Psychiatric services : a journal of the American Psychiatric Association
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This study aimed to examine variability in pricing of generic antipsychotic medications in a diverse metropolitan area and to determine whether prices varied by pharmacy type. ⋯ This report is the first on pharmacy-level variability in the costs of generic antipsychotic treatment options for schizophrenia. Appreciable differences were found in the costs of generic antipsychotics. Understanding variability in antipsychotic pricing may be important for providers serving uninsured patients.
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This study aimed to estimate the cost-effectiveness of esketamine, a novel intranasally dosed antidepressant, for patients in the United States with treatment-resistant depression. ⋯ Esketamine is unlikely to be cost-effective for management of treatment-resistant depression in the United States unless its price falls by more than 40%.
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Using benzodiazepines and opioids together substantially increases the risk of fatal overdose. Yet, concurrent benzodiazepine and opioid prescribing rates continue to increase amid the opioid overdose epidemic. Therefore, this study sought to identify patterns and predictors associated with self-reported concurrent benzodiazepine and opioid use among community-dwelling adults. ⋯ Several individual-level factors were associated with reporting concurrent benzodiazepine and opioid use. Therefore, enhanced educational interventions targeting both clinicians and community-dwelling adults are warranted to minimize use of this high-risk medication combination.
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The receipt of telemedicine for the management of mental illness, also known as telepsychiatry, is being adopted in emergency departments (EDs), but little is known about this approach. This study investigated the prevalence and applications of telepsychiatry in general EDs in the United States. ⋯ In 2016, 20% of EDs received telepsychiatry services, and most receiving telepsychiatry had no other emergency psychiatric services. The latter finding suggests that telepsychiatry is used to fill a critical need. Further studies are warranted to investigate barriers to implementing telepsychiatry in EDs without access to emergency psychiatric services.
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This Open Forum focuses on specific challenges, contingency planning considerations, and downstream impacts of COVID-19 on inpatient psychiatric care. COVID-19 is a novel coronavirus that has been declared a pandemic. ⋯ Nuanced considerations of five contingency planning strategies in response to COVID-19 are described, including COVID-19-specific precautions, visitor restrictions, physician workforce considerations, operational adjustments, and group therapy changes. Organized leadership and clear communication are identified as early priorities in pandemic response to minimize misinformation and address immediate challenges.