Medical Patients with PTSD Identify Issues with Hospitalization

Fletcher, Kathlyn E.; Collins, Jamie A; Holzhauer, Brian; Lewis, Flower; Hendricks, M.

doi:10.1007/s11606-019-05480-y

Cited by 2 publications

(4 citation statements)

References 4 publications

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“…A recent small survey study reported that 40% of patients anticipated triggers for their PTSD symptoms in the hospital; such triggers included loud noises and being shaken awake. 24 Two papers describe case vignettes of patients who had exacerbations of their PTSD while in the Intensive Care Unit (ICU), although neither contain frequency or severity data. 25,26 Approximately 8% of patients in VA ICUs have PTSD, 27 and a published abstract suggests that they appear to require more sedation than do patients without PTSD.…”

Section: The Literature About Ptsd In Hospitalized Patientsmentioning

confidence: 99%

“…The literature is sparse describing frequency or type of problems encountered by hospitalized medical patients with PTSD. A recent small survey study reported that 40% of patients anticipated triggers for their PTSD symptoms in the hospital; such triggers included loud noises and being shaken awake 24 . Two papers describe case vignettes of patients who had exacerbations of their PTSD while in the Intensive Care Unit (ICU), although neither contain frequency or severity data 25,26 .…”

Section: The Literature About Ptsd In Hospitalized Patientsmentioning

confidence: 99%

“…Extra time spent with the patient, while challenging in the hectic hospital environment, is critical, and nonpharmacological treatments should be the priority. Engaging patients by asking about their PTSD triggers 24 may help prevent exacerbations. For example, some patients may specify how they prefer to be woken up to prevent startle reactions.…”

Section: Inpatient Management Of Ptsdmentioning

confidence: 99%

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Hospitalized Medical Patients with Posttraumatic Stress Disorder (PTSD): Review of the Literature and a Roadmap for Improved Care

et al. 2020

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Posttraumatic Stress Disorder (PTSD) is common in the United States, with a prevalence of nearly 8% in the general population and between 10%-30% in veterans. Despite how common PTSD is, inpatient providers may not be familiar with its manifestations or feel comfortable taking care of patients who may exhibit symptoms related to it. In our combined experience as VA-based hospital medicine care providers, we have cared for thousands of patients hospitalized for a primary medical condition who also have PTSD as a comorbidity. We have noticed in our practices that we only focus our attention on PTSD if a related problem arises during a patient’s hospitalization (eg, confrontations with the care team or high levels of anxiety). We contend that a more proactive approach could lead to better care, but little evidence about best practices exists to inform the interdisciplinary team how to optimally care for hospitalized medical patients with PTSD. In this narrative review, we present a synthesis of existing literature, describe how trauma-informed care could be used to guide the approach to patients with PTSD, and generate ideas for changes that inpatient providers could implement now, such as engaging patients to prevent PTSD exacerbations and promoting better sleep in the hospital.

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Section: The Literature About Ptsd In Hospitalized Patientsmentioning

confidence: 99%

Section: The Literature About Ptsd In Hospitalized Patientsmentioning

confidence: 99%

Section: Inpatient Management Of Ptsdmentioning

confidence: 99%

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Hospitalized Medical Patients with Posttraumatic Stress Disorder (PTSD): Review of the Literature and a Roadmap for Improved Care

et al. 2020

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“…Our hospital has well-established infectious diseases (ID) and addiction medicine teams [ 14 , 15 ], but lacked processes to prioritize patient preferences, optimize infection outcomes, and reduce harms of drug use among people needing long-term IV antibiotics. To address these gaps, we created a novel multidisciplinary and interprofessional care conference, “OPTIONS-DC,” to identify treatment options agreeable to both patients and providers using the frameworks of harm reduction and patient-centered care.…”

Section: Introductionmentioning

confidence: 99%

“OPTIONS-DC”, a feasible discharge planning conference to expand infection treatment options for people with substance use disorder

et al. 2021

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Background Serious bacterial infections associated with substance use often result in long hospitalizations, premature discharges, and high costs. Out-of-hospital treatment options in people with substance use disorder (SUD) are often limited. Methods We describe a novel multidisciplinary and interprofessional care conference, “OPTIONS-DC,” to identify treatment options agreeable to both patients and providers using the frameworks of harm reduction and patient-centered care. We retrospectively reviewed charts of patients who had an OPTIONS-DC between February 2018 and July 2019 and used content analysis to understand the conferences’ effects on antibiotic treatment options. Results Fifty patients had an OPTIONS-DC during the study window. Forty-two (84%) had some intravenous (IV) substance use and 44 (88%) had an active substance use disorder. Participants’ primary substances included opioids (65%) or methamphetamines (28%). On average, conferences lasted 28 min. OPTIONS-DC providers recommended out-of-hospital antibiotic treatment options for 34 (68%) of patients. OPTIONS-DC recommended first line therapy of IV antibiotics for 35 (70%) patients, long-acting injectable antibiotics for 14 (28%), and oral therapy for 1 (2%). 35 (70%) patients that had an OPTIONS-DC completed an antibiotic course and 6 (12%) left the hospital prematurely. OPTIONS-DC expanded treatment options by exposing and contextualizing SUD, psychosocial risk and protective factors; incorporating patient preferences; and allowing providers to tailor antibiotic and SUD recommendations. Conclusions OPTIONS-DC is a feasible intervention that allows providers to integrate principles of harm reduction and offer patient-centered choices among patients needing prolonged antibiotic treatment.

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Medical Patients with PTSD Identify Issues with Hospitalization

Cited by 2 publications

References 4 publications

Hospitalized Medical Patients with Posttraumatic Stress Disorder (PTSD): Review of the Literature and a Roadmap for Improved Care

Hospitalized Medical Patients with Posttraumatic Stress Disorder (PTSD): Review of the Literature and a Roadmap for Improved Care

“OPTIONS-DC”, a feasible discharge planning conference to expand infection treatment options for people with substance use disorder

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