Abstract
Aims and MethodThe ability of routine clinical practice to detect drug use at acute psychiatric admission was assessed by comparing the results of urinalysis with information on drug use extracted from patient records (n=112).ResultsUrinalysis detected drug use in 23% of the sample. Cannabis was the drug most frequently found. Of the cases of drug use positively identified by urinalysis, 54% were not identified in the notes. Some information on drug use proximal to admission was found in 40% of patient records. Patients asked about proximal drug use were younger than those not asked.Clinical ImplicationsAll patients should be asked about drug use.
Highlights
Some information on drug use proximal to admission was found in 40% of patient records
There was no significant difference in age between the sample and those who refused or those who were not asked to take part, nor any association with gender, use of the Mental Health Act or diagnosis
Police were involved in 21%, violence was recorded in 5% and the Mental Health Act was used in 13% of admissions
Summary
Urinalysis detected drug use in 23% of the sample. Cannabis was the drug most frequently found. Some information on drug use proximal to admission was found in 40% of patient records. The medical records include the psychiatric admission interview routinely used by clerking doctors, which has a question on drug history to be asked of all patients (Goldberg, 1997). Any specific drugs mentioned were noted, as were age, gender, ICD-10 diagnosis (World Health Organization, 1992), prescription of opiates and/or benzodiazepines at admission; source of information on drug use (e.g. patient report or other source); and police involvement, violence and use of the Mental Health Act. Data were analysed using SPSS for Windows, version 10. Confidence intervals (CIs) were calculated to estimate the sensitivity of the notes in detecting drug use
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