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Multidisciplinary review to identify patients who could be managed in primary care
Vincent Io Agyapong1, Olorunfemi Ahmodu2, Allys Guerandel2
1Dept of Psychiatry,School of Medicine,University of Dublin,Trinity College and St Patrick's University Hospital,James's Street,Dublin 8,Ireland.
Objectives:
Primary care teams have the potential to deliver much of the care currently provided by specialist services. The aim of this review was to determine from patients' clinical records and multidisciplinary team discussions, those that may be suitable for discharge back into primary care.
Methods:
A retrospective review of the clinical notes of all patients attending a psychiatric outpatient clinic was carried out by all members of the multidisciplinary team to determine the appropriateness of continuing to provide psychiatric services in a specialised psychiatric clinic rather than in a primary care setting, taking into account the patients demographic and clinical variables.
Results:
It was recommended that 60% of all the patients needed to continue attending the local mental health service, 35.2% could be discharged back into primary care for continuing management whilst the remaining 4.8% could be managed jointly between primary care and the community mental health service. The bulk of the patients recommended for discharge into primary care had a diagnosis of anxiety disorder or depression and all of them had been stable on their treatment for more than six months.
Conclusion:
Regular multidisciplinary team review has a potential to identify patients who could be discharged back into primary care.
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