Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-08T07:26:24.631Z Has data issue: false hasContentIssue false

The use of haematological screening tests in acute psychogeriatric admissions

Published online by Cambridge University Press:  13 June 2014

Oscar Daly
Affiliation:
Lagan Valley Hospital, Lisburn, Co. Antrim, BT28 1JP, Northern Ireland

Abstract

Objective: Case notes on 116 patients aged 65 or more admitted to a general psychiatry hospital over a three month period were examined to assess the current use of haematological screening tests.

Method: Retrospective justification for tests performed, rate of abnormal results, and consequences for patient management were assessed by case note review.

Results: A total of 200 screening tests, 105 of which appeared justified, were performed; 66 patients were screened, of whom 85% had at least one abnormal result. Those who were older were less likely to be screened. There was no relationship between diagnosis and being screened. Of the 90 abnormal results received, less then one third affected clinical management.

Conclusions: The financial and other costs of screening tests are discussed. The current use of haematological screening tests in this population appears erratic and often adds little to patient management.

Type
Audits
Copyright
Copyright © Cambridge University Press 1995

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.White, AJ, Barraclough, B. Benefits and problems of routine laboratory investigation in adult psychiatric admissions. Br J Psychiatry 1989; 155: 6572CrossRefGoogle Scholar
2.Ornston, D, Schwartz, M, Smith, DC, Stem, S. Laboratory studies for every medicated outpatient: are they really necessary? Am J Psychiatry 1974; 131: 711–4.CrossRefGoogle ScholarPubMed
3.Beresford, TP, Hall, RCW, Wilson, FC, Blow, F. Clinical laboratory data in psychiatric outpatients. Psychosom 1985; 26: 731–4.CrossRefGoogle ScholarPubMed
4.Sweer, L, Martin, DC, Ladd, RA, Miller, JK, Karpf, M. The medical evaluation of elderly patients with major depression. J Gerontol 1988; 43: M53–8.CrossRefGoogle ScholarPubMed
5.Ouslander, JG. Physical illness and depression in the elderly. J Am Geriatr Soc 1982; 30: 593–9.CrossRefGoogle ScholarPubMed
6.Fowkes, FGR. Containing the use of diagnostic tests. BMJ 1985; 290: 488–9.CrossRefGoogle ScholarPubMed
7.Willett, AB, King, T. Implementation of laboratory screening procedures on a short term psychiatric inpatient unit. Dis Nerv Sys 1977; 38: 867–70.Google ScholarPubMed
8.Martin, RL, Cloninger, CR, Guze, SB, Clayton, PJ. Mortality in a follow-up of 500 psychiatric outpatients. Arch Gen Psychiatry 1985; 42: 4754.CrossRefGoogle Scholar
9.Eastwood, MR, Trevelyan, MH. Relationship between physical and psychiatric disorder. Psychol Med 1972; 2(4): 363–72.CrossRefGoogle ScholarPubMed
10.Larson, E, Reifler, BV, Featherstone, HJ, English, DR. Dementia in elderly outpatients: a prospective study. Ann Intern Med 1984; 100: 417–23.CrossRefGoogle ScholarPubMed
11.Thomas, CJ. The use of screening investigations in psychiatry. Br J Psychiatry 1979; 135: 6772.CrossRefGoogle ScholarPubMed
12.Colgan, J, Philpot, M. The routine use of investigations in elderly psychiatric patients. Age Ageing 1985; 14: 163–7.CrossRefGoogle ScholarPubMed
13.Burke, AW. Physical disorder among day hospital patients. Br J Psychiatry 1978; 133: 22–7.CrossRefGoogle ScholarPubMed
14.Honig, A, Pop, P, Tan, ES, Philipsen, H, Romme, MAJ. Physical illness in chronic psychiatric patients from a community psychiatric unit. Br J Psychiatry 1989; 155: 5864.CrossRefGoogle ScholarPubMed
15.Enns, M, Ross, C, Clark, P. Thyroid screening tests in psychiatric inpatients. Gen Hosp Psychiatry 1992; 14: 334–9.CrossRefGoogle ScholarPubMed
16.Hein, MD, Jackson, IM. Review: thyroid function in psychiatric illness. Gen Hosp Psychiatry 1990; 12: 232–44.CrossRefGoogle ScholarPubMed
17.Gewirtz, GR, Malaspina, D, Hatterer, JA, et al.Occult thyroid dysfunction in patients with refractory depression. Am J Psychiatry 1988; 145: 1012–4.Google ScholarPubMed
18.Consensus Conference. Differential diagnosis of dementing diseases. JAMA, 1987;258:3411–6.CrossRefGoogle Scholar
19.O'Neill, T, McCaffrey, B. Further support from an Irish psychiatric hospital for lack of value of routine serological tests for syphilis. Ir J Psychol Med 1989; 6: 142.CrossRefGoogle Scholar
20.Boodhoo, JA. Syphilis serology in a psychogeriatric population – is the effort worthwhile? Br J Psychiatry 1989; 155: 259–62.CrossRefGoogle Scholar
21.Kinghorn, G. The re-emergence of syphilis. Br J Hosp Med 1993; 49: 684–5.Google ScholarPubMed
22.Sheline, Y, Kehr, C. Cost and utility of routine admission laboratory testing for psychiatric inpatients. Gen Hosp Psychiatry 1990; 12: 329–34.CrossRefGoogle ScholarPubMed
23.Sox, HC, Maguilies, I, Sox, CH. Psychologically mediated effects of diagnostic tests. Ann Intern Med 1981; 95: 680–5.CrossRefGoogle ScholarPubMed
24.White, A. Psychiatrists' use of investigations. Psychiatr Bull 1988; 12: 430–3.CrossRefGoogle Scholar