Monday, March 14, 2005

Computer Order Entry Systems Can Increase Medication Errors Medscape Medical News story - "As hospitals have come under pressure from patients and health insurers to lower the rate of medication errors and adverse drug events, a small but growing number have purchased computerized physician order entry (CPOE) systems. These systems, credited with lowering medication errors by up to 81%, can flag harmful drug-drug interactions, eliminate mistakes due to illegible handwriting, and reduce the likelihood of errors that stem from drugs with similar names. But instead of preventing such mistakes, a new study finds that a widely used CPOE system actually fostered 22 types of medication error risks, some of them with disturbing frequency. The study appears in the March 9 issue of JAMA." "med" See also the full article, Role of Computerized Physician Order Entry Systems in Facilitating Medication Errors, which is available online at no cost from JAMA.  
  

Schizophrenia and Recovery: An Expert Interview With Stephen R. Marder, MD Medscape Psychiatry & Mental Health interview with Stephen R. Marder, MD, Professor and Director, Section on Psychosis, University of California at Los Angeles Neuropsychiatric Institute; and Director, Desert Pacific Mental Illness Research, Education, and Clinical Center, US Department of Veterans Affairs - "I think a recovery model has a number of components. First of all, the focus of treatment isn't just on stabilizing the patient in his or her current condition, but on having that patient improve the quality of his or her life. In the past, the focus of treatment by psychiatrists was on controlling symptoms so that patients could remain in the community and not be hospitalized. But patients and families are saying that control of symptoms is really less important than improving function. Patients are asking to be able to return to work, to return to school, and even are suggesting that psychiatrists may be underestimating the ability of people with schizophrenia to function in the community. The recovery model has a focus on improvement of overall function..." [Viewing Medscape resources requires registration, which is free].  
  

Medical and psychiatric disorders commonly coexist Psychiatry Matters story - "Researchers have found that both medical and psychiatric comorbidity is common in children with psychiatric disorders, particularly in girls. 'Data in this study emphasize the fact that associations do exist between psychiatric disorders and medical disorders and knowledge of such associations could be useful in planning health services for children... and in providing appropriate therapy,' say Donald Spady (University of Alberta, Edmonton, Canada) and colleagues..."  
  

New Jersey Parity Battle Bolstered by Cost Study Article at JoinTogether - "Advocates for addiction and mental-health parity were making good progress in New Jersey's last legislative session when opponents successfully threw up a potential stumbling block: a call for a study on the costs of the proposal. But while the legislative push was delayed by the report, the end result was positive for parity advocates: the government study found that the cost of requiring insurers to cover addiction and mental health was quite low, and parity supporters now have a new tool to use in making their case to lawmakers."  
  

Data Lacking on Link Between Drugs, Behavior  Psychiatric News story - "CNS drugs may produce behavioral toxicity in children, but not all such side effects can be explained by these medications. Drugs designed to treat psychiatric illnesses may sometimes produce side effects expressed as behavioral changes, yet they are less common than often believed. ... Although SSRI antidepressants have received most attention recently, Carlson pointed out at a conference sponsored by the American Academy of Child and Adolescent Psychiatry that alcohol and barbiturates can cause aggression, excitement, or irritability, while tricyclics can do the same and induce hallucinations, as well. "  
  

Workers Focus on Positives of Genetic Research  Psychiatric News story - "Researchers were surprised to find that American employees at two work sites were generally open to the idea of having people participate in research exploring the genetics of mental and physical illnesses. How do Americans view participation in research having to do with the genetics of mental and physical illnesses? Quite favorably, a pilot study suggests. It was headed by Laura Roberts, M.D., chair of psychiatry at the Medical College of Wisconsin and a bioethics professor for the college's Health Policy Institute. Results appeared in the January-February Comprehensive Psychiatry."  
  

Medicaid in the Cross Hairs New York Times editorial - "Everyone seems to be howling about the cost of Medicaid, and no wonder. Spending on the health care program for the poor has been exploding, up from about $200 billion in 2000 to more than $300 billion at last count. State governments, which share the costs with the federal government, were hit with the bill just as the economic downturn hit their revenues. And the Bush administration, awash in red ink, wants to cut costs. The biggest problem with Medicaid is that it has been deputized to do a lot of jobs it wasn't originally created for. Intended as a health insurance program for families on welfare and people with disabilities, Medicaid has gradually been stretched to cover for Congress's failure to deal with the millions of low-income American workers without health insurance, and the refusal of Medicare to pay for long-term nursing home care for the elderly." [Viewing New York Times resources requires registration, which is free].  
  

The Quality Cure? New York Times Magazine story on David Cutler, whose "diagnosis has shaken up the health-care-policy world. 'The real reason health-care reform has not succeeded,'' he has written, 'is that it is rooted in a misconception of what health-care reform should accomplish.' ... He says that most health-care spending is actually good. Spending has been rising, he says, because it delivers positive, and measurable, economic value, and because it can do more things that Americans want. Therefore, Cutler says, we should focus on improving the quality of care rather than on reducing our consumption of it. Rather than pay less, he wants to pay more wisely -- to encourage health-care providers to do more of what they should and less of what is wasteful." [Viewing New York Times resources requires registration, which is free].  
  

Schools struggle with increased role (Vermont) Brattleboro Reformer story - "The number of children diagnosed with serious mental and emotional disorders increases every year, national and state data show. At the same time, changes in federal education laws require the public schools to find a seat for everyone who walks through the door. And while Vermont has developed innovative programs, pairing the state education system with the mental health department, the schools struggle with the increased role they are asked to play in caring for these children. Educators and administrators say that too many students are not receiving the proper care they need, and the schools are assuming more of a responsibility to deliver this care to children with serious mental illnesses and emotional disorders..."  
  

Culture plays role in mental health (Colorado)  Greeley Tribune story on Multicultural Services Program at North Range Behavioral Health - "The therapists speak both English and Spanish and were either born or have lived in a Latin American country. Since its opening in 2003, the program has treated hundreds of Weld County Latinos who weren't comfortable at other treatment centers, said program director Becky Marrujo. Marrujo and her crew deliver mental health counseling to children, adolescents, adults, couples and families. They also offer a parenting class. The patients range from new immigrants to Greeley residents and natives. The clients share a common desire to get treatment from therapists who speak their language and understand their culture. According to the 2000 Census, Weld County has more than 48,000 Latinos, the majority from Mexico."  
  

Children face uphill battle for mental health care (Massachusetts) Sentinel & Enterprise story - "Some parents say they are waiting 16 to 32 hours in the HealthAlliance Hospital/Leominster Emergency Room just to have their children who are suffering from mental illness seen by an evaluator. And after all that waiting, even the luckiest children -- some very young -- may be shipped hours away from home to the nearest available hospital bed. Parent advocates, officials and hospital staff acknowledge the difficulty of finding inpatient psychiatric care for children and teens. They say it affects residents statewide -- not just in Leominster and Fitchburg. The lack of beds comes down to a lack of money..."  
  

MindYourMindAn "innovative internet resource for youth who are looking for credible, up-to-date information on mental health and creative stress management," managed and sponsored by The Youth Discovery Program of the London Mental Health Crisis Service. This program was initiated in 2001 to respond to the needs of youth between the ages of 16 – 24 for crisis management and support.