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Abstract for poster sessions / European Psychiatry 22 (2007) S101eS220
Aim: Purpose of this study was to investigate patients perspective on
service quality and their satisfaction with services. Also to ensure that
the standards relating to patient assessment and treatment are adhered
to and to ensure that all patients have the opportunity to comment on
the services and that patient opinions are considered in future service
planning.
Method: An 8 items patient satisfaction questionnaire was devised by the author and was distributed to residents on discharge
from two rehabilitation wards. Fifteen questionnaires were completed
in the 18 month period.
Results: Out of total of 15 cases, 53% were female and 47% male
patient. Their mean age was 37.5 years and their mean length of stay
in the rehab ward was 23 months. All patients were satisfied with admission process and environment of the wards. Significant majority
satisfied with treatment received. To 87% this was their first admission to the rehab unit and the 93% reported that they would recommend the rehabilitation ward to a friend or relative and that they
would use this unit again in the future.
Conclusion: Central issue emerged whether the patient was satisfied or dissatisfied with the care they recieved but they all suggested
that the quality of care between the patients and individual member of
staff were central to the quality of the care. The high quality therapeutic relationship and caring environment is the essence of satisfaction
and it may determine the outcome of psychiatric treatment.
P233
United Kingdom 2 St George’s University of London, London,
United Kingdom 3 Institute of Psychiatry, London, United Kingdom
Background: In the UK, Black and minority ethnic (BME) patients
have been reported to be disproportionately detained under the Mental Health Act.
Aims: Systematic review of all UK literature on ethnicity and detention with meta-analysis of detention rates for BME patients, to determine range of explanatory hypotheses and examine the evidence
for these hypotheses
Methods: Electronic data bases searched for all date-based studies
(1984-2005). Meta-analyses performed where data available. Explanations offered for any excess categorised and evidence examined.
Results: 49 studies identified, 19 included in meta-analyses. Compared with White patients, Blacks were 3.83 times, BME patients
3.35 times and Asians 2.06 times more likely to be detained. Racial
stereotyping and discrimination against BME patients was the most
often cited explanation (53% studies); followed by alienation and
mistrust of psychiatric services (28%); higher rates of psychosis
(22%); delay in help seeking (18%); and misdiagnosis/ under recognition of illness (16%). There was no primary evidence provided by
any study to confirm any of these explanations, while some papers
presented data that contradicted these explanations.
Conclusions: BME patients experience higher rates of detention
under the MHA than White patients. Available explanations offered
for this excess are largely unsupported. Explanations such as ‘institutional racism’ in psychiatry neither accurately account for the excess,
nor help find ways of reducing detention rates.
An audit of risperidone long acting injection in Lincolnshire, UK
A. Singh 1, S. Lugg 2. 1 Lincolnshire Partnership Trust, Department
of Psychiatry, Pilgrim Hospital, Lincoln, United Kingdom 2 Pilgrim
Hospital, Lincoln, United Kingdom
Risperidone long acting injection (RLAI) is the first injectable atypical antipsychotic to be licensed in the UK. This study reports the outcomes of patients prescribed RLAI in Lincolnshire Partnership Trust
during two years period following its launch.
Aim and methodology: That RLAI are prescribed appropriately
and patients are monitored on an ongoing basis. An audit tool was
sent to each psychiatrist, data were collected retrospectively on 28
patients.
Results: Out of 28 patients 19 still taking RLAI. Data not available on one patient. All patients had received oral atypical prior to
RLAI. 23 were exposed to oral Risperidone. 80% reported significant
improvement only 5 experienced mild side effects. 21 suffered from
Schizophrenia and 6 from Bipolar Affective Disorder. At the time of
initiation, 25 in patients and 3 in community. Significant improvement noted 2 months and 7 months after initiation. All of them
were monitored regularly.
Conclusions: RLAI appears well tolerated and markedly effective
in vast majority of patients only 3 patients showed negative response.
RLAI can offer considerable benefit to a significant number of patients suffering from Schizophrenia and Bipolar Affective Disorder
with psychotic symptoms.
P234
Ethnicity and detention in the UK: A systematic review and metaanalysis
S.P. Singh 1, N. Greenwood 2, S. White 2, R. Churchill 3. 1 Health
Sciences Research Institute, University of Warwick, Coventry,
P235
Review of the evidence for the long-term efficacy of atypical antipsychotic agents in the treatment of patients with schizophrenia and related psychoses
D.W. Stewart 1, M.S. Turner 2. 1 Department of General Psychiatry,
NHS/Ravenscraig Hospital, Greenock, Scotland 2 Department of
General Psychiatry, NHS/The Larkfield Centre, Glasgow, Scotland
In schizophrenia, the objectives of long-term maintenance therapy are
to achieve continuous relief from psychotic symptoms, to prevent relapse, to optimize patient functioning and improve quality of life. It is
now generally accepted that atypical antipsychotic agents are more
effective than conventional agents in achieving these goals over the
short term. In order to define the role of atypical antipsychotics as
maintenance treatment for schizophrenia, studies published between
January 1994 and September 2006 that evaluated the long-term efficacy (>1 year) of atypical antipsychotics were identified and reviewed from literature searches using MEDLINE and EMBASE.
The primary research parameters were ‘atypical’, ‘antipsychotic’,
‘schizophrenia’, ‘relapse’, ‘long-term’, ‘maintenance’ and ‘efficacy’.
Aspects of safety were also considered for these agents. Results from
these long-term studies consistently demonstrated that atypical antipsychotics have substantial advantages over oral conventional antipsychotics as proven by fewer relapses, more effective symptom
control and a lower incidence of movement disorders, although
some atypical agents were associated with a higher incidence of
weight gain.
However, due to issues of compliance, the clinical advantage of oral
atypical antipsychotics has often been limited. As such, the use of longacting preparations of atypical antipsychotics, which provide consistent
and sustained drug coverage, warrants further investigation for the successful long-term management of patients with schizophrenia.