The Malaga Schizophrenia Case-Register (Resma): Overview of Methodology and Patient Cohort

Moreno-Küstner, Berta; Mayoral, Fermín; Pérez, Olga Gómez; García‐Herrera, José María; Algarra, José; Rivas, Fabio; Pérez, Rita; Becerra, Francisco; Gornemann, Isolde

doi:10.1177/0020764008092237

Cited by 13 publications

(14 citation statements)

References 28 publications

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“…The RESMA collects cases from two large clinical databases of mental health services provision, one from an outpatient setting: SISMA (Mental Health Information System) and the other from an inpatient setting: CMBD (Minimum Basic Data Set). More details are explained elsewhere [22]. …”

Section: Methodsmentioning

confidence: 99%

“…The Global Level of Severity (GLS) is an index assigned to patients with schizophrenia or related disorders by psychiatrists, who usually treat patients according to symptom severity, disease evolution, social adjustment, disability level and treatment adherence. This index is used by psychiatrists in the clinical setting of the public mental health services in order to include patients in the category of "Severe Mental Illness" and thus assign more resources [22]. The GLS ranges from less severe (level I) to more severe (level IV) (Table 1).…”

Section: Methodsmentioning

confidence: 99%

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Factors associated with use of community mental health services by schizophrenia patients using multilevel analysis

Moreno-Küstner

Mayoral

Rivas

et al. 2011

BMC Health Serv Res

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BackgroundPersons with schizophrenia and related disorders may be particularly sensitive to a number of determinants of service use, including those related with illness, socio-demographic characteristics and organizational factors. The objective of this study is to identify factors associated with outpatient contacts at community mental health services of patients with schizophrenia or related disorders.MethodsThis cross-sectional study analyzed 1097 patients. The main outcome measure was the total number of outpatient consultations during one year. Independent variables were related to socio-demographic, clinical and use of service factors. Data were collected from clinical records.ResultsThe multilevel linear regression model explained 46.35% of the variance. Patients with significantly more contacts with ambulatory services were not working and were receiving welfare benefits (p = 0.02), had no formal education (p = 0.02), had a global level of severity of two or three (four being the most severe) (p < 0.001), with one or more inpatient admissions (p < 0.001), and in contact with both types of professional (nurses and psychiatrists) (p < 0.001). The patients with the fewest ambulatory contacts were those with diagnoses of persistent delusional disorders (p = 0.04) and those who were attended by four of the 13 psychiatrists (p < 0.001).ConclusionsAs expected, the variables that explained the use of community service could be viewed as proxies for severity of illness. The most surprising finding, however, was that a group of four psychiatrists was also independently associated with use of ambulatory services by patients with schizophrenia or related disorders. More research is needed to carefully examine how professional support networks interact to affect use of mental health.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Factors associated with use of community mental health services by schizophrenia patients using multilevel analysis

Moreno-Küstner

Mayoral

Rivas

et al. 2011

BMC Health Serv Res

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“…Patients with schizophrenia usually present with difficulties in diverse areas of daily life: they are predominantly unemployed, single, and have a low educational level 62–64. They have also difficulties with housing, as the Team Assessment Psychiatric Services (TAPS) project described65 and current literature emphasizes,66 and their income depends on community aids 67.…”

Section: Unmet Psychosocial and Economic Needsmentioning

confidence: 99%

Unmet needs in the management of schizophrenia

Torres-González¹,

Ibanez-Casas²,

Saldivia³

et al. 2014

NDT

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Studies on unmet needs during the last decades have played a significant role in the development and dissemination of evidence-based community practices for persistent schizophrenia and other severe mental disorders. This review has thoroughly considered several blocks of unmet needs, which are frequently related to schizophrenic disorders. Those related to health have been the first block to be considered, in which authors have examined the frequent complications and comorbidities found in schizophrenia, such as substance abuse and dual diagnosis. A second block has been devoted to psychosocial and economic needs, especially within the field of recovery of the persistently mentally ill. Within this block, the effects of the current economic difficulties shown in recent literature have been considered as well. Because no patient is static, a third block has reviewed evolving needs according to the clinical staging model. The fourth block has been dedicated to integrated evidence-based interventions to improve the quality of life of persons with schizophrenia. Consideration of community care for those reluctant to maintain contact with mental health services has constituted the fifth block. Finally, authors have aggregated their own reflections regarding future trends. The number of psychosocial unmet needs is extensive. Vast research efforts will be needed to find appropriate ways to meet them, particularly regarding so-called existential needs, but many needs could be met only by applying existing evidence-based interventions. Reinforcing research on the implementation strategies and capacity building of professionals working in community settings might address this problem. The final aim should be based on the collaborative model of care, which rests on the performance of a case manager responsible for monitoring patient progress, providing assertive follow-up, teaching self-help strategies, and facilitating communication among the patient, family doctor, mental health specialist, and other specialists.

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“…Data on the total number of GP visits were obtained from digitised primary care records (DIRAYA program). Sociodemographic and clinical information about patients was obtained from RESMA [26,27]. Information about the PCCs was collected from their directors, who were interviewed using a questionnaire designed by the research team of this study.…”

Section: Data Sourcesmentioning

confidence: 99%

Factors Associated with the Use of Primary Care Centres in Persons with Schizophrenia

Anguiano

Pérez

Aragón

et al. 2020

Preprint

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Background. Patients with schizophrenia and related disorders have more physical problems than the general population. Primary care professionals play an important role in the care of these patients as they are the main entry point into the healthcare system. We aimed to identify patient, general practitioner, and primary care centre factors associated with the number of visits of patients with schizophrenia and related disorders to general practitioners. Methods. A descriptive, cross-sectional study was conducted in 13 primary care centres belonging to the Clinical Management Unit of Mental Health of the Regional Hospital of Málaga, Spain. The eligible population was composed of patients with schizophrenia and related disorders attending these primary care centres in the study area. Our dependent variable was the total number of general practitioner visits made by patients with schizophrenia and related disorders during the 3.5-year observation period. The independent variables were grouped into three: a) patient variables (sociodemographic and clinical), b) general practitioner variables, and c) primary care centre characteristics. Descriptive, bivariate, and multivariate analyses using the random forest method were performed. Results. A total of 259 patients with schizophrenia and related disorders, 96 general practitioners, and 13 primary care centres were included. The annual mean was 3.9 visits per patient. The results showed that general practitioner age, patient gender, patient marital status, primary care centre to which the patient belonged, taking antipsychotic medication, presenting any cardiovascular risk factor, and frequency of mental health training sessions at the primary care centre were associated with an increased number of visits to general practitioners. Conclusions. The only general practitioner characteristic that was associated with the number of visits was age. There were also patient variables involved in the number of visits. Finally, mental health training for general practitioners was important for these professionals to manage patients with schizophrenia and related disorders.

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The Malaga Schizophrenia Case-Register (Resma): Overview of Methodology and Patient Cohort

Cited by 13 publications

References 28 publications

Factors associated with use of community mental health services by schizophrenia patients using multilevel analysis

Factors associated with use of community mental health services by schizophrenia patients using multilevel analysis

Unmet needs in the management of schizophrenia

Factors Associated with the Use of Primary Care Centres in Persons with Schizophrenia

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