针对老年医疗住院患者的积极综合咨询-联络精神病学:HOME研究RCT对其有效性和成本效益的研究
Michael Sharpe1, Jane Walker1, Maike van Niekerk1
1Psychological Medicine Research, University of Oxford Department of Psychiatry, Warneford Hospital, Oxford, UK.
Health and social care delivery research
|December 8, 2025
概括
积极的综合咨询-联络精神病学增强了对老年住院患者的护理,显示了积极的经验和短期的成本节省. 虽然它没有显著减少住院时间,但它提高了出院率,特别是在更长的住院期间.
科学领域:
- 老年医学 老年医学
- 精神病学是一个精神病学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 老年医疗住院患者存在复杂的生物心理社会挑战,往往导致长时间住院治疗.
- 积极的综合咨询-联络精神病学 (PIC-LP) 是为了帮助病房团队管理这种复杂性而开发的.
- 其目的是减少老年医疗住院患者住院时间.
研究的目的:
- 评估PIC-LP在改善老年住院患者医疗护理方面的经验,有效性和成本效益.
- 在HOME研究中,评估了综合精神科咨询的影响.
主要方法:
- 一个多中心,个别随机对照试验,涉及三个NHS医院的24个病房.
- 参与者是65岁或以上的医疗住院患者,紧急入院,预计至少停留2天.
- 干预涉及PIC-LP临床医生,作为综合病房团队成员,提供主动的生物心理社会评估和出院专注的护理;通常的护理作为对照.
主要成果:
- 2744名参与者被录取;患者和工作人员对PIC-LP有积极的体验.
- 平均住院时间相似:11.37天 (PIC-LP) 与11.85天 (常规护理),没有统计学上显著的差异 (p=0.18).
- 随着PIC-LP的治疗,出院率的统计学显著增加 (8.5%高,p=0.042) 被观察到,特别是在预期停留时间较长的患者中. 此外,PIC-LP在短期内 (1-3个月) 节省了适度的成本.
结论:
- 老年医疗住院患者和病房工作人员对PIC-LP有积极的体验,增强了医疗护理.
- 该研究为PIC-LP的开发和评估提供了支持,尽管没有证明整体住院时间的显著减少.
- PIC-LP显示了医院系统中短期成本节约的潜力.
相关概念视频
Psychosis: Goals of Pharmacotherapy
446
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
446
Documentation in Long-Term and Home Healthcare Setting
1.4K
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
1.4K
Drug Therapy
232
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
232
Methods of Documentation VI: Case Management Model
839
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...
For example, a patient with a chronic...
839
Drug Dosing: Geriatric Patients
212
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
212


