The Canadian Survey of Standards of Electroconvulsive Therapy Practice: A Call for Accreditation

Chan, Peter; Graf, Peter; Enns, Murray W.; Delva, Nicholas J.; Gilron, Ian; Lawson, J. S.; Gosselin, Caroline; Patry, Simon; Milev, Roumen; Jewell, Mark; Martin, Barry

doi:10.1177/070674371205701009

Cited by 9 publications

(10 citation statements)

References 31 publications

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“…21,22 Our results also showed that indication and practices of ECT were consistent with established international guidelines. 1,23,24 Depressive disorders, such as major depression, constituted the main indication, corresponding to 75% of ECT use. This corresponds to practices observed in Western countries.…”

Section: Discussionmentioning

confidence: 99%

“…30 We observed wide variations in ECT caseload per hospital across the country. 8 Based on these observations, the authors 7,8,24 concluded that an accreditation process and a standardisation of collected data would be necessary to ensure high-quality practices. Establishing a national registry on ECT in Quebec would also respond to this advocacy.…”

Section: Discussionmentioning

confidence: 99%

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Electroconvulsive Therapy Practice in the Province of Quebec: Linked Health Administrative Data Study from 1996 to 2013

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Electroconvulsive Therapy Practice in the Province of Quebec: Linked Health Administrative Data Study from 1996 to 2013

et al. 2017

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“…To this day, the mechanism of action of ECT has not been clearly elucidated 6 . Standards of practice of ECT may differ according to institutes or between countries 7 . Although in the past, the most common indication for ECT was schizophrenia, major depression has recently come to be the most common indication.…”

Section: Introductionmentioning

confidence: 99%

Is There a Role of Gender in Electroconvulsive Therapy Response?

Bolu

Özselek²,

Akarsu³

et al. 2015

Klinik Psikofarmakoloji Bülteni-Bulletin of Clinical Psychophar

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Is there a role of gender in electroconvulsive therapy response? Objective: Gender difference is a significant determinant of treatment response. As in pharmacological agents, knowledge about this difference is also important for electroconvulsive therapy as an effective treatment modality. The current study aimed to examine the gender differences in terms of indications for electroconvulsive therapy, responses to treatment, and side effects that occur during its application. Methods: The hospital records of 176 adult patients (39 females and 137 males) having undergone bilateral temporal electroconvulsive therapy under anesthesia between 2007 and 2012 were examined retrospectively. Results: The mean age of women was higher than that of men, and the duration of hospitalization was longer in men. There was a significant difference between the genders in terms of the indications of electroconvulsive therapy. Major depression as a diagnosis and suicidal thoughts as an indication were more common in women, while catatonia was more common in men. The most frequent side effects were cardiovascular side effects and allergic reactions. No significant difference was determined in the response rates of the patients to electroconvulsive therapy according to their diagnosis and genders. Conclusion: Our results once again demonstrated that electroconvulsive therapy is a highly effective treatment in both genders. Some gender differences exist in terms of indication and diagnosis, although there was no difference in terms of response to electroconvulsive therapy. There is a need for prospective studies to identify the reasons for these differences.

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“…Similar gaps have been reported in other countries but to a smaller extent. In a study that was undertaken in Canada, it was found that 16% of the institutions that participated in the study were not following any standard guidelines during ECT (40). Less than 30% of the participants of this study indicated having some written policy for managing concurrent medications during ECT and practice was quite variable regarding individual psychotropics.…”

Section: Discussionmentioning

confidence: 99%

A Qualitative Exploration of Gaps and Challenges in Knowledge and Practices of Electroconvulsive Therapy by Key Personnel in Public and Private Mental Health Units in Kenya

et al. 2019

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Background: Evidence-based research for electroconvulsive therapy (ECT) practice in Kenya is scarce. This has seemingly stifled knowledge with regard to ECT practice among key personnel in the country. Research shows that evidence-based guidelines not only harmonize clinical practice in a certain region but also improve health outcomes and quality of clinical decisions made by key personnel. This study aimed at assessing knowledge and administration of ECT by key personnel in psychiatric units in Kenya. Method: This is a qualitative study targeting multiple stakeholders in mental health facilities. The study was undertaken in three counties: Nairobi, Nakuru and Eldoret. Snowballing sampling method was used to interview 33 targeted respondents who work in ECT departments or actively interacted with the procedure in both private and public facilities. Researcher-designed respondent profile questionnaire and interview guides focusing on knowledge, practice and barriers in delivery of ECT were used as tools. Data collected were transcribed from the audio recordings. Thematic and content analyses of these semi-structured interviews were carried out based on the patterns that were noted across the data collected. The interviews were read by the research team and re-read to highlight the core ideas. Findings were presented in form of themes, which were illustrated along with representative verbatim quotations. Results: Overall, the key personnel were knowledgeable about ECT in different stages of the procedure, but we noticed methodological incongruence in their practice with regard to the pre-ECT preparation, stimulus dose calculation adequacy of seizure and in the procedure for dose adjustment of psychotropic medication before and after ECT sessions. The identified barriers to the uptake of evidence-based practice were lack of infrastructure, inadequate funding, lack of adequate training and negative perception by patients, relatives and even some participants. Conclusion: Though key personnel in this study showed that they had knowledge on ECT administration, lack of standard guidelines on ECT practice led to lack of standardized training on the procedure hence the methodological incongruence. Inadequate infrastructure, knowledge and negative perception towards the procedure seemed to interfere with uptake of ECT as an intervention. Recommendations: The study makes the following recommendations: adoption of a guideline by psychiatrists, intense training on ECT, specialized training for nurses in ECT and dose calculation for psychiatrists and registrars. Funding should be made available for new ECT machines. Lastly, education and awareness creation should be done about ECT to help deal with negative perception towards the intervention.

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The Canadian Survey of Standards of Electroconvulsive Therapy Practice: A Call for Accreditation

Cited by 9 publications

References 31 publications

Electroconvulsive Therapy Practice in the Province of Quebec: Linked Health Administrative Data Study from 1996 to 2013

Electroconvulsive Therapy Practice in the Province of Quebec: Linked Health Administrative Data Study from 1996 to 2013

Is There a Role of Gender in Electroconvulsive Therapy Response?

A Qualitative Exploration of Gaps and Challenges in Knowledge and Practices of Electroconvulsive Therapy by Key Personnel in Public and Private Mental Health Units in Kenya

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