Risk factors associated with readmissions of patients with severe mental disorders under treatment with antipsychotics
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFMG |
Texto Completo: | https://doi.org/10.1186/s12888-022-03794-6 http://hdl.handle.net/1843/64327 https://orcid.org/0000-0002-6267-1278 https://orcid.org/0000-0002-9390-4652 https://orcid.org/0000-0003-1635-5175 https://orcid.org/0000-0003-0275-8416 |
Resumo: | Background: The aim of this study was to assess the risk of readmission in patients with severe mental disorders, compare it between patients using different types of antipsychotics and determine risk factors for psychiatric readmission. Methods: Medical records of a non-concurrent cohort of 625 patients with severe mental disorders (such as psychoses and severe mood disorders) who were first discharged from January to December 2012 (entry into the cohort), with longitudinal follow-up until December 2017 constitute the sample. Descriptive statistical analysis of characteristics of study sample was performed. The risk factors for readmission were assessed using Cox regression. Results: Males represented 51.5% of the cohort, and 75.6% of the patients had no partner. Most patients (89.9%) lived with relatives, and 64.7% did not complete elementary school. Only 17.1% used more than one antipsychotic, 34.2% did not adhere to the treatment, and 13.9% discontinued the medication due to unavailability in public pharmacies. There was a need to change the antipsychotic due to the lack of therapeutic response (11.2% of the patients) and adverse reactions to the antipsychotic (5.3% of the patients). Cox regression showed that the risk of readmission was increased by 25.0% (RR, 1.25; 95% CI, 1.03–1.52) when used typical antipsychotics, compared to those who used atypical ones, and by 92.0% (RR, 1.92; 95% CI, 1.63–2.27) when patients did not adhere to maintenance treatment compared to those who adhered. Conclusions: Use of atypical antipsychotics and adherence to treatment were associated with a lower risk of psychiatric readmissions. |
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2024-02-20T16:22:51Z2024-02-20T16:22:51Z202222https://doi.org/10.1186/s12888-022-03794-61471-244Xhttp://hdl.handle.net/1843/64327https://orcid.org/0000-0002-6267-1278https://orcid.org/0000-0002-9390-4652https://orcid.org/0000-0003-1635-5175https://orcid.org/0000-0003-0275-8416Background: The aim of this study was to assess the risk of readmission in patients with severe mental disorders, compare it between patients using different types of antipsychotics and determine risk factors for psychiatric readmission. Methods: Medical records of a non-concurrent cohort of 625 patients with severe mental disorders (such as psychoses and severe mood disorders) who were first discharged from January to December 2012 (entry into the cohort), with longitudinal follow-up until December 2017 constitute the sample. Descriptive statistical analysis of characteristics of study sample was performed. The risk factors for readmission were assessed using Cox regression. Results: Males represented 51.5% of the cohort, and 75.6% of the patients had no partner. Most patients (89.9%) lived with relatives, and 64.7% did not complete elementary school. Only 17.1% used more than one antipsychotic, 34.2% did not adhere to the treatment, and 13.9% discontinued the medication due to unavailability in public pharmacies. There was a need to change the antipsychotic due to the lack of therapeutic response (11.2% of the patients) and adverse reactions to the antipsychotic (5.3% of the patients). Cox regression showed that the risk of readmission was increased by 25.0% (RR, 1.25; 95% CI, 1.03–1.52) when used typical antipsychotics, compared to those who used atypical ones, and by 92.0% (RR, 1.92; 95% CI, 1.63–2.27) when patients did not adhere to maintenance treatment compared to those who adhered. Conclusions: Use of atypical antipsychotics and adherence to treatment were associated with a lower risk of psychiatric readmissions.Fundamento: O objetivo deste estudo foi avaliar o risco de readmissão em pacientes com transtornos mentais graves, compará-lo entre pacientes em uso de diferentes tipos de antipsicóticos e determinar fatores de risco para readmissão psiquiátrica. Métodos: Prontuários de uma coorte não concomitante de 625 pacientes com transtornos mentais graves (como psicoses e transtornos graves de humor) que receberam alta hospitalar de janeiro a dezembro de 2012 (entrada na coorte), com acompanhamento longitudinal até dezembro de 2017 constituem a amostra. Foi realizada análise estatística descritiva das características da amostra do estudo. Os fatores de risco para readmissão foram avaliados por meio da regressão de Cox. Resultados: O sexo masculino representou 51,5% da coorte e 75,6% dos pacientes não tinham companheiro. A maioria dos pacientes (89,9%) morava com familiares e 64,7% não completaram o ensino fundamental. Apenas 17,1% faziam uso de mais de um antipsicótico, 34,2% não aderiram ao tratamento e 13,9% interromperam o medicamento por indisponibilidade em farmácias públicas. Houve necessidade de troca do antipsicótico devido à falta de resposta terapêutica (11,2% dos pacientes) e reações adversas ao antipsicótico (5,3% dos pacientes). A regressão de Cox mostrou que o risco de readmissão aumentou em 25,0% (RR, 1,25; IC 95%, 1,03–1,52) quando usaram antipsicóticos típicos, em comparação com aqueles que usaram atípicos, e em 92,0% (RR, 1,92; 95% IC, 1,63–2,27) quando os pacientes não aderiram ao tratamento de manutenção em comparação aos que aderiram. Conclusões: O uso de antipsicóticos atípicos e a adesão ao tratamento foram associados a um menor risco de readmissões psiquiátricas.engUniversidade Federal de Minas GeraisUFMGBrasilFAR - DEPARTAMENTO DE FARMÁCIA SOCIALMED - DEPARTAMENTO DE MEDICINA PREVENTIVA SOCIALBMC psychiatryTranstornos mentaisAntipsicóticosReadmissão do pacienteHospitais psiquiátricosSevere mental disordersAntipsychoticsReadmissionPsychiatric hospitalRisk factors associated with readmissions of patients with severe mental disorders under treatment with antipsychoticsFatores de risco associados às readmissões de pacientes com transtornos mentais graves em tratamento com antipsicóticosinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-022-03794-6Ronaldo PortelaMilton Leonard WainbergSaulo CastelHelian Nunes de OliveiraCristina Mariano Ruasapplication/pdfinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGLICENSELicense.txtLicense.txttext/plain; charset=utf-82042https://repositorio.ufmg.br/bitstream/1843/64327/1/License.txtfa505098d172de0bc8864fc1287ffe22MD51ORIGINALRisk factors associated with readmissions of patients with severe mental disorders under treatment with antipsychotics.pdfRisk factors associated with readmissions of patients with severe mental disorders under treatment with antipsychotics.pdfapplication/pdf207284https://repositorio.ufmg.br/bitstream/1843/64327/2/Risk%20factors%20associated%20with%20readmissions%20of%20patients%20with%20severe%20mental%20disorders%20under%20treatment%20with%20antipsychotics.pdf5a341f70f634f08c9711630799b56f32MD521843/643272024-02-20 13:22:51.678oai:repositorio.ufmg.br:1843/64327TElDRU7vv71BIERFIERJU1RSSUJVSe+/ve+/vU8gTu+/vU8tRVhDTFVTSVZBIERPIFJFUE9TSVTvv71SSU8gSU5TVElUVUNJT05BTCBEQSBVRk1HCiAKCkNvbSBhIGFwcmVzZW50Ye+/ve+/vW8gZGVzdGEgbGljZW7vv71hLCB2b2Pvv70gKG8gYXV0b3IgKGVzKSBvdSBvIHRpdHVsYXIgZG9zIGRpcmVpdG9zIGRlIGF1dG9yKSBjb25jZWRlIGFvIFJlcG9zaXTvv71yaW8gSW5zdGl0dWNpb25hbCBkYSBVRk1HIChSSS1VRk1HKSBvIGRpcmVpdG8gbu+/vW8gZXhjbHVzaXZvIGUgaXJyZXZvZ++/vXZlbCBkZSByZXByb2R1emlyIGUvb3UgZGlzdHJpYnVpciBhIHN1YSBwdWJsaWNh77+977+9byAoaW5jbHVpbmRvIG8gcmVzdW1vKSBwb3IgdG9kbyBvIG11bmRvIG5vIGZvcm1hdG8gaW1wcmVzc28gZSBlbGV0cu+/vW5pY28gZSBlbSBxdWFscXVlciBtZWlvLCBpbmNsdWluZG8gb3MgZm9ybWF0b3Mg77+9dWRpbyBvdSB277+9ZGVvLgoKVm9j77+9IGRlY2xhcmEgcXVlIGNvbmhlY2UgYSBwb2zvv710aWNhIGRlIGNvcHlyaWdodCBkYSBlZGl0b3JhIGRvIHNldSBkb2N1bWVudG8gZSBxdWUgY29uaGVjZSBlIGFjZWl0YSBhcyBEaXJldHJpemVzIGRvIFJJLVVGTUcuCgpWb2Pvv70gY29uY29yZGEgcXVlIG8gUmVwb3NpdO+/vXJpbyBJbnN0aXR1Y2lvbmFsIGRhIFVGTUcgcG9kZSwgc2VtIGFsdGVyYXIgbyBjb250Ze+/vWRvLCB0cmFuc3BvciBhIHN1YSBwdWJsaWNh77+977+9byBwYXJhIHF1YWxxdWVyIG1laW8gb3UgZm9ybWF0byBwYXJhIGZpbnMgZGUgcHJlc2VydmHvv73vv71vLgoKVm9j77+9IHRhbWLvv71tIGNvbmNvcmRhIHF1ZSBvIFJlcG9zaXTvv71yaW8gSW5zdGl0dWNpb25hbCBkYSBVRk1HIHBvZGUgbWFudGVyIG1haXMgZGUgdW1hIGPvv71waWEgZGUgc3VhIHB1YmxpY2Hvv73vv71vIHBhcmEgZmlucyBkZSBzZWd1cmFu77+9YSwgYmFjay11cCBlIHByZXNlcnZh77+977+9by4KClZvY++/vSBkZWNsYXJhIHF1ZSBhIHN1YSBwdWJsaWNh77+977+9byDvv70gb3JpZ2luYWwgZSBxdWUgdm9j77+9IHRlbSBvIHBvZGVyIGRlIGNvbmNlZGVyIG9zIGRpcmVpdG9zIGNvbnRpZG9zIG5lc3RhIGxpY2Vu77+9YS4gVm9j77+9IHRhbWLvv71tIGRlY2xhcmEgcXVlIG8gZGVw77+9c2l0byBkZSBzdWEgcHVibGljYe+/ve+/vW8gbu+/vW8sIHF1ZSBzZWphIGRlIHNldSBjb25oZWNpbWVudG8sIGluZnJpbmdlIGRpcmVpdG9zIGF1dG9yYWlzIGRlIG5pbmd177+9bS4KCkNhc28gYSBzdWEgcHVibGljYe+/ve+/vW8gY29udGVuaGEgbWF0ZXJpYWwgcXVlIHZvY++/vSBu77+9byBwb3NzdWkgYSB0aXR1bGFyaWRhZGUgZG9zIGRpcmVpdG9zIGF1dG9yYWlzLCB2b2Pvv70gZGVjbGFyYSBxdWUgb2J0ZXZlIGEgcGVybWlzc++/vW8gaXJyZXN0cml0YSBkbyBkZXRlbnRvciBkb3MgZGlyZWl0b3MgYXV0b3JhaXMgcGFyYSBjb25jZWRlciBhbyBSZXBvc2l077+9cmlvIEluc3RpdHVjaW9uYWwgZGEgVUZNRyBvcyBkaXJlaXRvcyBhcHJlc2VudGFkb3MgbmVzdGEgbGljZW7vv71hLCBlIHF1ZSBlc3NlIG1hdGVyaWFsIGRlIHByb3ByaWVkYWRlIGRlIHRlcmNlaXJvcyBlc3Tvv70gY2xhcmFtZW50ZSBpZGVudGlmaWNhZG8gZSByZWNvbmhlY2lkbyBubyB0ZXh0byBvdSBubyBjb250Ze+/vWRvIGRhIHB1YmxpY2Hvv73vv71vIG9yYSBkZXBvc2l0YWRhLgoKQ0FTTyBBIFBVQkxJQ0Hvv73vv71PIE9SQSBERVBPU0lUQURBIFRFTkhBIFNJRE8gUkVTVUxUQURPIERFIFVNIFBBVFJPQ++/vU5JTyBPVSBBUE9JTyBERSBVTUEgQUfvv71OQ0lBIERFIEZPTUVOVE8gT1UgT1VUUk8gT1JHQU5JU01PLCBWT0Pvv70gREVDTEFSQSBRVUUgUkVTUEVJVE9VIFRPRE9TIEUgUVVBSVNRVUVSIERJUkVJVE9TIERFIFJFVklT77+9TyBDT01PIFRBTULvv71NIEFTIERFTUFJUyBPQlJJR0Hvv73vv71FUyBFWElHSURBUyBQT1IgQ09OVFJBVE8gT1UgQUNPUkRPLgoKTyBSZXBvc2l077+9cmlvIEluc3RpdHVjaW9uYWwgZGEgVUZNRyBzZSBjb21wcm9tZXRlIGEgaWRlbnRpZmljYXIgY2xhcmFtZW50ZSBvIHNldSBub21lKHMpIG91IG8ocykgbm9tZXMocykgZG8ocykgZGV0ZW50b3IoZXMpIGRvcyBkaXJlaXRvcyBhdXRvcmFpcyBkYSBwdWJsaWNh77+977+9bywgZSBu77+9byBmYXLvv70gcXVhbHF1ZXIgYWx0ZXJh77+977+9bywgYWzvv71tIGRhcXVlbGFzIGNvbmNlZGlkYXMgcG9yIGVzdGEgbGljZW7vv71hLgo=Repositório de PublicaçõesPUBhttps://repositorio.ufmg.br/oaiopendoar:2024-02-20T16:22:51Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false |
dc.title.pt_BR.fl_str_mv |
Risk factors associated with readmissions of patients with severe mental disorders under treatment with antipsychotics |
dc.title.alternative.pt_BR.fl_str_mv |
Fatores de risco associados às readmissões de pacientes com transtornos mentais graves em tratamento com antipsicóticos |
title |
Risk factors associated with readmissions of patients with severe mental disorders under treatment with antipsychotics |
spellingShingle |
Risk factors associated with readmissions of patients with severe mental disorders under treatment with antipsychotics Ronaldo Portela Severe mental disorders Antipsychotics Readmission Psychiatric hospital Transtornos mentais Antipsicóticos Readmissão do paciente Hospitais psiquiátricos |
title_short |
Risk factors associated with readmissions of patients with severe mental disorders under treatment with antipsychotics |
title_full |
Risk factors associated with readmissions of patients with severe mental disorders under treatment with antipsychotics |
title_fullStr |
Risk factors associated with readmissions of patients with severe mental disorders under treatment with antipsychotics |
title_full_unstemmed |
Risk factors associated with readmissions of patients with severe mental disorders under treatment with antipsychotics |
title_sort |
Risk factors associated with readmissions of patients with severe mental disorders under treatment with antipsychotics |
author |
Ronaldo Portela |
author_facet |
Ronaldo Portela Milton Leonard Wainberg Saulo Castel Helian Nunes de Oliveira Cristina Mariano Ruas |
author_role |
author |
author2 |
Milton Leonard Wainberg Saulo Castel Helian Nunes de Oliveira Cristina Mariano Ruas |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Ronaldo Portela Milton Leonard Wainberg Saulo Castel Helian Nunes de Oliveira Cristina Mariano Ruas |
dc.subject.por.fl_str_mv |
Severe mental disorders Antipsychotics Readmission Psychiatric hospital |
topic |
Severe mental disorders Antipsychotics Readmission Psychiatric hospital Transtornos mentais Antipsicóticos Readmissão do paciente Hospitais psiquiátricos |
dc.subject.other.pt_BR.fl_str_mv |
Transtornos mentais Antipsicóticos Readmissão do paciente Hospitais psiquiátricos |
description |
Background: The aim of this study was to assess the risk of readmission in patients with severe mental disorders, compare it between patients using different types of antipsychotics and determine risk factors for psychiatric readmission. Methods: Medical records of a non-concurrent cohort of 625 patients with severe mental disorders (such as psychoses and severe mood disorders) who were first discharged from January to December 2012 (entry into the cohort), with longitudinal follow-up until December 2017 constitute the sample. Descriptive statistical analysis of characteristics of study sample was performed. The risk factors for readmission were assessed using Cox regression. Results: Males represented 51.5% of the cohort, and 75.6% of the patients had no partner. Most patients (89.9%) lived with relatives, and 64.7% did not complete elementary school. Only 17.1% used more than one antipsychotic, 34.2% did not adhere to the treatment, and 13.9% discontinued the medication due to unavailability in public pharmacies. There was a need to change the antipsychotic due to the lack of therapeutic response (11.2% of the patients) and adverse reactions to the antipsychotic (5.3% of the patients). Cox regression showed that the risk of readmission was increased by 25.0% (RR, 1.25; 95% CI, 1.03–1.52) when used typical antipsychotics, compared to those who used atypical ones, and by 92.0% (RR, 1.92; 95% CI, 1.63–2.27) when patients did not adhere to maintenance treatment compared to those who adhered. Conclusions: Use of atypical antipsychotics and adherence to treatment were associated with a lower risk of psychiatric readmissions. |
publishDate |
2022 |
dc.date.issued.fl_str_mv |
2022 |
dc.date.accessioned.fl_str_mv |
2024-02-20T16:22:51Z |
dc.date.available.fl_str_mv |
2024-02-20T16:22:51Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/1843/64327 |
dc.identifier.doi.pt_BR.fl_str_mv |
https://doi.org/10.1186/s12888-022-03794-6 |
dc.identifier.issn.pt_BR.fl_str_mv |
1471-244X |
dc.identifier.orcid.pt_BR.fl_str_mv |
https://orcid.org/0000-0002-6267-1278 https://orcid.org/0000-0002-9390-4652 https://orcid.org/0000-0003-1635-5175 https://orcid.org/0000-0003-0275-8416 |
url |
https://doi.org/10.1186/s12888-022-03794-6 http://hdl.handle.net/1843/64327 https://orcid.org/0000-0002-6267-1278 https://orcid.org/0000-0002-9390-4652 https://orcid.org/0000-0003-1635-5175 https://orcid.org/0000-0003-0275-8416 |
identifier_str_mv |
1471-244X |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartof.pt_BR.fl_str_mv |
BMC psychiatry |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
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Universidade Federal de Minas Gerais |
dc.publisher.initials.fl_str_mv |
UFMG |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
FAR - DEPARTAMENTO DE FARMÁCIA SOCIAL MED - DEPARTAMENTO DE MEDICINA PREVENTIVA SOCIAL |
publisher.none.fl_str_mv |
Universidade Federal de Minas Gerais |
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reponame:Repositório Institucional da UFMG instname:Universidade Federal de Minas Gerais (UFMG) instacron:UFMG |
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