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PubMedDate not supplied

[Functional status and quality of life in Latin American outpatients with schizophrenia treated with atypical or typical antipsychotics: outcomes of the 12 months schizophrenia outpatient health outcomes (IC-SOHO) Study].

OBJECTIVE: Functional status and quality of life outcomes in Latin American outpatients with schizophrenia were compared after 12 months of monotherapy treatment with olanzapine, risperidone or typical antipsychotics. METHOD: Both outcomes were assessed as part of a prospective, large (N= 7658), international (27 countries), observational study. RESULTS: from the Latin American subpopulation (N= 2671; 11 countries) are presented. Compared to typical antipsychotics, olanzapine and risperidone were associated with significantly (p < 0.05) greater odds of employment and social activity, and significantly greater improvements in quality of life. Olanzapine was also associated with significantly greater odds of living independently, compared to typical antipsychotics. CONCLUSION: This study indicates that functional status and quality of life outcomes are likely to be more favorable when Latin American outpatients with schizophrenia are treated with olanzapine or risperidone monotherapy, rather than typical antipsychotics.

Adult↗
PubMed2005

Use of concomitant medication with antipsychotic treatment in outpatients with schizophrenia: results from the European Schizophrenia Outpatients Health Outcomes (SOHO) study.

Use of concomitant medications with antipsychotic agents in the treatment of schizophrenia is common but lacks a clear scientific rationale. We evaluated concomitant medication usage during the first 6 months of the prospective, observational, European Schizophrenia Outpatient Health Outcomes (SOHO) study, examining its frequency, variation according to type of antipsychotic drug used, and impact on treatment tolerability. We also determined factors that were associated with concomitant medication use. The use of concomitant medications differed greatly among the countries participating in the SOHO study. The presence of depressive symptoms and being female were associated with the use of concomitant antidepressants. Certain antipsychotics were associated with less use of concomitant medications: significantly fewer olanzapine-, quetiapine- and clozapine-treated patients used concomitant anticholinergics or anxiolytics/hypnotics. Patients using concomitant medications had an increased incidence of sexually related side effects and extrapyramidal side effects (EPS) at 6 months follow-up compared with patients not using concomitant medications. The results should be interpreted conservatively due to the observational design of SOHO.

Adult↗
PubMed1987

Patterns of outpatient consultation: a survey of outpatients attending a metropolitan psychiatric hospital.

A survey of all outpatients (n = 1135) attending a regional psychiatric hospital during a 3-month period. Psychoses constituted 72% and non-psychotic disorders 25%. Psychoses had a greater proportion of long-term attenders while non-psychotic disorders, though frequent (43%) among recent attenders, showed a high attrition rate. Demographic characteristics, patterns of attendance, selected clinical features, level of functioning and difficulties of management of the different diagnostic groups are presented and discussed. Reasons are adduced to explain why patients who were deemed suitable for transfer to other care had not been discharged from hospital. Steps taken to reduce the patient load and increase the efficiency of the services are described.

Adolescent↗
PubMed2001

The use of outpatient parenteral antimicrobial therapy in the management of osteomyelitis: data from the Outpatient Parenteral Antimicrobial Therapy Outcomes Registries.

Because osteomyelitis requires lengthy parenteral antibiotic treatment in patients who are often otherwise healthy, it lends itself well to outpatient parenteral antibiotic therapy (OPAT). Four delivery models for OPAT are (1) self-administration at home, (2) administration by a visiting nurse in the home, (3) infusion center and (4) nursing home. Patient selection is critical to the success of any OPAT program. Clinical and microbiologic data were compiled for more than 500 osteomyelitis patients reported in a registry of OPAT cases in the United States. The most commonly isolated pathogen was Staphylococcus aureus. The antibiotics used most frequently were vancomycin and ceftriaxone. Of 255 patients assessed for bacteriologic outcome, 2 patients developed infection with a new organism and 2 failed to eliminate the causative organism by the end of OPAT therapy. Of 266 patients who were assessed for clinical outcome, 259 improved and 7 failed. Data collected by the OPAT Outcomes Registry confirms that osteomyelitis can be safely and effectively treated with intravenous antibiotics outside the hospital.

Aged↗
PubMed2005

[Management of cancer chemotherapy for outpatients--effectiveness of using cancer chemotherapy protocol database for outpatients].

The present study investigated that a cancer chemotherapy protocol registration system was a safe management of cancer chemotherapy for outpatients. A protocol database was made with a personal computer and 122 protocols for 15 diseases were registered until the end of April 2005. As a result, it was easy to check injection prescriptions. Sixty-one errors including 13 dosage errors for 2409 prescriptions were corrected. The time to check prescriptions were shortened, preparation and dosage mistakes were prevented, and stocking drug decreased by dissolution liquids being made with a standardization of using the same bottle (the cost of stocking drug: 40,418 yen). Therefore, the system and database are effective in raising safety of treatments and an increase in efficiency.

Ambulatory Care↗
PubMed2002

Prescription of hypnotics and tranquilisers at the Geneva prison's outpatient service in comparison to an urban outpatient medical service.

OBJECTIVES: Examine whether an overconsumption of tranquillizers exists in prison and discuss possible reasons. METHODS: Comparative study during three weeks at Geneva: prison outpatient service and Medical Policlinic (MP) of the University Hospital. RESULTS: When comparing the 113 (prison) and 151 (MP) male patients younger than 39 years, we found important differences concerning the quality and quantity of prescriptions of psychoactive drugs: ten times more prison patients than patients from the MP were treated with benzodiazepines (BZD). The differences persisted even when considering only prisoners who were not known to be street drug, alcohol or long time BZD consumers. CONCLUSIONS: The differences cannot be explained by the high percentage of drug addicts in prison. Our results suggest the importance of factors related to the prison environment.

Adult↗
PubMed1983

EEG sleep in outpatients with generalized anxiety: a preliminary comparison with depressed outpatients.

To develop further perspective on the psychophysiology of generalized anxiety disorder and primary depression, all-night electroencephalographic (EEG) sleep measures in outpatients with diagnoses of generalized anxiety disorder and primary (nondelusional) depression were compared. Both groups had difficulty initiating and maintaining sleep, and diminished amounts of slow-wave sleep. Compared to patients with generalized anxiety disorder, depressives had a shorter rapid eye movement (REM) latency, greater REM sleep percent and eye movement activity, and a different temporal distribution of REM sleep. Anxious patients showed few changes from first to second night, whereas depressives showed increases in several REM sleep indexes. The combination of REM sleep latency and REM percent correctly classified 86.7% of patients. These data may provide a more direct measure of central nervous system arousal and sleep/wake function than previous studies in the psychophysiology of anxiety. They also lend support to the clinical distinction between generalized anxiety disorder and primary depression and to the classification of anxiety states as disorders of initiating and maintaining sleep.

Adult↗
PubMed1985

Are American psychiatric outpatients more depressed than Chinese outpatients?

It has often been suggested that Americans tend to seek psychiatric help for depression, whereas Chinese patients are more likely to have somatic symptoms of emotional disturbance. When the authors tested this assumption by studying 99 Taiwanese and 97 American psychiatric outpatients given computerized diagnoses based on information obtained in a standard psychiatric interview schedule, they found that the Chinese patients scored higher on the measures of somatization but also on the measures of depression.

Adolescent↗
PubMedDate not supplied

Reversal of the central effects of midazolam by intravenous flumazenil after general anesthesia in outpatients premedicated with an opioid and a muscle relaxant: report of a multicenter double-blind clinical study. The Flumazenil in General Anesthesia in Outpatients Study Group II.

Flumazenil was studied in a double-blind multicenter trial to confirm its efficacy and safety in antagonizing the central effects of benzodiazepines after general anesthesia (midazolam, short-acting narcotic, nitrous oxide) with muscle relaxants and selected potent volatile anesthetics as needed. One hundred seventy-two outpatients were randomly assigned to receive either flumazenil or placebo titrated to the point of reversal of sedation or a maximum dose of 1 mg of flumazenil or 10 ml of placebo. The test drug was given intravenously (0.2 mg flumazenil or 2 ml placebo) at 1-minute intervals. Tests of alertness, psychomotor function, and memory were conducted prestudy and at baseline before the administration of flumazenil and at 5-, 15-, 30-, 60-, 120-, and 180-minute intervals after administration. The changes from prestudy or baseline scores were analyzed to compare differences between treatment groups. Seventy-five percent of the 105 flumazenil-treated patients and 14% of the 55 placebo-treated patients who met the qualifications for efficacy evaluations obtained a criterion level of response as measured by the Observer's Assessment of Alertness/Sedation Scale. Most (76%) patients who were alert at 5 minutes maintained their level of wakefulness throughout the 180-minute observation period. All 172 patients were included in evaluations of safety. Fifty percent of 113 flumazenil-treated patients and 31% of 59 placebo-treated patients reported one or more adverse experiences. The most frequently reported were nausea, vomiting, and dizziness. Only 6 adverse effects in the flumazenil group and 1 in the placebo group were considered severe; the remainder were mild or moderate. None were considered serious or potentially serious. Postoperative administration of flumazenil (mean dose, 0.85 mg) safely provided a prompt, controlled reversal of the sedative and psychomotor effects of midazolam in most patients.

Adult↗
PubMedDate not supplied

Reversal of the central effects of midazolam by intravenous flumazenil after general anesthesia in outpatients: a multicenter double-blind clinical study. The Flumazenil in General Anesthesia in Outpatients Study Group I.

In a US double-blind, multicenter study, flumazenil, a benzodiazepine antagonist, administered postoperatively in a mean intravenous dose of 0.67 mg (range, 0.2 to 1 mg), was superior to placebo in reversing sedation and other central nervous system effects of benzodiazepines in outpatients recovering from general anesthesia induced by midazolam, fentanyl or sufentanil, and nitrous oxide. Within 5 minutes after administration of flumazenil, sedation was reversed in 94% (87 of 93) of flumazenil-treated patients, compared with 13% (6 of 46) of placebo-treated patients. The criterion response (Observer's Assessment of Alertness/Sedation Scale score of 4 or 5) that was achieved at 5 minutes was maintained in 79 (93%) of 85 patients throughout the 180-minute observation period. Psychomotor performance, measured by the Finger-to-Nose Test, was rated as normal at 5 minutes posttreatment for 77% (71 of 92) of flumazenil-treated patients, and 4% (2 of 46) of placebo-treated patients. The reversal of amnesia, as determined by the Picture Recall Test was less consistent. Patients given flumazenil did not experience more pain at the operative site or require more analgesic medication than did those given placebo. Nausea (flumazenil 24%; placebo 15%), dizziness (flumazenil 12%; placebo 2%), and vomiting (flumazenil 10%; placebo 9%) were the most frequent adverse effects in each group. In conclusion, flumazenil provided prompt arousal from benzodiazepine-induced sedation and was well tolerated.

Adolescent↗
PubMed2004

[Psychopharmaceutical prescriptions to older people. A comparison between patients in aged- and nursing homes, outpatient treatment with nursing care and outpatients without nursing care].

To determine, whether age, sex, grade of need of care and living in nursing homes can influence prescribing behavior in elderly. In a retrospective and longitudinal study, the pattern of psychoactive drug prescriptions of nursing home residents was compared with non-institutionalized people with and without need of care. During 1999, the computerized files of 3592 people (> 60 years), insured by a health insurance fund (BKK) in Berlin, Germany, were obtained. Nursing home residents received significantly more prescriptions of psychoactive drugs than the others, especially more neuroleptics (40.1% versus 12.4% and 7.4%). Quality of prescriptions seemed to be higher in nursing homes (use of drugs with fewer side effects and less possible interactions), psychoactive drug prescriptions were given more frequently by psychiatrists and neurologists (37%). Non-institutionalized patients received them most from general practitioners (45%). Women received more prescriptions of psychoactive drugs than male patients. With rising grade of need of care, proportionately more patients received psychoactive drugs. The results of this study show some evidence of the lacking quality in the prescriptions of psychopharmaceuticals to the elderly.

Age Distribution↗