Weekend prescribing practices and subsequent seclusion and restraint in a psychiatric inpatient setting.
OBJECTIVE
This case-control study examined the role of early medication management in preventing seclusion and restraint.


METHODS
Data were extracted from the medical records, including whether standing medication was increased, decreased, or left unchanged during the first 48 hours of hospitalization.


RESULTS
Compared with inpatients who did not experience seclusion or restraint (N=39), those who did (N=39) were younger (p=.01) and more likely to be male (p=.023) and to have a primary discharge diagnosis of bipolar disorder, mixed or manic episode, schizophrenia, or schizoaffective disorder (p<.001). Patients whose standing medication was not changed during the first 48 hours of hospitalization had 5.5 times as many restraints as patients whose dose was increased or who received new prescriptions (p=.027).


CONCLUSIONS
Early use of medication can reduce the incidence of seclusion and restraint among high-risk patients early in their hospitalization.
Goldbloom
David Lee
DL
Department of Psychiatry, Beth Israel Medical Center, First Ave. and 16th St., New York, NY 10003, USA. dgoldblo2002@yahoo.com
Mojtabai
Ramin
R
Serby
Michael J
MJ
D000046:Academic Medical Centers; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000453:epidemiology; D016022:Case-Control Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City; D010356:Patient Isolation / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011567:Psychiatric Department, Hospital / Q000592:standards*; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000453:epidemiology; D012149:Restraint, Physical / Q000706:statistics & numerical data*; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology; D014600:Utilization Review / Q000706:statistics & numerical data
D014150:Antipsychotic Agents