TY - JOUR

T1 - Comparison of restraint data from four countries

AU - Lepping, Peter

AU - Masood, Barkat

AU - Flammer, Erich

AU - Noorthoorn, Eric O.

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Background Previous studies comparing restraint datafrom different countries had to rely on randomly publisheddata and showed wide variance in the prevalence ofrestraint between countries.Aim To systematically compare datasets from four similarEuropean countries with regard to restraint prevalence.Methods We analysed whole country or area datasets onrestraint from Wales, Ireland, Germany and the Netherlandssystematically, thus excluding selection, patient andsetting bias. Learning disability (LD) and forensic settingswere analysed separately. Differences in proportionsbetween countries were tested by means of Chi square,with number of admissions, admission days and catchmentarea as denominator and counts of restraint as numerators.Results Full datasets were obtained allowing calculationsof total admissions, total restraint numbers, numbers ofpatients involved and total occupied bed days. Data forIreland is from 2012 and from 2013 for the other threecountries. The percentage of patients exposed to restraintvaries between 4.5 and 9.4 %. The average number ofrestraints per patient is stable at around 3 in all countries.Patient numbers affected by restraint per 100 occupied beddays per month vary between 0.095 and 0.200. TheNetherlands have the highest use of seclusion (79 %), thelongest restraint times and low use of enforced medication.Wales the lowest use of seclusion (2 %), followed by Ireland(29 %) and Germany (49 %). Events per 100 admissionsper month vary between 17 and 21. Patients affectedby restraint per 100 admissions per month vary between 5.4and 7.5. LD services account for a disproportionately highnumber of restraint events.Conclusion Patient related restraint data are remarkablysimilar between countries. Type and length of restraint stillvary significantly.

AB - Background Previous studies comparing restraint datafrom different countries had to rely on randomly publisheddata and showed wide variance in the prevalence ofrestraint between countries.Aim To systematically compare datasets from four similarEuropean countries with regard to restraint prevalence.Methods We analysed whole country or area datasets onrestraint from Wales, Ireland, Germany and the Netherlandssystematically, thus excluding selection, patient andsetting bias. Learning disability (LD) and forensic settingswere analysed separately. Differences in proportionsbetween countries were tested by means of Chi square,with number of admissions, admission days and catchmentarea as denominator and counts of restraint as numerators.Results Full datasets were obtained allowing calculationsof total admissions, total restraint numbers, numbers ofpatients involved and total occupied bed days. Data forIreland is from 2012 and from 2013 for the other threecountries. The percentage of patients exposed to restraintvaries between 4.5 and 9.4 %. The average number ofrestraints per patient is stable at around 3 in all countries.Patient numbers affected by restraint per 100 occupied beddays per month vary between 0.095 and 0.200. TheNetherlands have the highest use of seclusion (79 %), thelongest restraint times and low use of enforced medication.Wales the lowest use of seclusion (2 %), followed by Ireland(29 %) and Germany (49 %). Events per 100 admissionsper month vary between 17 and 21. Patients affectedby restraint per 100 admissions per month vary between 5.4and 7.5. LD services account for a disproportionately highnumber of restraint events.Conclusion Patient related restraint data are remarkablysimilar between countries. Type and length of restraint stillvary significantly.

U2 - 10.1007/s00127-016-1203-x

DO - 10.1007/s00127-016-1203-x

M3 - Article

VL - 51

SP - 1301

EP - 1309

JO - Social Psychiatry and Psychiatric Epidemiology

JF - Social Psychiatry and Psychiatric Epidemiology

SN - 0933-7954

IS - 9

ER -