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This study aims to understand whether psychotropic prescribing practices for people with intellectual disabilities are in keeping with best practice guidelines.

This service evaluation project was a retrospective analysis of routinely collected data from the care records of all 36 people with intellectual disability discharged from an intellectual disability assessment and treatment unit during the first five years of the Stop Over medicating People with Intellectual Disabilities and/or autistic people (STOMP) initiative. Data were gathered at four time points (pre-admission, discharge, 6- and 12-month follow-up) before being analysed to understand whether psychotropic prescribing differed among people with different clinical characteristics/traits/diagnoses. Changes over time were also explored to ascertain whether and how prescribing altered from admission to discharge, and over the subsequent year of community living.

Most people with intellectual disabilities left the assessment and treatment unit on fewer regular psychotropic medications and at lower doses than at admission. These optimised regimes were still apparent 12 months post-discharge, suggesting effective discharge planning and community care packages. Inpatients with severe intellectual disabilities generally received more anxiolytics and hypnotics, at higher doses. Autistic people tended to receive more psychotropics in total and at higher cumulative doses, a pattern that persisted post discharge. A third of the sample were admitted on regular anti-psychotic medications despite having no corresponding psychotic diagnosis, a proportion that remained relatively stable through discharge and into the community.

This study highlights subsets of the intellectual disability population at particular risk of receiving high doses of psychotropics and a feasible template for providers intending to undertake STOMP-focused evaluations.

Adopting new technologies to improve supply chain activities and processes is essential due to increasingly complex and dynamic business environments. Particularly in the pharmaceutical industry, high-quality standards must be met, requiring transparency and visibility in the supply chain. This research aims at investigating the implementation of blockchain technology in the supply chain of an Egyptian pharmaceutical company.

The research applies a single case-study approach building on the theoretical underpinnings of transaction cost economics. Twenty-five semistructured interviews were conducted with pharmacies and employees of the case company to identify the blockchain technologies' potential for pharmaceutical supply in Egypt. Further analyzing the frequencies of the codes, the authors elaborate on specific relationships between the observed practices.

The research revealed the potential benefits of adopting blockchain technology. Transaction costs are indeed positively impacted by reduced contracting costs, processing costs and lead times, also ensuring the safe delivery of medications. However, the findings also highlight obstacles related to running costs, awareness and company culture. Regarding supply chain governance, blockchain technology can enhance collaboration within the supply chain as well as with important stakeholders.

Insufficient management of pharmaceutical supply chains (PSC) may affect a company's reputation but also disrupt the patient's healing process due to temperature damage and counterfeit medicines. Blockchain governance, in this vein, can ensure a safer and more reliable supply of pharmaceutical products. For intraorganizational purposes, however, cloud solutions, barcoding and generally digital platforms are rated more frequently than blockchain solutions.

The present study contributes to an advanced understanding how blockchain technology supports PSC, particularly in an emerging country context like Egypt. It thereby confirms and extends previous research as well as adds to the theoretical underpinnings of digitalized supply chains.

This study aims to examine the relationship between medication for opioid use disorder (MOUD) among pregnant individuals, referral source, mental health, political affiliation and substance use policies in all 50 states in the USA.

This study describes MOUD receipt among pregnant people with an opioid use disorder (OUD) in 2018. The authors explored sociodemographic differences in MOUD receipt, referrals and co-occurring mental health disorders. The authors included a comparison of MOUD receipt among states that have varying substance use policies and examined the impact of these policies and the political affiliation on MOUD. The authors used multilevel binary logistic regression to examine effects of individual and state-level characteristics on MOUD.

Among 8,790 pregnant admissions with OUD, the majority who received MOUD occurred in the Northeast region (71.52%), and 14.99% were referred by the criminal justice system (n = 1,318). Of those who were self-referred, 66.39% received MOUD, while only 30.8% of referrals from the criminal justice system received MOUD. Those referred from the criminal justice system or who had a co-occurring mental health disorder were least likely to receive MOUD. The multilevel model showed that while policies were not a significant predictor, a state’s political affiliation was a significant predictor of MOUD.

The study has some methodological limitations; a state-level analysis, even when considering the individual factors, may not provide sufficient description of community-level or other social factors that may influence MOUD receipt. This study adds to the growing literature on the ineffectiveness of prenatal substance use policies designed specifically to increase the use of MOUD. If such policies are consistently assessed as not contributing to substantial increase in MOUD among pregnant women over time, it is imperative to investigate potential mechanisms in these policies that may not facilitate MOUD access the way they are intended to.

Findings from this study aid in understanding the impact that a political affiliation may have on treatment access; states that leaned more Democratic were more likely to have higher rates of MOUD, and this finding can lead to research that focuses on how and why this contributes to greater treatment utilization. This study provides estimates of underutilization at a state level and the mechanisms that act as barriers, which is a stronger assessment of how state-specific policies and practices are performing in addressing prenatal substance use and a necessary step in implementing changes that can improve the links between pregnant women and MOUD.

To the best of the authors’ knowledge, this is the first study to explore individual-level factors that include mental health and referral sources to treatment that lead to MOUD use in the context of state-level policy and political environments. Most studies estimate national-level rates of treatment use only, which can be useful, but what is necessary is to understand what mechanisms are at work that vary by state. This study also found that while substance use policies were designed to increase MOUD for pregnant women, this was not as prominent a predictor as other factors, like mental health, being referred from the criminal justice system, and living in a state with more Democratic-leaning affiliations.

Older people living in nursing homes have complex care needs and frequently need specialists’ advice and support that can be challenging to deliver in a rural setting. The aim of this paper is to describe a model of integrated care in a rural area supported by a nurse case manager.

A real-world evidence study of people living in Ribes de Freser nursing home, was conducted between specific timeframes in 2019 and 2022, comparing the casemix and outcomes of a traditional care model with the integrated interdisciplinary model.

The integrated care model led to a significant reduction in transfers to the emergency department, hospitalisations, outpatient medical visits and a reduction in the number of medicines. In addition, the number of residents receiving end-of-life care at the nursing home showed a substantial increase.

This case study contributes valuable evidence supporting the implementation of an integrated model of nurse case manager support in nursing homes, particularly in the rural contexts, where access to specialist medical staff may be limited. The findings highlight the potential benefits of person-centred integrated care for older adults, addressing their complex needs and improving end-of-life care in nursing home settings.

Cannabis use continues to increase worldwide, and a number of nation states are changing their cannabis policies. Policy changes require research into key populations, namely, people who use cannabis. This study aims to examine sociodemographic differences of young Finns who reported using cannabis mainly for self-medication versus mainly recreationally, as well as their reported effects of cannabis use.

The data come from an anonymous online survey (N = 247, 70.0% males, 25.9% females, 4.1% other) that was analysed using multiple logistic regression. The authors focused on whether various demographic indicators differed between those who reportedly used cannabis mainly for recreational purposes and mainly for self-medicinal purposes. The authors also qualitatively examined the respondents’ experienced effects of cannabis, both desired and undesired.

Being older and female, living in a smaller city and earlier age of initiation of cannabis use were statistically significant in predicting the medicinal use of cannabis. The majority of recreational effects were related to themes such as relaxation and pleasure, but many participants also reported desired medical effects. Similarly, many participants reported several undesired effects.

Understanding especially young people’s motivations to use cannabis, which include using it for various medical effects, can improve the design of harm reduction and treatment programmes as well as enhance the well-being of people who use cannabis.

This study gives a nuanced account of sociodemographic factors and motivations of young people who use cannabis in Finland as well as the reported effects it has on them, which complements data from national drug surveys.

This review aimed to identify and map published studies on self-care practices to manage common acute health conditions in the Philippines.

The authors conducted a scoping review in PubMed, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), ProQuest Central, Journal Storage (JSTOR) and the Philippine Council for Health Research and Development – Health Research and Development Information Network (HERDIN). The authors included all studies on self-care practices to manage common acute conditions, namely low back pain, allergic rhinitis, general acute pain, cough, cold, diarrhea, constipation and stress, published up to 2021 in the Philippines. Information on the article type, aim of the study, study design and setting, population characteristics and size, and self-practices employed for the conditions were extracted and synthesized.

The authors identified various self-care practices for acute conditions among the general population and indigenous peoples in the Philippines from 26 studies included in the review: the use of medicines with and without a prescription, appropriate and inappropriate antibiotic use, use of medicinal plants and other traditional and alternative therapies and products, recreational activities and healthy habits and behaviors, and self-management or seeking care from traditional healers (albularyo or manggagamot) or health professionals. A number of considerations influenced their decision on how to manage symptoms, including perceived severity of the condition, availability and perceived effectiveness of treatment, cost, and advice from trusted sources of health information.

The authors searched five major databases and a local research database, but some studies may still have been missed in the review. The review also excluded intervention studies on the outcomes of self-care, which limits the authors' ability to make conclusions on the effectiveness of the different modalities of self-care.

Filipinos engage in a variety of “safe” (or evidence-informed) and “unsafe” (or harmful) self-care practices. While the term “self-care” is not routinely used by the general population and health providers, it is widely enculturated and practiced in the Philippines. Self-care benefits individuals and the health system, but there are also practices that increase risk of adverse outcomes and death including inappropriate antibiotic use, prescription sharing and reuse, and delays in seeking adequate treatment from a health professional. To leverage on self-care in advancing Universal Health Coverage (UHC) goals, the authors recommend a national strategy that provides guidance on how to practice responsible self-care, further research on the effectiveness and safety of alternative medicine and other priority areas, and better integration of self-care in the formal education and health systems. The authors also propose that the research agenda on self-care include acute health conditions, given their impact and burden on health and the economy.

This is the first published review of self-care practices for managing common acute health conditions, which captured practices of various groups and populations including indigenous peoples.

The purpose of the study was to examine whether there were differences in the provision of non-pharmacological interventions based on the level of intellectual disability and the presence or absence of autism. Mental health conditions are often underdiagnosed in adults with intellectual disability and do not always receive psychological interventions as recommended by the National Institute for Health and Care Excellent guidelines. To realise the national UK programme’s aim of stopping the overuse of medications in people with intellectual disability, it is important that these individuals have access to appropriate non-pharmacological interventions. The authors examined the relationship between an individual’s level of intellectual disability and the presence or absence of autism with access to relevant non-pharmacological interventions from specialist community intellectual disability services.

A cross-sectional study of adults accessing four specialist intellectual disability services in North West England in 2019.

There was a high prevalence of mental health comorbidity, even higher for autistic adults. However, a relatively small percentage of the study population was receiving psychological interventions. The most frequent non-pharmacological intervention was a positive behaviour support plan, irrespective of comorbid mental illnesses.

Not having access to psychological interventions for the treatment of mental illness could result in poor health outcomes and increasing health inequalities. The study highlights the need for developing psychological interventions, particularly for those with moderate to severe intellectual disability and for those with associated autism.

This large sample study examined the relationship between intellectual disability level and the presence of autism with accessing psychological interventions.

The aim of this study is to investigate the roles of psychiatric mental health nurses during their work experiences in inpatient clinical settings.

A focus group of 10 graduate psychiatric nurses with more than two years’ practice in inpatient psychiatric settings reflected on their last six months’ work placements and continuous employment. The transcripts and field notes were analyzed through thematic analysis of inductive data.

Two main themes emerged: management roles and clinical roles. The participants reflected on caring activities and obstacles encountered in fulfilling their professional roles.

Multiple practice issues emerged. The participants perceived that psychiatric nurse specialists are required to perform more caring functions than practicable in the inpatient setting due to an excess of noncaring duties, structural minimization of the caring role and inadequate training. They felt that many of the functions performed were not within their expectations of the caring role of a psychiatric nurse specialist and believed that changes in nurse education and attention to clarification of nurses’ roles might enhance the role they play in patient care.

The rate of female committals to prison has grown rapidly in recent years. Women in prison are likely to have trauma histories and difficulties with their mental health. This paper aims to synthesise the findings of qualitative literature to gain a deeper understanding of the experiences of women in the context of prison-based mental health care.

A systematic search of five academic databases, Cumulative Index to Nursing and Allied Health Literature, Applied Social Sciences Index and Abstracts, Psychological Information Database (PsycINFO), Excerpta Medica DataBASE (EMBASE) and Medline, was completed in December 2020. This study’s search strategy identified 4,615 citations, and seven studies were included for review. Thomas and Harden’s (2008) framework for thematic synthesis was used to analyse data. Quality appraisal was conducted using the Joanna Briggs Institute Checklist for Qualitative Research (Lockwood et al., 2015).

Four analytic themes were identified that detail women’s experiences of prison-based mental health care: the type of services accessed and challenges encountered; a reduction in capacity to self-manage mental well-being; the erosion of privacy and dignity; and strained relationships with prison staff. There is a paucity of research conducted with women in the context of prison-based mental health care. The findings suggest there is a need for greater mental health support, including the need to enhance relationships between women and prison staff to promote positive mental health.

To the best of the authors’ knowledge, this is the first systematic review conducted on the experiences of women in the context of prison-based mental health care.

To better understand the reality of living with the diseases and conditions that its drugs and therapies are developed to treat, the Novartis leadership determined a need for more meaningful insights into patients’ lives. They sought to develop a systematic, creative methodology – informed by the psychology of insightful rather than analytical thinking – to properly integrate and deploy the research commissioned into its day-to-day business decision-making. For it is well established that better understanding of the patient reality drives both compliance and adherence “beyond the pill”. The purpose of this paper is to bring the novel methodology of creativity to a wider audience and ensure that many others – notably in patient advocacy organizations – can benefit from this approach.

A core team of Insight and Analytics and Patient Engagement leads from various therapeutic area teams worked in partnership with a psychologist and practitioner in the field of insightful thinking, to develop an effective methodology that could reliably surface and articulate genuine patient insights. This methodology – the i4i Insights Discovery™ process – was developed, piloted, refined and codified in 2020 and implemented across the company in 2021–2022. It uses a combination of convergent and divergent thinking techniques – human rather than artificial intelligence, combining diverse research outputs – to understand patients’ lives better. With enhanced understanding, the insights then shape educational and behavioral strategies to drive adherence and compliance.

At a time of tightening budgets and demands to deliver enhanced impact from research budgets, i4i Insights Discovery™ has enabled Novartis teams to turn existing research outputs into profound and useful understandings of what it means to live with specific diseases and develop evidence-based patient engagement strategies; insight-driven decision-making around the lifecycle of any compound. i4i Insights Discovery™ has been applied across Novartis’s diverse areas of expertise, from heart disease to cancer, from organ transplantation to dermatology, from food allergy to ophthalmology.

The i4i Insights Discovery™ process enables Novartis teams to gain deeper understanding of patients’ lives without the need to commission additional research; to do more with less. These insights enable cross-functional Novartis teams to develop better-informed strategies that better address the needs of patients and their care partners, of health-care professionals and health-care systems. The team creating the process is looking to make the i4i Insights Discovery™ approach a gold standard of insight discovery, both for pharma and health care and in other categories, too.

The i4i Insights Discovery™ process is a practical, novel application of well-established principles in the psychology of insightful thinking to address a clear business imperative. By repurposing and reinterpreting existing research outputs using creative verbal and visual exercises, it delivers a more human and empathetic understanding of the patient reality. It moves teams from “So what?” – this is what the data mean – to “Now what?” – this is what we should do as a result.