Evidence map›Paper›PMID 32381136›Full record

ArticleEuropean psychiatry : the journal of the Association of European Psychiatrists2020

Diagnose, indicate, and treat severe mental illness (DITSMI) as appropriate care: A three-year follow-up study in long-term residential psychiatric patients on the effects of re-diagnosis on medication prescription, patient functioning, and hospital bed utilization.

H M Veereschild, E O Noorthoorn, H L I Nijman, C L Mulder, M Dankers, J A Van der Veen, A J M Loonen, G J M Hutschemaekers

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Article in European psychiatry : the journal of the Association of European Psychiatrists, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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0cells of the map it votes in
3citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

H M VeereschildGGNet Community Mental Health Center, Warnsveld, The Netherlands.
E O NoorthoornGGNet Community Mental Health Center, Warnsveld, The Netherlands.
H L I NijmanFivoor, Forensic Psychiatric Institute, Rotterdam, The Netherlands.
C L MulderPublic Mental Health Care, Parnassia Psychiatric Institute, Rotterdam, The Netherlands.
M DankersDutch Institute for Rational Use of Medicine, Utrecht, The Netherlands.
J A Van der VeenGGNet Community Mental Health Center, Warnsveld, The Netherlands.
A J M LoonenPharamacology Department of Pharmacotherapy, Epidemiology & Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands.
G J M HutschemaekersDepartment of Social Sciences, Clinical Psychology at the Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWhile polypharmacy is common in long-term residential psychiatric patients, prescription combinations may, from an evidence-based perspective, be irrational. Potentially, many psychiatric patients are treated on the basis of a poor diagnosis. We therefore evaluated the DITSMI model (i.e., Diagnose, Indicate, and Treat Severe Mental Illness), an intervention that involves diagnosis (or re-diagnosis) and appropriate treatment for severely mentally ill long-term residential psychiatric patients. Our main objective was to determine whether DITSMI affected changes over time regarding diagnoses, pharmacological treatment, psychosocial functioning, and bed utilization.

methodsDITSMI was implemented in a consecutive patient sample of 94 long-term residential psychiatric patients during a longitudinal cohort study without a control group. The cohort was followed for three calendar years. Data were extracted from electronic medical charts. As well as diagnoses, medication use and current mental status, we assessed psychosocial functioning using the Health of the Nations Outcome Scale (HoNOS). Bed utilization was assessed according to length of stay (LOS). Change was analyzed by comparing proportions of these data and testing them with chi-square calculations. We compared the numbers of diagnoses and medication changes, the proportions of HoNOS scores below cut-off, and the proportions of LOS before and after provision of the protocol.

resultsImplementation of the DITSMI model was followed by different diagnoses in 49% of patients, different medication in 67%, some improvement in psychosocial functioning, and a 40% decrease in bed utilization.

conclusionsOur results suggest that DITSMI can be recommended as an appropriate care for all long-term residential psychiatric patients.

Indexed as

AdultBenchmarkingDrug PrescriptionsFemaleFollow-Up StudiesHumansLength of StayLongitudinal StudiesLong-Term CareMaleMental DisordersMiddle AgedOutcome Assessment, Health CareAppropriate caremedication and hospital bed utilizationre-diagnosesevere mental illness

Identifiers

PMID32381136
PMCPMC7358634

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