Department of Psychiatry, University of Maryland, School of Medicine, Baltimore, MD 21201, USA.
Int J Psychiatry Med. 2012;44(1):1-15. doi: 10.2190/PM.44.1.a.
This study sought to determine whether patients on psychiatric medication evaluated by inpatient consultation psychiatrists followed up with psychiatric aftercare and continued psychiatric medication 8 weeks post-discharge. Barriers to care and their effect on aftercare follow-up were assessed.
This was a prospective study of a consecutive sample of adults who received a psychiatric consultation and were prescribed psychotropic medication during hospitalization on the general medical or surgical inpatient units at the University of Maryland Medical Center. Baseline information was collected from 36 patients who received an inpatient psychiatric consultation and were: (1) prescribed psychiatric medications; and (2) discharged to home. Follow-up data was collected from 21 (58.3%) of these patients 8 weeks post-discharge.
Of 36 patients who provided baseline data, 93% recognized they had a psychiatric disorder, 90% recognized the importance of taking psychiatric medication, and 80% recognized the importance of psychiatric aftercare. Aftercare recommendations were included in only 33% of patient discharge instructions. Of 21 patients providing follow-up data, 57% reported receiving psychiatric aftercare. Patients who did not receive psychiatric aftercare were significantly more likely to be at risk for poor literacy (88.9% vs. 33.3% Fisher's exact test = 0.024) and were less often given psychiatric aftercare instructions at discharge (22% vs. 42%).
Poor communication of aftercare instructions as well as poor literacy may be associated with lack of psychiatric aftercare. Consultation psychiatrists should assess literacy and insure aftercare information is provided to patients.
本研究旨在确定接受住院会诊精神科医生评估的精神科药物治疗患者在出院后 8 周是否接受精神科随访和继续精神科药物治疗。评估了护理障碍及其对随访的影响。
这是一项对在马里兰大学医学中心普通内科或外科住院患者接受精神科会诊并开处精神药物的连续成年患者的前瞻性研究。对 36 名接受住院精神科会诊并符合以下条件的患者进行了基线资料收集：（1）开处精神科药物；（2）出院回家。对其中 21 名（58.3%）患者在出院后 8 周进行了随访数据收集。
在提供基线资料的 36 名患者中，93%的患者认识到自己有精神障碍，90%的患者认识到服用精神药物的重要性，80%的患者认识到精神科随访的重要性。只有 33%的患者出院医嘱中包含了随访建议。在提供随访数据的 21 名患者中，57%的患者报告接受了精神科随访。未接受精神科随访的患者更有可能存在阅读困难的风险（88.9%比 33.3%Fisher 精确检验=0.024），并且在出院时较少接受精神科随访指导（22%比 42%）。
随访医嘱沟通不良以及阅读能力较差可能与缺乏精神科随访有关。会诊精神科医生应评估阅读能力并确保向患者提供随访信息。
