A pilot study of antipsychotic prescribing decisions for acutely-Ill hospitalized patients.

Background: Evidence on antipsychotic prescribing decisions is limited. This pilot study quantified factors considered in choosing an antipsychotic and evaluated the influence of metabolic status on treatment decisions.

Methods: Prescribing decisions by 4 psychiatrists were examined based on 80 adult patients initiated on antipsychotic medication diagnosed with schizophrenia, schizoaffective disorder or bipolar disorder by DSM-IV criteria, who were admitted to an acute inpatient psychiatric program of an urban Veterans Affairs Medical Center.

Why patients sign out against medical advice (AMA): factors motivating patients to sign out AMA.

A retrospective review of the against medical advice (AMA) discharges revealed that the majority of the patients left AMA for personal reasons, i.e., sickness or death in the family; reconciliation with spouse, girl friend, or family members; financial problems; and legal issues such as a court date.

Nicotine intervention during detoxification and treatment for other substance use.

This preliminary study evaluated the efficacy of a brief smoking cessation intervention (30 controls, 34 intervention groups) on a smoke-free inpatient unit for substance use detoxification. Controls received usual care, including the transdermal nicotine patch and referral to an outpatient smoking program. The intervention group additionally received a structured motivational enhancement program.

Survey of hepatitis B and C in addiction treatment unit.

The survey on our unit revealed that 80% of injection drug users (IDUs) had hepatitis B core antibody (HBcAB), and 90% had hepatitis C virus antibody (HCVAB). Less than half of each group did not know or were unsure of the mode of transmission and spread of HCV. These findings emphasize the need to focus on education, especially about transmission of hepatitis B and C infection in drug addicts, particularly IDUs.