Self-reported health-related quality of life of mental health service users with serious mental illness in New Zealand.

Introduction: Although people with serious mental illness (SMI) have a high prevalence of physical illness, health-related quality of life (HQoL) has not been sufficiently explored.

Aim: To explore the self-reported HQoL of mental health service users in New Zealand.

Methods: Responses on the Medical Outcomes Study 36 Item Short Form (SF-36) measure of HQoL from 404 adult mental health service users in a metropolitan district health board area in New Zealand were analysed and compared to a representative sample of the general population.

Five-year follow-up of an acute psychiatric admission cohort in Auckland, New Zealand.

Aim: This paper describes a follow-up of acute psychiatric hospital contact in Auckland, New Zealand for an admission cohort in the 5-years past an index admission (published in the NZMJ in 2005).

Methods: A 5-year follow-up study of hospital psychiatric service utilisation by 924 patients admitted (index admission) in Auckland during 2000. Hospital admissions within New Zealand for this population were extracted from electronic records.

Towards quality Pacific services: the development of a service self-evaluation tool for Pacific addiction services in New Zealand.

Objectives: To describe the development and use of a quality improvement service self-evaluation tool within Pacific addiction services in New Zealand.

Methods: The study involved two phases: (i) a development phase; and (ii) a testing phase. In Phase I, a preliminary tool was developed and piloted with two Pacific addiction drugs services.

Barriers and solutions to implementing metabolic risk assessment in a secondary mental health service.

Objectives: The aim of this study is to understand the barriers and resulting solutions encountered by mental health service staff during the implementation of a metabolic risk assessment programme.

Method: Semi-structured qualitative interviews were held with key programme staff. Thematic analysis was performed on the resulting data.

Implementing metabolic risk assessment in a secondary care mental health service.

Objectives: The aim of this study was to describe a metabolic risk assessment programme that was established by community mental health teams working within one locality of a District Health Board in Auckland.

Conclusions: Physical health disparities between people with serious mental illness and the general population are of great concern. We have described a systematic way to engage with clients about the prevention of two important contributors to these disparities: cardiovascular disease and diabetes mellitus.

Clinician experiences of employing the AmpliChip® CYP450 test in routine psychiatric practice.

These findings are from a qualitative study examining clinician experiences of employing the AmpliChip® CYP450 test in psychiatric practice. One hundred tests were made available to secondary care mental health service clinicians commencing patient treatment with risperidone across three District Health Boards within New Zealand. Feedback was sought on clinicians' (n = 33) experiences of ordering the test and receiving results, utilization of results, and perceived advantages and disadvantages.

An investigation into whether clients and/or their respective clinicians are aware of pending service exit in the first two months of treatment admission.

Introduction And Aims: When a client exits an alcohol and other drug (AOD) treatment service against clinical advice, they and their service may incur significant disadvantage. The extent of awareness by both clients and clinicians that treatment would not continue has not been examined. Accordingly, this paper presents findings from a study that sought to identify whether clients and/or their respective clinicians were aware of pending service exit that occurred within the first 2 months of treatment admission.

Explicit versus implicit review to explore combination antipsychotic prescribing.

Objective: To use structured implicit review following large-scale explicit audit of antipsychotic polyprescribing to: (1) determine the true rate of antipsychotic polytherapy that deviated from best practice for schizophrenia treatment; and (2) assess whether explicit antipsychotic polytherapy criterion was appropriate for identifying patients at risk for medication problems and assessing quality of care.

Methods: Antipsychotic prescribing was reviewed for outpatients in four public health services in Auckland, New Zealand on 31 October 2004 (T1). Schizophrenia patients in one service (n = 794) prescribed antipsychotic polytherapy (n = 84, 10.

The CYP2D6 metaboliser status of patients prescribed risperidone for the treatment of psychosis.

Aim: To identify the distribution of CYP2D6 metaboliser status in patients who were being prescribed risperidone for the treatment of psychosis in a New Zealand-based clinical population.

Method: 100 AmpliChip CYP450 Test kits were made available by Roche Diagnostics. Clinicians in mental health services across three Auckland District Health Boards were instructed that the tests were being made available for use with patients who were being prescribed risperidone for the first time.

Exploration of Pacific perspectives of Pacific models of mental health service delivery in New Zealand.

There is increasing concern about the inequalities, overall health outcomes, and mental health of Pacific peoples residing in New Zealand. The New Zealand Mental Health Survey (Te Rau Hinengaro), conducted in 2003/2004, identfied Pacific peoples as having a higher 12-month prevalence of mental disorders than the general population. The burden of mental health amongst Paqfic peoples was identified as high and associated with other socioeconomic correlates.

Mood stabilizer loading versus titration in acute mania: audit of clinical practice.

Objective: The aim of the present study was to investigate whether the use of a loading strategy with lithium or valproate followed recommended practice and second, whether this had any impact on indicators of outcome in acutely manic inpatients.

Method: A 12 month retrospective review of admissions to two adult psychiatric units in Auckland, New Zealand, was conducted. Demographic, legal status, psychiatric admissions, outcome indicators (length of stay, intensive care and seclusion use) and medication data were collected for all patients with a diagnosis of acute bipolar mania who started mood stabilizer treatment within 3 days of admission (n=93).

Ethnic comparisons of antipsychotic use in schizophrenia.

Objective: The aim of the present study was to compare ethnic groups for antipsychotic prescribing in schizophrenia over 4.5 years.

Methods: All clinical files in three mental health services caring for outpatients in Auckland, New Zealand were reviewed at two time points (T1 =31 March 2000, T2 =31 October 2004).

Outcomes for schizophrenia patients with clozapine treatment: how good does it get?

The objective of this study was to describe the extent/change (2000-2004) of clozapine prescribing in schizophrenia in New Zealand and examine the outcomes associated with increasing treatment duration, and vs. those who discontinue clozapine. Consecutive chart reviews were conducted for adult outpatients in Auckland/Northland regions (T1 = 31 March 2000, T2 = 31 October 2001, T3 = 31 March 2003, T4 = 31 October 2004).

Treatment pathway and patterns of clozapine prescribing for schizophrenia in New Zealand.

Objective: To describe the treatment pathway and patterns of clozapine use in patients with schizophrenia, including coprescribed psychotropic medications, and compare the extent of coprescribing of clozapine with that of non-clozapine schizophrenia treatment in community mental health services in the Auckland and Northland regions of New Zealand.

Methods: A retrospective chart review was conducted for adult outpatients receiving care from community mental health services on October 31, 2004. Data collected for all patients prescribed an antipsychotic included demographics (sex, age, ethnicity); principal diagnosis (Diagnostic and Statistical Manual of Mental Disorders, 4th edition); comorbid conditions; duration of mental illness; psychiatric admissions; and treatment information (psychotropic medications, with dose and route of administration).

Sociodemographic, functional and clinical correlates in outpatients with schizophrenia: comparison with affective disorders.

Objectives: To describe the demographic, social and functional characteristics and service utilization of people with schizophrenia attending four public psychiatric services in New Zealand and to compare this with (i) people with severe affective disorders attending the same four services and (ii) the New Zealand general population; and to examine conformity with evidence-based pharmacological treatment of schizophrenia.

Methods: Clinical files for all adult outpatients attending the four specialist services were reviewed in October 2004 (n =6164). Patient characteristics, social and functional indicators, diagnosis, duration of illness, and admission information were recorded and analysed for schizophrenia, bipolar disorder and depression (n =5032).

Alcohol assessment: the practice, knowledge, and attitudes of staff working in the general medical wards of a large metropolitan hospital.

Aims: To measure the prevalence of routine alcohol assessment; to assess its clinical utility in the general medical wards of a large urban hospital; and to assess medical and nursing staff knowledge with regard to standard drink measures and recommended drinking limits as well as their attitudes towards alcohol assessment.

Methods: The prevalence of alcohol assessment and the clinical utility of the resulting information was determined via a retrospective file review (n=109). The knowledge and attitudes of medical and nursing staff were measured via questionnaire (n=106).

Sedative-hypnotic treatment in an acute psychiatric setting: comparison with best practice guidance.

Objective: The aim of this study was to review treatment patterns of sedative-hypnotic agents within an acute adult inpatient psychiatric service, compare prescribing with best-practice recommendations for use and explore potential interventions.

Setting: Two urban acute inpatient psychiatric units in the Waitemata community.

Method: A retrospective review of all consecutive admissions to these two adult psychiatric units was conducted during the period 1st January to 30th June 2002.

Atypical antipsychotic use for adult outpatients in New Zealand's Auckland and Northland regions.

Aim: To outline the prescribing patterns of atypical antipsychotics for adult mental health outpatients in Auckland and Northland in 2004.

Methods: All community files were reviewed retrospectively (n = 6165). Patient characteristics, diagnosis, and antipsychotic and concurrent medication were recorded and analysed.

Trends in antipsychotic prescribing in schizophrenia in Auckland.

Objective: This study describes antipsychotic prescribing practices for outpatients with schizophrenia over a 3 year period in two large mental health catchment areas of Auckland.

Methods: All community files were reviewed at three time points. Patient characteristics, diagnosis and antipsychotic treatment information were recorded and analysed.

Pacific healthcare workers and their treatment interventions for Pacific clients with alcohol and drug issues in New Zealand.

Aim: To provide an overview of the treatment interventions and practices of Pacific alcohol and other drugs (AOD) services in New Zealand.

Methods: Face-to-face interviews were conducted with 31 Pacific staff members from 13 services registered with the Alcohol Advisory Council of New Zealand National Directory. Issues around assessment, treatment interventions, outcome measures, service structure, and resources were explored.