Sometimes the good guy wins.
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Insurance, Liability↗
Biomedical subjects
W R Coyle
Publications and source records attributed to W R Coyle.
Clozapine therapy and clinical outcomes in Kentucky psychiatric hospitals.
We reviewed the protocol for determining patient eligibility to receive clozapine in Kentucky state psychiatric facilities. Results of a retrospective review of the clinical outcomes of the initial 42 patients who received clozapine under this protocol are reported. Patients receiving clozapine were severely ill patients with a mean duration of illness and mean length of current hospitalization of 11 years and 2 years, respectively. Symptomatic response was dramatic with a reduction in total Brief Psychiatric Rating Scale (BPRS) and Clinical Global Impression (CGI) ratings of 48.4% and 36.3%, respectively. The time patients spent in restraints decreased significantly following clozapine initiation. Clozapine was well tolerated, with sedation being the most common adverse effect reported. One patient experienced a seizure and another developed leukopenia. Following 12 weeks of clozapine treatment, the patient discharge rate was 42.9%.
Adult↗
Clinical sequelae of overt non-compliance with psychotropic agents.
A group of 487 patients admitted to Eastern State Hospital in Lexington, Kentucky, during a 3-month period were prospectively followed to determine the incidence of psychotropic medication refusal, unique characteristics of refusers, factors leading to refusal, and clinical outcome of those who refused. Patients who refused any dose(s) of psychotropic medications were identified within 24 hours of refusal. For patients who refused for 24 hours or more, the psychiatrist was asked to complete a 4-item questionnaire. Our data indicate that medication refusal leads to poorer clinical outcomes, as measured by length of hospitalization and incidence and duration of restraint episodes.
Adult↗