Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-20T17:34:20.186Z Has data issue: false hasContentIssue false
  • English
  • Français

Multidisciplinary review to identify patients who could be managed in primary care

Published online by Cambridge University Press:  13 June 2014

Vincent IO Agyapong ,
Olorunfemi Ahmodu  and
Allys Guerandel
Vincent IO Agyapong
Affiliation:
Dept of Psychiatry, School of Medicine, University of Dublin, Trinity College and St Patrick's University Hospital, James's Street, Dublin 8, Ireland
Olorunfemi Ahmodu
Affiliation:
St Vincent's University Hospital, Dublin 4, Ireland
Allys Guerandel
Affiliation:
St Vincent's University Hospital, Dublin 4, Ireland
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: Primary care teams have the potential to deliver much of the care currently provided by specialist services. The aim of this review was to determine from patients' clinical records and multidisciplinary team discussions, those that may be suitable for discharge back into primary care.

Methods: A retrospective review of the clinical notes of all patients attending a psychiatric outpatient clinic was carried out by all members of the multidisciplinary team to determine the appropriateness of continuing to provide psychiatric services in a specialised psychiatric clinic rather than in a primary care setting, taking into account the patients demographic and clinical variables.

Results: It was recommended that 60% of all the patients needed to continue attending the local mental health service, 35.2% could be discharged back into primary care for continuing management whilst the remaining 4.8% could be managed jointly between primary care and the community mental health service. The bulk of the patients recommended for discharge into primary care had a diagnosis of anxiety disorder or depression and all of them had been stable on their treatment for more than six months.

Conclusion: Regular multidisciplinary team review has a potential to identify patients who could be discharged back into primary care.

Keywords

Primary careMental healthSpecialised psychiatric services
Type
Brief Reports
Information
Irish Journal of Psychological Medicine , Volume 28 , Issue 3 , September 2011 , pp. 138 - 140
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Rodenburg, H, Bos, V, O'Malley, Cet al.General practice care of enduring mental health problems: an evaluation of the Wellington Mental Health Liaison Service. NZ Med J 2004 Sep 24; 117(1202): U1077.Google ScholarPubMed
2.Gask, L. Overt and covert barriers to the integration of primary and specialist mental health care. Soc Sci Med 2005; 61: 1785–1794CrossRefGoogle Scholar
3. Primary Care – A New Direction, Quality and Fairness – A Health System for You – Health Strategy (Assessed online Sept 1, 2010 at www.dohc.ie/publications/pdf/primcare.pdf?direct=1)Google Scholar
4.Creed, F, Marks, B. Liaison psychiatry in general practice: a comparison of the liaison-attachment scheme and shifted outpatient models. J R Coll Gen Pract 1989 Dec; 39(329): 514–7.Google Scholar
5.Strathdee, G, McDonald, E. Innovations: establishing psychiatric attachments to general practice: a six stage plan. Psychiatr Bull 1992; 154: 72–6.Google Scholar
6.England, E, Lester, H. Integrated mental health services in England: a policy, paradox? Int J Integrated Care 2005 Oct 3; 5. ISSN 1568-4156. www.ijic.org/CrossRefGoogle Scholar
7.Watters, L, Gannon, M, Murphy, D. Attitudes of general practitioners to the psychiatric services. Ir J Psych Med 1994; 11: 44–46.CrossRefGoogle Scholar
8. Statement of Strategy 2008 – 2010 Department of Health and Children, May 16, 2008. (Assessed online Sept 6, 2010 www.dohc.ie/publications/pdf/en_strategy08.pdf?direct=1)Google Scholar
9. Primary care model – a description. Department of Health and Children (Assessed online Sept 6, 2010 www.dohc.ie/publications/pdf/primcare.pdf?direct=1)Google Scholar
10.Crosse, C. A meaningful day: integrating psychosocial rehabilitation into community treatment of schizophrenia. Med J Aust 2003 May 5; 178 Suppl: S76–8.Google ScholarPubMed
11.Brown, J Belle, Lent, B, Stirling, A, Takhar, J, Bishop, J. Caring for seriously mentally ill patients – Qualitative study of family physicians' experiences. Can Fam Physician 2002; 48: 915–920.Google ScholarPubMed
12.Wilkinson, G. The role of primary care physicians in the treatment of patients with long-term mental disorders. Int Rev Psychiatry 1991; 3: 35–42.CrossRefGoogle Scholar
13.Katon, W, Gonzales, J. A review of randomized trials of psychiatric consultationliaison studies in primary care. Psychosomatics 1994; 35: 268–78.CrossRefGoogle ScholarPubMed
14.Mental After Care Association. First national GP survey of mental health in primary care. London: MACA; 1999.Google Scholar
15.Rodenburg, H, Bos, V, O'Malley, C, McGeorge, P, Love, T, Dowell, A. General practice care of enduring mental health problems: an evaluation of the Wellington Mental Health Liaison Service. J NZ Med Ass 2004 Sept 24; 117(1202)Google ScholarPubMed
16.Kendrick, T, Sibbald, B, Burns, T, Freeling, P. Role of general practitioners in care of the long term mentally ill patients. BMJ 1991; 302: 508–10.CrossRefGoogle ScholarPubMed
17.Burns, T, Greenwood, N, Kendrick, T, Garland, C. Attitudes of general practitioners and community mental health team staff towards the locus of care for people with chronic psychotic disorders. Prim Care Psychiatry 2000; 6: 67–71.CrossRefGoogle Scholar
18.Bindman, J, Johnson, S, Wright, Set al.Integration between primary and secondary services in the care of the severely mentally ill: patients' and general practitioners' views. Br J Psychiatry 1997; 171: 169–74.CrossRefGoogle ScholarPubMed
19.Kates, N, Craven, M, Crustolo, Aet al.Integrating Mental Health Services Within Primary Care – A Canadian Program. Gen Hosp Psychiatry 1997; 19: 324–332.CrossRefGoogle ScholarPubMed