1.Outcomes of the Early Psychosis Intervention Programme (EPIP) Singapore
Poon Lye Yin ; Swapna Verma ; Chong Siow Ann
The Singapore Family Physician 2013;39(1):10-13
Psychoses are serious and potentially chronic mental disorders with a profound impact, in terms of economic cost and human suffering, on patients, their families and society. Early detection and treatment, through reducing the duration of untreated psychosis, however, could lead to a better outcome. In 2001, the Early Psychosis Intervention Programme (EPIP), Singapore was started with the following key strategies: (1) early detection of psychosis through outreach to and network with the community and our partners; (2) provision of clinical treatment that is evidence-based; and (3) conducting clinically relevant research to evaluate our service to be accountable to the stake-holders and to ensure cost-effectiveness. A myriad of structure, process and outcome measures offering a multi-dimensional evaluation were chosen to make us accountable to a broad range of stakeholders, from our funders, other service providers, to our patients and their families. EPIP has shown good outcomes in terms of number of patients accepted into the programme, as well as our clinical service provision. Such outcomes are achieved with our community partners playing an important role. General Practitioners, in particular, are vital not only in the detection, management of such individuals, but also in the re-integration of our patients back to community.
2.Support for Wellness Achievement Programme (SWAP): A service for individuals with at-risk mental state in singapore.
Sujatha RAO ; Santhathevi PARIYASAMI ; Sarah Ann TAY ; Lay Keow LIM ; Spencer YUEN ; Lye Yin POON ; Helen LEE ; Swapna VERMA
Annals of the Academy of Medicine, Singapore 2013;42(10):552-555
3.Reducing polypharmacy through the introduction of a treatment algorithm: use of a treatment algorithm on the impact on polypharmacy.
Siow-Ann CHONG ; Nigila RAVICHANDRAN ; Lye-Yin POON ; Kai-Ling SOO ; Swadna VERMA
Annals of the Academy of Medicine, Singapore 2006;35(7):457-460
INTRODUCTIONPolypharmacy is very common in the psychiatric setting despite the lack of evidence to justify its use. The objective of this study was to review the prescription patterns in a tertiary mental health institute in Asia and evaluate the impact of a treatment algorithm for patients with first-episode psychosis (FEP) on the use of polypharmacy.
MATERIALS AND METHODSA treatment algorithm was implemented for patients accepted into an Early Psychosis Intervention Programme (EPIP) and the prescription patterns of these patients were compared with a comparator group (pre-EPIP) before the use of the algorithm. The prescribing pattern was established at 2 points: at baseline after the diagnosis was made, and 3 months later.
RESULTSThere were 68 subjects in the comparator group and 483 EPIP patients; the latter were on the average younger. None in the comparator group was diagnosed to have an affective psychosis. There was a significant reduction in the rate of antipsychotic polypharmacy, prolonged use of benzodiazepines and anticholinergic medication in EPIP patients. This group also had an increase in the use of second-generation antipsychotics and received lower doses of antipsychotics.
CONCLUSIONThe implementation of a treatment algorithm coupled with audit has changed the trend towards polypharmacy among patients with FEP.
Adult ; Algorithms ; Antipsychotic Agents ; administration & dosage ; Female ; Humans ; Male ; Polypharmacy ; Psychotic Disorders ; drug therapy