Clinical decision-making before discharge in hospitalized persons with schizophrenia: a Spanish Delphi expert consensus

Introduction The care of people with schizophrenia (PWS) is usually provided in an outpatient setting by community mental health teams. However, PWS frequently require inpatient treatment because of a wide array of clinical, personal and/or social situations. Unfortunately, to our knowledge, there a...

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Authors: Montes JM, Agüera-Ortiz L, Mané A, Martinez-Raga J, Gutiérrez-Rojas L
Format: article
Status:Published version
Publication Date:2024
Country:España
Institution:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repository:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p17431
Online Access:https://fisabio.portalinvestigacion.com/publicaciones/17431
Access Level:Open access
Keyword:schizophrenia
inpatient
hospitalization
discharge
expert consensus
Delphi method
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spelling Clinical decision-making before discharge in hospitalized persons with schizophrenia: a Spanish Delphi expert consensusMontes JMAgüera-Ortiz LMané AMartinez-Raga JGutiérrez-Rojas Lschizophreniainpatienthospitalizationdischargeexpert consensusDelphi methodIntroduction The care of people with schizophrenia (PWS) is usually provided in an outpatient setting by community mental health teams. However, PWS frequently require inpatient treatment because of a wide array of clinical, personal and/or social situations. Unfortunately, to our knowledge, there are no guidelines available to help psychiatrists in the decision-making process on hospital discharge for PWS. The aim of this project was to develop an expert consensus on discharge criteria for PWS after their stay in an acute inpatient psychiatric unit.Methods Using a modified Delphi method a group of 42 psychiatrists throughout Spain evaluated four areas of interest regarding this issue: clinical symptomatology, treatment-related factors, follow-up health care units after discharge, and physical health and monitoring.Results After two rounds, among the 64 statements, a consensus was reached for 59 (92.2%) statements. In three (17.7%) of the 17 statements on 'clinical symptomatology' and 2 (13.3%) of the 15 statements on 'follow-up health care units after discharge', a consensus was not reached; in contrast, a consensus was reached for all statements concerning 'treatment-related factors' and those concerning 'physical health and monitoring'. The consensus results highlight the importance for discharge of the control of symptoms rather than their suppression during admission and of tolerability in the selection of anantipsychotic.Discussion Although there is a lack of relevant data for guiding the discharge of PWS after hospitalization in an acute inpatient psychiatric unit, we expect that this consensus based on expert opinion may help clinicians to take appropriate decisions.FRONTIERS MEDIA SA2024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/17431Frontiers in PsychiatryISSN: 16640640reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p174312026-06-11T12:45:17Z
dc.title.none.fl_str_mv Clinical decision-making before discharge in hospitalized persons with schizophrenia: a Spanish Delphi expert consensus
title Clinical decision-making before discharge in hospitalized persons with schizophrenia: a Spanish Delphi expert consensus
spellingShingle Clinical decision-making before discharge in hospitalized persons with schizophrenia: a Spanish Delphi expert consensus
Montes JM
schizophrenia
inpatient
hospitalization
discharge
expert consensus
Delphi method
title_short Clinical decision-making before discharge in hospitalized persons with schizophrenia: a Spanish Delphi expert consensus
title_full Clinical decision-making before discharge in hospitalized persons with schizophrenia: a Spanish Delphi expert consensus
title_fullStr Clinical decision-making before discharge in hospitalized persons with schizophrenia: a Spanish Delphi expert consensus
title_full_unstemmed Clinical decision-making before discharge in hospitalized persons with schizophrenia: a Spanish Delphi expert consensus
title_sort Clinical decision-making before discharge in hospitalized persons with schizophrenia: a Spanish Delphi expert consensus
dc.creator.none.fl_str_mv Montes JM
Agüera-Ortiz L
Mané A
Martinez-Raga J
Gutiérrez-Rojas L
author Montes JM
author_facet Montes JM
Agüera-Ortiz L
Mané A
Martinez-Raga J
Gutiérrez-Rojas L
author_role author
author2 Agüera-Ortiz L
Mané A
Martinez-Raga J
Gutiérrez-Rojas L
author2_role author
author
author
author
dc.subject.none.fl_str_mv schizophrenia
inpatient
hospitalization
discharge
expert consensus
Delphi method
topic schizophrenia
inpatient
hospitalization
discharge
expert consensus
Delphi method
description Introduction The care of people with schizophrenia (PWS) is usually provided in an outpatient setting by community mental health teams. However, PWS frequently require inpatient treatment because of a wide array of clinical, personal and/or social situations. Unfortunately, to our knowledge, there are no guidelines available to help psychiatrists in the decision-making process on hospital discharge for PWS. The aim of this project was to develop an expert consensus on discharge criteria for PWS after their stay in an acute inpatient psychiatric unit.Methods Using a modified Delphi method a group of 42 psychiatrists throughout Spain evaluated four areas of interest regarding this issue: clinical symptomatology, treatment-related factors, follow-up health care units after discharge, and physical health and monitoring.Results After two rounds, among the 64 statements, a consensus was reached for 59 (92.2%) statements. In three (17.7%) of the 17 statements on 'clinical symptomatology' and 2 (13.3%) of the 15 statements on 'follow-up health care units after discharge', a consensus was not reached; in contrast, a consensus was reached for all statements concerning 'treatment-related factors' and those concerning 'physical health and monitoring'. The consensus results highlight the importance for discharge of the control of symptoms rather than their suppression during admission and of tolerability in the selection of anantipsychotic.Discussion Although there is a lack of relevant data for guiding the discharge of PWS after hospitalization in an acute inpatient psychiatric unit, we expect that this consensus based on expert opinion may help clinicians to take appropriate decisions.
publishDate 2024
dc.date.none.fl_str_mv 2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/17431
url https://fisabio.portalinvestigacion.com/publicaciones/17431
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv FRONTIERS MEDIA SA
publisher.none.fl_str_mv FRONTIERS MEDIA SA
dc.source.none.fl_str_mv Frontiers in Psychiatry
ISSN: 16640640
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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