Müller, Katharina Czwalinna, Ruihao Wang, Caroline Lücke, Alexandra P Lam, Alexandra Philipsen, Jürgen M Gschossmann, Sebastian Moeller

{"title":"Occurence of Post-Traumatic Stress Symptoms, Anxiety and Depression in the Acute Phase of Transient Ischemic Attack and Stroke.","authors":"Helge H O Müller, Katharina Czwalinna, Ruihao Wang, Caroline Lücke, Alexandra P Lam, Alexandra Philipsen, Jürgen M Gschossmann, Sebastian Moeller","doi":"10.1007/s11126-020-09873-9","DOIUrl":"https://doi.org/10.1007/s11126-020-09873-9","url":null,"abstract":"Rates of post-traumatic stress symptoms, anxiety and depression are increased in patients having experienced a transient ischemic attack (TIA) or stroke several months ago. However, data of psychiatric symptoms in the acute phase within the first days after ictus are lacking. In 20 patients with stroke and 33 patients with TIA we assessed disease severity by means of the NIHSS, levels of depression and anxiety by HADS, PTSD-like symptoms by PC-PTSD, quality of life (HrQoL) by SF-12, and coping style by brief COPE Inventory within the first 5 days after ictus. NIHSS on admission was lower in patients with TIA (0 ± 1) than in patients with stroke (3 ± 2, p < 0.001). HADS depression score was significantly higher in patients with stroke (7.0 ± 4.5) than in patients with TIA (4.9 ± 4.0). HADS anxiety score, HrQoL and coping styles were similar between TIA and stroke patients (p > 0.05). 5 and 3 of 33 TIA patients as well as 4 and 3 of 20 stroke patients had at least 11 points in the HADS anxiety and depression score respectively (p = 0.001). 2 of 33 TIA patients and 2 of 20 stroke patients had more than 2 points in the PC-PTSD (p = 0.646). We did not find consistent correlations between the NIHSS and the psychometric parameters. Within the first five days after patients having experienced a TIA or stroke PTSD-like, anxious and depressive symptoms are more common than in the general population. As the acute psychological status after ictus is predictive for psychiatric comorbidity years later physicians should pay attention and adequately treat psychiatric symptoms already in the acute phase of stroke.Trial Registration: German Clinical Trials Register, DRKS00021730, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00021730 , registered 05/19/2020- Retrospectively registered.","PeriodicalId":520814,"journal":{"name":"The Psychiatric quarterly","volume":" ","pages":"905-915"},"PeriodicalIF":3.5,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11126-020-09873-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38771657","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: 10

Patient Satisfaction with and Use of Telemental Health Services in the Perinatal Period: a Survey Study. 围产期患者对远程心理健康服务的满意度和使用:一项调查研究。

IF 3.5

The Psychiatric quarterly Pub Date : 2021-09-01 Epub Date: 2021-01-03 DOI: 10.1007/s11126-020-09874-8

Marra Ackerman, Elizabeth Greenwald, Paraskevi Noulas, Christina Ahn

{"title":"Patient Satisfaction with and Use of Telemental Health Services in the Perinatal Period: a Survey Study.","authors":"Marra Ackerman, Elizabeth Greenwald, Paraskevi Noulas, Christina Ahn","doi":"10.1007/s11126-020-09874-8","DOIUrl":"https://doi.org/10.1007/s11126-020-09874-8","url":null,"abstract":"We aimed to assess patients' utilization of and satisfaction with telemental health (TMH) in the perinatal period. We hypothesized that satisfaction with TMH would be at least equal to, if not greater than, with in-person appointments. We conducted a cross-sectional survey between March 2018-June 2019 to evaluate patient satisfaction with and use of TMH services in the perinatal period. Participants used TMH services across the second and third trimester of pregnancy and the first year post-partum. Nearly half of the patients (8/19, 42%) used TMH to see their provider within the first two weeks post-partum. Participants were most commonly in treatment for anxiety (14/19, 74%) and/or depression (9/19, 47%). Most participants agreed or strongly agreed (13/19, 69%) that TMH improved their access to healthcare and that they could see the clinician as well as if they met in person (14/19, 74%). TMH was a highly accepted and appreciated method of mental health care delivery for perinatal women when offered as an alternative to in-person or telephone sessions.","PeriodicalId":520814,"journal":{"name":"The Psychiatric quarterly","volume":" ","pages":"925-933"},"PeriodicalIF":3.5,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11126-020-09874-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38775033","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: 22

A Predictive Model for Estimating Risk of Harm and Aggression in Inpatient Mental Health Clinics. 心理健康门诊住院病人伤害与攻击风险的预测模型

IF 3.5

The Psychiatric quarterly Pub Date : 2021-09-01 Epub Date: 2021-01-22 DOI: 10.1007/s11126-020-09880-w

Emanuele Blasioli, Elkafi Hassini, Peter J Bieling

引用次数: 0

Mental Health Staff Perceptions of Improvement Opportunities around COVID-19: A Mixed-Methods Analysis. 精神卫生工作人员对COVID-19改善机会的看法:一项混合方法分析

IF 3.5

The Psychiatric quarterly Pub Date : 2021-09-01 Epub Date: 2021-02-11 DOI: 10.1007/s11126-021-09890-2

Tanner Bommersbach, Lisa Dube, Luming Li

{"title":"Mental Health Staff Perceptions of Improvement Opportunities around COVID-19: A Mixed-Methods Analysis.","authors":"Tanner Bommersbach, Lisa Dube, Luming Li","doi":"10.1007/s11126-021-09890-2","DOIUrl":"https://doi.org/10.1007/s11126-021-09890-2","url":null,"abstract":"While COVID-19 has had widespread impact on the way behavioral health services are delivered, very little research exists characterizing how providers have perceived these changes. This study used mixed-methods to understand the complex and varied experiences of staff of a psychiatric service line at a large tertiary medical center with high community spread of COVID-19. A brief convenience survey was sent to all staff of the service line and thematic analysis generated brief themes and their frequency. Qualitative focus groups were then held to elucidate greater detail on survey responses. In total, 99 individuals responded to the survey and 17 individuals attended two focus groups in which theoretical saturation was achieved. While brief survey responses generated three broad themes, including operations, telehealth and technology, and communication, focus group data provided nuanced information about these themes, including reasons underlying heightened stress and fatigue felt by staff, inadequacy of technology while finding innovative approaches for its use, and appreciation for the benefits of telehealth while expressing concern for patients not served well by it. These mixed-methods findings highlight the complexities of implementing widespread changes during COVID-19 and demonstrate how survey and focus group data can be used to evaluate rapid care transformations driven by COVID-19.","PeriodicalId":520814,"journal":{"name":"The Psychiatric quarterly","volume":" ","pages":"1079-1092"},"PeriodicalIF":3.5,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11126-021-09890-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25360546","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: 14

On-Site Prescription Dispensing Improves Antidepressant Adherence among Uninsured Depressed Patients. 现场处方分配改善抗抑郁药物依从性在没有保险的抑郁症患者。

IF 3.5

The Psychiatric quarterly Pub Date : 2021-09-01 Epub Date: 2021-02-15 DOI: 10.1007/s11126-021-09885-z

Samuel K Powell, Claire L Gibson, Ibeawuchi Okoroafor, Josimar Hernandez-Antonio, Elisa M Nabel, Yasmin S Meah, Craig L Katz

{"title":"On-Site Prescription Dispensing Improves Antidepressant Adherence among Uninsured Depressed Patients.","authors":"Samuel K Powell, Claire L Gibson, Ibeawuchi Okoroafor, Josimar Hernandez-Antonio, Elisa M Nabel, Yasmin S Meah, Craig L Katz","doi":"10.1007/s11126-021-09885-z","DOIUrl":"https://doi.org/10.1007/s11126-021-09885-z","url":null,"abstract":"The successful treatment of depressive disorders critically depends on adherence to prescribed treatment regimens. Despite increasing rates of antidepressant medication prescription, adherence to the full treatment course remains poor. Rates of antidepressant non-adherence are higher for uninsured patients and members of some marginalized racial and ethnic communities due to factors such as inequities in healthcare and access to insurance. Among patients treated in a free, student-run and faculty-supervised clinic serving uninsured patients in a majority Hispanic community in East Harlem, adherence rates are lower than those observed in patients with private or public New York State health insurance coverage. A prior study of adherence in these patients revealed that difficulty in obtaining medications from an off-site hospital pharmacy was a leading factor that patients cited for non-adherence. To alleviate this barrier to obtaining prescriptions, we tested the effectiveness of on-site, in-clinic medication dispensing for improving antidepressant medication adherence rates among uninsured patients. We found that dispensing medications directly to patients in clinic was associated with increased visits at which patients self-reported proper adherence and increased overall adherence rates. Furthermore, we found evidence that higher rates of antidepressant medication adherence were associated with more favorable treatment outcomes. All patients interviewed reported increased satisfaction with on-site dispensing. Overall, this study provides promising evidence that on-site antidepressant dispensing in a resource-limited setting improves medication adherence rates and leads to more favorable treatment outcomes with enhanced patient satisfaction.","PeriodicalId":520814,"journal":{"name":"The Psychiatric quarterly","volume":" ","pages":"1093-1107"},"PeriodicalIF":3.5,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11126-021-09885-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25370066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3