Authors (including presenting author) :
Chan F (1), IP CK (1), Wong WT (1), Tai WK (1), Sheung WH (2), Choi KW (2), Choi THW (3), Fung MLE (4), Wong KY (4), Law HY (4), Chan CYK (4), Wong WY (5), Tsang, LYL (2), Wong TY (5)
Affiliation :
(1) Department of Psychiatry, Tai Po Hospital, (2) Department of Psychiatry, Alice Ho Miu Ling Nethersole Hospital, (3) Department of Psychiatry, Prince of Wales Hospital, (4) Occupation Therapy Department, Alice Ho Miu Ling Nethersole Hospital, (5) Department of Psychiatry, North District Hospital
Introduction :
Dual-diagnosed patients, those with both substance-use disorder and any psychiatric disorder, are at a significantly higher risk of violence, suicide, and healthcare utilisation. In response to these challenges, a multidisciplinary substance abuse specialist team was established in the New Territories East Cluster in 8/2020. This team, including psychiatrists, psychiatric nurses, occupational therapists and social workers, has adopted an integrated model providing care to these patients throughout their journey.
Objectives :
1. To evaluate the effects of the integrated model of the service
2. To identify the protective factor for dual-diagnosed patients to sustain abstinence after being discharged from psychiatric hospitals
Methodology :
A retrospective review of dual-diagnosed patients admitted to Tai Po Hospital from 9/2022 – 7/2023 has been conducted. A comparison of 1-year-before and 1-year-after index admission towards the yearly admission rate, yearly unplanned readmission rate, and OPD attendance rate were conducted. Also, linear and logistic regression were conducted to identify the significant relationship between 12-month abstinence and the socio-demographic, psychiatric and substance abuse background of those patients.
Result & Outcome :
113 patients have been admitted during that period. 69% are male, with an average age of 40.73 + 8.68 years old. Most are single, locally born and educated up to junior secondary level. 46.9% were identified to have risk of violence as labelled as Special Care or Intensive Care, and 29.2% of them were discharged under Conditional Discharge. An encouraging finding was noted as the yearly admission rate dropped from 0.44 times/year to 0.33 times/year (A reduction of 25%) while the outpatient attendance rate increased from 67.5% to 85.1% (An improvement of 26.1%). The 12-month abstinence rate is 46%, comparatively higher than global data. Patients referred to community detox service, under Conditional Discharge, single-drug abusers, being employed, are noted to have a significant positive outcome in getting abstinence from abused substances.
In conclusion, the integrated model with multidisciplinary input in a multidimensional patient journey has yielded positive outcomes. The reduction in admission rates and the improvement in outpatient attendance are not just promising signs, but beacons of hope that this model can significantly improve patients' overall outcomes. Moreover, protective factors were identified to guide future care formulation for these groups of patients.
