Abstract
Introduction: The occurrence of mental disorders and chronic diseases is associated with low treatment compliance and an increased mortality. The main objective of this study was to analyze medication prescriptions at hospital discharge in order to verify the patients’ access to the prescribed treatment. Methods: This is a descriptive and retrospective study performed between September 2013 and September 2018 with patients admitted in the psychiatric ward of a university hospital in the state of Rio Grande do Sul. The studied patients consisted of 274 adults over 18 years of age admitted to this hospital with at least one psychiatric comorbidity included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) who lived in the city of Porto Alegre used specially controlled drugs, and had been hospitalized for at least 7 days. Results: Out of the 274 patients, 68.5% were readmitted once, 17.5% were readmitted twice, 9.5% were readmitted 3times, and 4.5% went through this process 4 times or more. A significant association (p = 0.014) was observed between the number of drugs not included in the Municipal Essential Medicines List upon first readmission and the number of readmissions. Among patients who were readmitted 3 times or more, 79% were prescribed drugs that were not on this list. Conclusions: The understanding of how therapeutic itineraries are established when searching for drugs contributes to setting effective lines of care where professionals may position themselves more proactively to reduce mental health complications.
Highlights
The occurrence of mental disorders and chronic diseases is associated with low treatment compliance and an increased mortality
To constitute an organized and integrated psychosocial care network with a focus on transitions of care and aiming at an effective whole-person care, we have reviewed the drug prescriptions issued to mental health patients upon their discharge from a university hospital
The study included 274 patients aged 18 years or older who were admitted to the psychiatric unit of the university hospital with at least one psychiatric comorbidity mentioned in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5); all patients lived in Porto Alegre, used continuous medications, and were hospitalized for at least 7 days
Summary
The occurrence of mental disorders and chronic diseases is associated with low treatment compliance and an increased mortality. Mental disorders account for approximately 12% of the global burden of disease[1,2]. With population aging and the management of comorbidities, psychiatric and physical disorders have become more relevant. These disorders are associated with an increased hospitalization risk, worse health outcomes, and increased costs[4]. Among adults diagnosed with mental disorders, 68% present chronic diseases. According to Alegria et al.[5] (cited by Abernathy et al.6), data indicate that the occurrence of mental disorders and chronic diseases is associated with low treatment compliance and increased mortality[5]
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