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Article
Publication date: 16 April 2024

Sadia Zahid, Bushra Rauf, Rachel Lee, Hafsa Sheikh, Ashok Roy and Rani Pathania

A quantitative observational study was conducted. The purpose of this study is to examine the continuing adherence to the stopping over-medication of people with intellectual…

Abstract

Purpose

A quantitative observational study was conducted. The purpose of this study is to examine the continuing adherence to the stopping over-medication of people with intellectual disability and/or autism guidelines for a cohort of outpatients seen in the outpatients’ clinics in the two teams who participated in this study to review the trend of psychotropic prescribing with a prescription indication along with the utilisation of non-pharmacological interventions.

Design/methodology/approach

Data was retrospectively collected over a period of one year for patients sampled conveniently in the outpatient’s clinic. The data was collected from two sites from psychiatric letters to the general practitioners (GPs), with the focus being psychotropic prescription indication and their adherence to British National Formulary limits, inclusion of a wider multi-disciplinary team or MDT (including nurses, psychologists and health support workers), use of Clinical Global Impression (CGI) scale for assessing medication side effects and response to treatment.

Findings

Most of the patients had at least one review in the previous six months. Antipsychotics were the highest prescribed medications without an indication for their use (13.3%) followed by anxiolytics and other medications. CGI recording was suboptimal, with 26% of the patient population did not have medication side effects and effectiveness monitored through this method. In total, 41% of patients were open to community nurses followed by other disciplines.

Originality/value

To the best of the authors’ knowledge, this is an original article following the pilot study completed by the authors.

Details

Advances in Mental Health and Intellectual Disabilities, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 26 December 2023

Russell Webster, Colin Fearns, Paula Harriott, Lisa Millar, Jardine Simpson, Jason Wallace and Michael Wheatley

The purpose of this paper is to examine lived experiences of opioid agonist treatment (OAT) during and immediately following release from detention in prisons in England and…

Abstract

Purpose

The purpose of this paper is to examine lived experiences of opioid agonist treatment (OAT) during and immediately following release from detention in prisons in England and Scotland.

Design/methodology/approach

Surveys were completed by serving prisoners in both countries and by those recently released from prison (England only). The survey findings were discussed in focus groups of people with lived experience. The combined findings from the surveys and focus groups were shared with an expert group of prison OAT providers and people with lived experience with the purpose of making recommendations for more accessible and effective OAT in custodial environments and continuity of OAT on release

Findings

The quality and accessibility of OAT varied considerably between establishments. It was reported to be harder to access OAT in Scottish prisons. It was often hard for people in prison to get the dosage of OAT they felt they needed and it was generally harder to access buprenorphine than methadone in English prisons. Only Scottish people in prison were aware of long-lasting forms of buprenorphine. People in English prisons had mixed experiences of the help available in prison, with no improvement recorded since a 2016 study. People in Scottish prisons were more likely to rate the help available as poor.

Research limitations/implications

The number of people accessed while actually in prison (73) was reduced by the impact of the pandemic, making it more difficult to access people in prison and because some were resistant to participating on the basis that they had already been consulted for a wide variety of research projects focused on the impact of COVID. The Scottish cohort (a total of 19 individuals comprising 14 survey respondents and five focus group members) is clearly too small a number on which to base robust claims about differences in OAT provision between the English and Scottish prison systems..

Practical implications

The study identifies key barriers to accessing OAT in prisons and suggests key components of more user-friendly approaches.

Social implications

This study provides an overview of the recent lived experiences of people accessing OAT in prison and on release and offers valuable recommendations on how to make service provision more effective and consistent.

Originality/value

This study provides an overview of the recent lived experiences of people accessing OAT in prison and on release in England and Scotland and offers valuable recommendations on how to make service provision more effective and consistent.

Details

International Journal of Prison Health, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2977-0254

Keywords

Article
Publication date: 31 August 2023

Arvinder P.S. Loomba

A key feature of human rights in health is access to safe, effective and affordable medicines. Pharmacovigilance is advocated for monitoring intended/unintended effects of…

Abstract

Purpose

A key feature of human rights in health is access to safe, effective and affordable medicines. Pharmacovigilance is advocated for monitoring intended/unintended effects of medicines to assure their safety. The purpose of this paper is to synthesize knowledge about supply chain impediments to safe medicines in developing nations and contribute to future development of research in this field.

Design/methodology/approach

This paper conducts a structured literature review based on Preferred Reporting Items for the Systematic Reviews and Meta-Analyses guidelines. It aims at profiling supply chain impediments to safe medicines in developing nations by reviewing 46 recent pharmacovigilance-specific papers published between 2005 and 2020.

Findings

Analysis of reviewed articles identified criticality of supply chain impediments that affect constituents across pharmaceutical in developing nations, which still struggle to maintain robust national pharmacovigilance systems due to lack of awareness, policy and practices.

Research limitations/implications

Research results can be applied by pharmaceutical industry decision-makers and drug safety professionals in developing nations. Because the review is qualitative in nature, its implication ought to be tested after actual implementation.

Practical implications

This review can help identify underinvestigated impediments and methods to aid in developing new pharmacovigilance knowledge areas in developing nation context.

Social implications

The review uncovers gaps in global health equity dialogue in developing nations. It also recognizes that macrolevel supply chain impediments exist due to unfair disease burden and health inequities in developing nations.

Originality/value

The paper examines supply chain impediments to safe medicines in developing nations with insights for future pharmacovigilance research. Identifying and classifying supply chain impediments through this review is the first step toward creating effective interventions for these impediments to safe medicines.

Details

International Journal of Human Rights in Healthcare, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2056-4902

Keywords

Article
Publication date: 30 January 2024

Danielle Adams, Richard P. Hastings, Ian Maidment, Chetan Shah and Peter E. Langdon

Evidence of overprescribing of psychotropic medicines to manage challenging behaviour in people with intellectual disabilities has led to national programmes within the UK to…

Abstract

Purpose

Evidence of overprescribing of psychotropic medicines to manage challenging behaviour in people with intellectual disabilities has led to national programmes within the UK to promote deprescribing, such as stopping the overprescribing of medication in people (with learning disabilities, autism or both). To successfully implement deprescribing initiatives, we need to understand how to engage stakeholders in the process.

Design/methodology/approach

In a published systematic review, we reported evidence about the process of deprescribing psychotropic medicines for people of all ages with intellectual disabilities and challenging behaviour. As a part of the original review, we searched for evidence about stakeholders’ experiences of the psychotropic deprescribing process, which was synthesised and reported within the current study.

Findings

Six studies were identified. Involving carers and people with intellectual disabilities, providing ongoing support and improving access to non-pharmacological interventions, including positive behaviour support, may contribute to successful outcomes, including reducing or stopping psychotropic medicines and improving quality of life. Implementing psychotropic deprescribing requires a multidisciplinary collaborative care approach and education for stakeholders.

Originality/value

There have been no previous reviews of stakeholder experiences of deprescribing psychotropic medications for people with intellectual disabilities and challenging behaviour. The existing literature is scant, and further research is needed.

Details

Tizard Learning Disability Review, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1359-5474

Keywords

Abstract

Purpose

This study aims to evaluate and summarize the effectiveness of cognitive behavioral therapy (CBT) and internet-based CBT (ICBT) interventions on relapse prevention and severity of symptoms among individuals with major depressive disorder (MDD). CBT is one of the most used and suggested interventions to manage MDD, whereas ICBT is a novel effective proposed approach.

Design/methodology/approach

The review was conducted following the preferred reporting items for systematic review and meta-analysis protocol. A comprehensive and extensive search was performed to identify and evaluate the relevant studies about the effectiveness of CBT and ICBT on relapse prevention and severity of symptoms among patients with MDD.

Findings

A total of eight research studies met the inclusion criteria and were included in this systematic review. RCT studies were conducted to assess and evaluate the effectiveness of CBT and ICBT on relapse prevention and severity of symptoms among patients with MDD. It has been found that CBT is a well-supported and evidently based effective psychotherapy for managing depressive symptoms and reducing the relapse and readmission rate among patients diagnosed with MDD. The ICBT demonstrated greater improvements in depressive symptoms during major depressive episodes among patients with MDDS. The ICBT program had good acceptability and satisfaction among participants in different countries.

Research limitations/implications

Despite the significant findings from this systematic review, certain limitations should be acknowledged. First, it is important to note that all the studies included in this review were exclusively conducted in the English language, potentially limiting the generalizability of the findings to non-English speaking populations. Second, the number of research studies incorporated in this systematic review was relatively limited, which may have resulted in a narrower scope of analysis. Finally, a few studies within the selected research had small sample sizes, which could potentially impact the precision and reliability of the overall conclusions drawn from this review. The authors recommend that nurses working in psychiatric units should use CBT interventions with patients with MDD.

Practical implications

This paper, a review of the literature gives an overview of CBT and ICBT interventions to reduce the severity of depressive symptoms and prevent patients’ relapse and rehospitalization and shows that CBT interventions are effective on relapse prevention among patients with MDD. In addition, there is still no standardized protocol to apply the CBT intervention in the scope of reducing the severity of depressive symptoms and preventing depression relapse among patients with major depressive disorder. Further research is needed to confirm the findings of this review. Future research is also needed to find out the most effective form and contents of CBT and ICBT interventions for MDD.

Social implications

CBT is a psychological intervention that has been recommended by the literature for the treatment of major depressive disorder (MDD). It is a widely recognized and accepted approach that combines cognitive and behavioral techniques to assist individuals overcome their depressive symptoms and improve their overall mental well-being. This would speculate that effectiveness associated with several aspects and combinations of different approaches in CBT interventions and the impact of different delivery models are essential for clinical practice and appropriate selection of the interventional combinations.

Originality/value

This systematic review focuses on the various studies that explore the effectiveness of face-to-face CBT and ICBT in reducing depressive symptoms among patients with major depressive disorder. These studies were conducted in different countries such as Iran, Australia, Pennsylvania and the USA.

Details

Mental Health and Social Inclusion, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2042-8308

Keywords

Article
Publication date: 20 December 2023

Samuel Adusei, Dorcas Nuertey and Emmanuel Poku

This study investigated the relationship between last-mile distribution or delivery (LMD) and commodity access through the mediating role of commodity availability and commodity…

Abstract

Purpose

This study investigated the relationship between last-mile distribution or delivery (LMD) and commodity access through the mediating role of commodity availability and commodity security and the moderating effect of supply chain integration (SCI).

Design/methodology/approach

The study adopted the survey research design and employed the questionnaire instrument in collecting primary data from respondents in Eastern Regional Health Institutions in Ghana. The total number of valid responses received was 204. The partial least squares structural equation modeling (PLS-SEM) approach was adopted to analyze the relationship between the study variables.

Findings

The findings showed that there is a positive and significant relationship between LMD and commodity availability as well as LMD and commodity security. Moreover, while the relationship between commodity availability and commodity access is positive and significant, that between commodity security and commodity access is positive but insignificant. Furthermore, there is a positive and statistically significant relationship between LMD and commodity access. The study discovered that the interaction between LMD and commodity access is insignificant and negatively affected by SCI.

Originality/value

To the best of the authors' knowledge, no previous studies have empirically verified the effect of LMD on commodity access in the presence of mediating factors such as commodity availability and commodity security and SCI as the moderating factors.

Details

Benchmarking: An International Journal, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1463-5771

Keywords

Open Access
Article
Publication date: 22 August 2023

Aleksi Hupli, Ali Unlu, Jussi Jylkkä and Atte Oksanen

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…

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Research limitations/implications

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.

Originality/value

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.

Details

Drugs, Habits and Social Policy, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2752-6739

Keywords

Article
Publication date: 22 August 2023

Bahtiar Bahtiar, Ida Ayu Kade Sri Widiastuti, Dwi Nopriyanto, Nurlaila Fitriani, Khumaidi Khumaidi, Arief Andriyanto and Iskandar Muda

The purpose of this study is to explore the lived experiences of the constraints of older adult family caregivers with chronic diseases in caring for and accessing health services…

Abstract

Purpose

The purpose of this study is to explore the lived experiences of the constraints of older adult family caregivers with chronic diseases in caring for and accessing health services during the COVID-19 pandemic.

Design/methodology/approach

This study used the descriptive phenomenology qualitative method. The sampling method was purposive sampling involving 16 older adult family caregivers.

Findings

The results of this study showed three themes such as difficulties in health services in hospitals during the COVID-19 pandemic (complaints of services provided by doctors, older adult treatment control problems and difficulty getting to hospital health facilities); difficulties accompanying taking older adult medicine (older adult non-compliance response to taking medication and older adult medicine assistance); and psychosocial complaints caring for and accompanying the older adult (negative emotions for the older adult, difficulty interacting with the older adult and the economic burden of caring for the older adult).

Practical implications

Barriers to family caregivers in caring for older adults with chronic diseases can help health-care service providers understand and support families caring for and assisting older adults, which may contribute to the quality of life and care for both family caregivers and older adults.

Originality/value

This study showed that Indonesian family caregivers faced difficulties caring for and living with older adults with chronic diseases during the pandemic. Family caregivers’ experiences are essential when developing an intervention to support and manage health care for older adults with chronic illnesses.

Details

Working with Older People, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1366-3666

Keywords

Article
Publication date: 22 April 2024

Roisin McColl, Peter Higgs and Brendan Harney

Globally, hepatitis C treatment uptake is lower among people who are homeless or unstably housed compared to those who are housed. Understanding and addressing this is essential…

Abstract

Purpose

Globally, hepatitis C treatment uptake is lower among people who are homeless or unstably housed compared to those who are housed. Understanding and addressing this is essential to ensure no one is left behind in hepatitis C elimination efforts. This study aims to explore peoples’ experiences of unstable housing and health care, and how these experiences influenced engagement in hepatitis C treatment.

Design/methodology/approach

Purposive sampling was used to recruit people with lived experience of injection drug use, hepatitis C and unstable housing in Melbourne, Australia. In-depth semistructured interviews were conducted and a case study approach with interpretative phenomenological analysis was used to identify personal experiential themes and group experiential themes.

Findings

Four people were interviewed. The precarious nature of housing for women who inject drugs was a group experiential theme, however, this did not appear to be a direct barrier to hepatitis C treatment. Rather, competing priorities, including caregiving, were personal experiential themes and these created barriers to treatment. Another group experiential theme was “right place, right time, right people” with these three elements required to facilitate hepatitis C treatment.

Originality/value

There is limited research providing in-depth insight into how personal experiences with unstable housing and health care shape engagement with hepatitis C treatment. The analyses indicate there is a need to move beyond a “one size fits-all” approach to hepatitis C care. Instead, care should be tailored to the needs of individuals and their personal circumstances and regularly facilitated. This includes giving greater attention to gender in intervention design and evaluation, and research more broadly.

Details

Drugs, Habits and Social Policy, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2752-6739

Keywords

Article
Publication date: 19 February 2024

Yixin Liang, Xuejie Ren and Lindu Zhao

The study aims to address a critical gap in existing healthcare payment schemes and care service pricing by recognizing the influential role of patients' decisions on…

Abstract

Purpose

The study aims to address a critical gap in existing healthcare payment schemes and care service pricing by recognizing the influential role of patients' decisions on self-management efforts. These decisions not only impact health outcomes but also shape the demand for care, subsequently influencing care costs. Despite the significance of this interplay, current payment schemes often overlook these dynamics. The research focuses on investigating the implications of a novel behavior-based payment scheme, designed to align incentives and establish a direct connection between patients' decisions and care costs. The primary objective is to comprehensively understand whether and how this innovative payment scheme structure influences key stakeholders, including patients, care providers, insurers and overall social welfare.

Design/methodology/approach

In this paper, we propose a game-theoretical model to incorporate the performance of self-management with the demand for healthcare service, compare the patient's effort decision for self-management and provider's price decision for healthcare service under a behavior-based scheme with that under two implemented widely payment schemes, that is, co-payment scheme and co-insurance scheme.

Findings

Our findings confirm that the behavior-based scheme incentives patient self-management more than current schemes while reducing their possibility of seeking healthcare service, which indirectly induces the provider to lower the price of the service. The stakeholders' utility under various payment schemes is sensitive to the cost of treatment and the perceived health utility of patients. Especially, patient health awareness is not always benefited provider profit, as it motivates patient self-management while diminishing the demand for care.

Originality/value

We provide a novel framework for characterizing behavior-based payment schemes. Our results confirm the need for modification of the current payment scheme to incentivize patient self-management.

Details

Kybernetes, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0368-492X

Keywords

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