Publications by authors named "Junji Takeshita"

Objectives: Addressing the methamphetamine epidemic will require a more complete understanding of its effect on healthcare systems and of the populations at risk. The objective of the study was to assess the impact of methamphetamine use on psychiatric emergency services outcomes and on Asian American (AA) and Pacific Islander (PI) populations, a historically overlooked population in substance use research.

Methods: A retrospective chart review was performed for all visits to a large level I trauma center in urban Hawaii from 2007 to 2019 that required psychiatric emergency services and in which urine drug screening was completed (N = 44,658).

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Article Synopsis
  • Evergreening refers to the tactics used by pharmaceutical companies to extend patent protections and maximize profits from brand name drugs after their initial patents expire.
  • These practices often lead to higher prices for psychotropic medications without necessarily improving their effectiveness, ultimately restricting access and utilization for patients.
  • A systematic review identified 11 strategies for evergreening, with case studies showing that some psychiatric medications can cost up to 211 times more than their original price, creating inefficiencies in healthcare and potentially lowering the quality of patient care.
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Objective: This study explored factors influencing a physician's choice to pursue geriatric psychiatry fellowship training from fellow and program director perspectives to improve recruitment into this critical need specialty.

Methods: Questionnaires were sent to the 54 fellows and 79 fellowship program directors of programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) available through the American Association for Geriatric Psychiatry (AAGP) listserv. A 5-point Likert scale (strongly disagree, disagree, neutral-undecided, somewhat agree, strongly agree) was used to score and rank these questionnaires.

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Evidence suggests that interdisciplinary care leads to improvements in patient care and efficiency. To determine whether integrating inpatient hospital behavioral health services would result in improved perceptions of patient care and efficiency, team members (N = 23) were surveyed 1 year after integration on measures of patient care, efficiency, and personal satisfaction. A majority of respondents believed integration improved patient care and efficiency.

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Background: The simultaneous use of dementia medications and anticholinergic medications occurs frequently. Cholinesterase inhibitors and anticholinergic medications likely counteract one another, potentially exposing patients to medications with decreased benefit, more adverse effects, and higher cost of care. We identified the rate of concurrent prescriptions of cholinesterase inhibitors/memantine with anticholinergics in an urban hospital setting with a large Asian and Pacific Islander population.

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Previous studies have shown significant ethnic differences in prescribing patterns of two or more antipsychotics. This study examined changes in atypical and typical antipsychotic prescriptions among Asian Americans and Pacific Islanders. Five hundred consecutive charts were reviewed for antipsychotics at the time of admission and discharge from each of two inpatient psychiatric facilities in Hawai'i.

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Intergenerational longitudinal studies over the lifespan provide valuable information for understanding the contexts and dynamic relations among cognition, family and health in adults and the elderly. The Hawai'i Family Study of Cognition (HFSC), initiated in the early 1970s, included a cohort of over 6500 individuals representing over 1800 families of parents and their offspring. The HFSC gathered data on cognitive, personality, biological and other psychosocial variables, and provided novel information on the nature of cognitive abilities, especially on family issues.

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Objectives: Minimal research has been done on sociodemographic differences in utilization of electroconvulsive therapy (ECT) for refractory depression, especially among Asian Americans and Pacific Islanders.

Methods: This study examined sociodemographic and diagnostic variables using retrospective data from Hawaii, an island state with predominantly Asian Americans and Pacific Islanders. Retrospective data were obtained from an inpatient and outpatient database of ECT patients from 2008 to 2010 at a tertiary care community hospital on O'ahu, Hawaii.

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Underserved populations often utilize the emergency room in place of primary care, particularly for short term behavioral health services. This study examined emergency department (ED) utilization rates for rurality, insurance, sex, and ethnicity in a large sample of adult patients in Hawai'i hospitals from 2000-2010 with a diagnosis of post-traumatic stress disorder (PTSD), mood disorder, or other anxiety disorder. Findings showed a higher rate of use by rural and suburban residents with a diagnosis of PTSD or other anxiety than by urban residents.

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Objective: Generalized anxiety disorder (GAD) is common, chronic, and debilitating. Treatment with benzodiazepines and newer antidepressants is often inadequate. This article reviews the effectiveness of alternative and augmenting medications, such as older antidepressants, antipsychotics, anticonvulsants, and β-blockers.

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Objective: : Sociocultural factors have been implicated in affecting prevalence, incidence, and diagnosis of depression but previous studies have included heterogeneous ethnic populations. We studied the influence of cultural assimilation on the prevalence and presentation of depressive symptoms in elderly Japanese American men.

Method: : This analysis was based on 3,139 Japanese American men aged 71-93 years who were participants in the Honolulu-Asia Aging Study between 1991 and 1993.

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Objective: Previous studies involving prescriptions of monoamine oxidase inhibitors (MAOIs) have focused on predominantly Caucasian populations with little representation of Asian Americans and Pacific Islanders. The Asian American diet includes tyramine-rich fermented food items. This study describes the characteristics of MAOI prescribing patterns in Hawaii, a state with predominantly Asian Americans and Pacific Islanders.

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Objective: The purpose of this paper was to review alternative formulations, delivery methods, and administration options for psychotropic medications in elderly patients with behavioral and psychological symptoms of dementia (BPSD).

Methods: A MEDLINE search was conducted initially in December 2008 and was updated in September 2009, including the search terms pharmacologic treatment and dementia, behavioral and psychological symptoms of dementia, alternative psychotropic medication formulations, alternative dosing methods of medication, drug delivery options, antidepressants and dementia, anxiolytics and dementia, antipsychotics and dementia, mood stabilizers and dementia, cognitive enhancers and dementia, medications and enteral feeding tubes, and hiding medication. Studies were limited to English-language articles dated from 1950 to 2009.

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