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Murphy AL, Hillier K, Ataya R, Thabet P, Whelan AM, O'Reilly C, Gardner D. A scoping review of community pharmacists and patients at risk of suicide. Can Pharm J (Ott) 2017; 150:366-379. [PMID: 29123596 DOI: 10.1177/1715163517733482] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Medications are commonly used in suicide attempts. Pharmacists are inextricably linked to medications and may have roles in helping those at risk of suicide. We conducted a scoping review to characterize the existing literature and make recommendations about future research. Methods We used a 6-step approach based on an existing scoping review methodological framework, including identifying the research question; identifying relevant studies and other literature; study and literature selection; data charting; collating, summarizing and reporting results; and dissemination of results. We searched electronic databases, various grey literature sources and mobile app stores. Results Thirty-five articles were included following screening of 1013 database citations. Of 1085 results from grey literature searches, we included 12. Most publications were opinion pieces (n = 22), followed by survey studies (n = 9), primarily assessing pharmacists' knowledge and attitudes. Themes included education and training to impact knowledge and attitudes, gatekeeping of medication supply, collaboration and integration, and role perception. Public perspectives on pharmacists' roles were limited. Conclusions Research regarding pharmacists' roles in the care of people at risk for suicide is limited. The areas that have dominated the literature include legal liability, especially with respect to gatekeeping medications, ethical decision making and education and training. Research is needed to determine what methods, outcomes and measures are required to best serve in building the evidence base for policy and practice decisions in this area.
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Affiliation(s)
- Andrea Lynn Murphy
- College of Pharmacy (Murphy, Hillier, Ataya, Thabet, Whelan), University of Sydney, Sydney, New South Wales, Australia
| | - Katelyn Hillier
- College of Pharmacy (Murphy, Hillier, Ataya, Thabet, Whelan), University of Sydney, Sydney, New South Wales, Australia
| | - Randa Ataya
- College of Pharmacy (Murphy, Hillier, Ataya, Thabet, Whelan), University of Sydney, Sydney, New South Wales, Australia
| | - Pierre Thabet
- College of Pharmacy (Murphy, Hillier, Ataya, Thabet, Whelan), University of Sydney, Sydney, New South Wales, Australia
| | - Anne Marie Whelan
- College of Pharmacy (Murphy, Hillier, Ataya, Thabet, Whelan), University of Sydney, Sydney, New South Wales, Australia
| | - Claire O'Reilly
- College of Pharmacy (Murphy, Hillier, Ataya, Thabet, Whelan), University of Sydney, Sydney, New South Wales, Australia
| | - David Gardner
- College of Pharmacy (Murphy, Hillier, Ataya, Thabet, Whelan), University of Sydney, Sydney, New South Wales, Australia
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Slovak K, Pope ND, Brewer TW. Geriatric Case Managers' Perspectives on Suicide Among Community-Dwelling Older Adults. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2016; 59:3-15. [PMID: 26646472 DOI: 10.1080/01634372.2015.1111966] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
It has been suggested that clinical screening for suicide, along with firearm assessment and safety counseling, are important in service provision to older adults. It is unclear, however, how geriatric case managers respond to these issues. This study surveyed geriatric case managers (n=161) from Area Agencies on Aging in Ohio on their knowledge, attitudes, and behaviors related to suicide, firearm assessment, and safety counseling. Results indicated that the majority of respondents (70%) agree their clients are at risk for suicide. However, few (30%) in this study reported that they assess for firearms and less than half (48%) discuss firearms with their clients/family members when specifically assessing for suicide. Analyses identified barriers that contribute to the decreased likelihood that routine firearm assessment and safety counseling would occur, such as lack of training and time. Implications include the need for training with geriatric case managers that addresses barriers to suicide, firearm assessment and safety counseling as a means to decrease these population risks.
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Affiliation(s)
- Karen Slovak
- a Department of Social Work , Malone University , Canton , Ohio , USA
| | - Natalie D Pope
- b College of Social Work , University of Kentucky , Lexington , Kentucky , USA
| | - Thomas W Brewer
- c College of Public Health , Kent State University , Kent , Ohio , USA
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Weber NS, Fisher JA, Cowan DN, Postolache TT, Larsen RA, Niebuhr DW. Descriptive epidemiology and underlying psychiatric disorders among hospitalizations with self-directed violence. PLoS One 2013; 8:e59818. [PMID: 23555791 PMCID: PMC3608546 DOI: 10.1371/journal.pone.0059818] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 02/19/2013] [Indexed: 12/02/2022] Open
Abstract
Background Suicide claims over one million lives worldwide each year. In the United States, 1 per 10,000 persons dies from suicide every year, and these rates have remained relatively constant over the last 20 years. There are nearly 25 suicide attempts for each suicide, and previous self-directed violence is a strong predictor of death from suicide. While many studies have focused on suicides, the epidemiology of non-fatal self-directed violence is not well-defined. Objective We used a nationally representative survey to examine demographics and underlying psychiatric disorders in United States (US) hospitalizations with non-fatal self-directed violence (SDV). Method International Classification of Disease, 9th Revision (ICD-9) discharge diagnosis data from the National Hospital Discharge Survey (NHDS) were examined from 1997 to 2006 using frequency measures and adjusted logistic regression. Results The rate of discharges with SDV remained relatively stable over the study time period with 4.5 to 5.7 hospitalizations per 10,000 persons per year. Excess SDV was documented for females, adolescents, whites, and those from the Midwest or West. While females had a higher likelihood of self-poisoning, both genders had comparable proportions of hospitalizations with SDV resulting in injury. Over 86% of the records listing SDV also included psychiatric disorders, with the most frequent being affective (57.8%) and substance abuse (37.1%) disorders. The association between psychiatric disorders and self-injury was strongest for personality disorders for both males (OR = 2.1; 95% CI = 1.3–3.4) and females (OR = 3.8; 95% CI = 2.7–5.3). Conclusion The NHDS provides new insights into the demographics and psychiatric morbidity of those hospitalized with SDV. Classification of SDV as self-injury or self-poisoning provides an additional parameter useful to epidemiologic studies.
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Affiliation(s)
- Natalya S Weber
- Preventive Medicine Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, United States of America.
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Malatynska E, Steinbusch HW, Redkozubova O, Bolkunov A, Kubatiev A, Yeritsyan NB, Vignisse J, Bachurin S, Strekalova T. Anhedonic-like traits and lack of affective deficits in 18-month-old C57BL/6 mice: Implications for modeling elderly depression. Exp Gerontol 2012; 47:552-64. [DOI: 10.1016/j.exger.2012.04.010] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Revised: 04/19/2012] [Accepted: 04/20/2012] [Indexed: 12/11/2022]
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Abstract
BACKGROUND Suicide is a major public health concern. The elderly have the highest rate of suicide and they make more lethal suicide attempts and have fewer psychiatric interventions than young people. Furthermore, they have old-age specific psychosocial difficulties. The present study investigated psychosocial risk factors and characteristics of an index suicide attempt of the elderly suicide attempters. METHODS Subjects included 388 patients who were admitted to the emergency room following self-poisoning. Two age groups were defined: younger patients (aged less than 65 years) and older patients (aged over 65 years). Data including demographic factors, suicidal risk factors and information about the current suicide attempt were obtained from a retrospective chart review. RESULTS The number of suicide attempters over the age of 65 years old was 57, and their mean age was 73.5 ± 7.5 years. The elderly patients had more underlying medical illnesses than the under-65 group (p < 0.001). Depression was the most common psychiatric diagnosis. Psychotropics were the most commonly ingested drugs in both groups, but the use of pesticides was more notable in the elderly. The elderly suicide attempters had higher risk-rating scores (p < 0.001) and lower rescue-rating scores (p = 0.014) than the under-65 group. Male-to-female ratio of the elderly group was nearly 1:1 unlike the under-65 group (p = 0.004). CONCLUSION Elderly suicide attempters had different psychosocial stressors such as physical illness and more lethal suicide attempts. Our study suggests the need for development of specific preventive strategies and management guidelines for the elderly suicide attempters.
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