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A Clinical Feasibility Study of the Forensic Psychiatry and Violence Oxford (FoVOx) Tool

Background: Risk assessment informs decisions around admission to and discharge from secure psychiatric hospital and contributes to treatment and supervision. There are advantages to using brief, scalable, free online tools with similar accuracy to instruments currently used. We undertook a study of...

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Autores principales: Cornish, Robert, Lewis, Alexandra, Parry, Owen Curwell, Ciobanasu, Oana, Mallett, Susan, Fazel, Seena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6928566/
https://www.ncbi.nlm.nih.gov/pubmed/31920751
http://dx.doi.org/10.3389/fpsyt.2019.00901
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author Cornish, Robert
Lewis, Alexandra
Parry, Owen Curwell
Ciobanasu, Oana
Mallett, Susan
Fazel, Seena
author_facet Cornish, Robert
Lewis, Alexandra
Parry, Owen Curwell
Ciobanasu, Oana
Mallett, Susan
Fazel, Seena
author_sort Cornish, Robert
collection PubMed
description Background: Risk assessment informs decisions around admission to and discharge from secure psychiatric hospital and contributes to treatment and supervision. There are advantages to using brief, scalable, free online tools with similar accuracy to instruments currently used. We undertook a study of one such risk assessment, the Forensic Psychiatry and Violence Oxford (FoVOx) tool, examining its acceptability, feasibility, and practicality. Methods: We completed the FoVOx tool on all discharges from six secure psychiatric hospitals in one region in England over two years. We interviewed 11 senior forensic psychiatrists regarding each discharge using a standardized questionnaire. Their patient’s FoVOx score was compared to clinical risk assessment, and the senior clinicians were asked if they considered FoVOx scores accurate and useful. A modified thematic analysis was conducted, and clinicians were surveyed about current risk assessment practice on discharge. Results: Of 90 consecutive discharges, 84 were included in the final analysis. The median FoVOx probability score was 11% risk of violent recidivism in two years after discharge. We estimated that 12 (14%) individuals reoffended since discharge; all were in the medium or high risk FoVOx categories. Clinical assessment of risk agreed with the FoVOx categories in around half the cases. Clinicians were more likely to provide lower risk categories compared with FoVOx ones. FoVOx was considered to be an accurate representation of risk in 67% of cases; clinicians revised their view on some patient’s risk assessment after being informed of their FoVOx scores. Completing FoVOx was reported to be helpful in the majority of cases. Reasons included improved communication with other agencies, reassurance to clinical teams, and identifying additional factors not fully considered. 10 of the 11 respondents reported that FoVOx was practical, and seven of 11 reported that they would use it in the future, highlighting its brevity and speed of use compared to existing risk assessment tools. Conclusions: Senior clinicians in this regional forensic psychiatric service found the FoVOx risk assessment tool feasible, practical, and easy to use. Its use addressed a lack of consistency around risk assessment at the point of discharge and, if used routinely, could assist in clinical decision-making.
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spelling pubmed-69285662020-01-09 A Clinical Feasibility Study of the Forensic Psychiatry and Violence Oxford (FoVOx) Tool Cornish, Robert Lewis, Alexandra Parry, Owen Curwell Ciobanasu, Oana Mallett, Susan Fazel, Seena Front Psychiatry Psychiatry Background: Risk assessment informs decisions around admission to and discharge from secure psychiatric hospital and contributes to treatment and supervision. There are advantages to using brief, scalable, free online tools with similar accuracy to instruments currently used. We undertook a study of one such risk assessment, the Forensic Psychiatry and Violence Oxford (FoVOx) tool, examining its acceptability, feasibility, and practicality. Methods: We completed the FoVOx tool on all discharges from six secure psychiatric hospitals in one region in England over two years. We interviewed 11 senior forensic psychiatrists regarding each discharge using a standardized questionnaire. Their patient’s FoVOx score was compared to clinical risk assessment, and the senior clinicians were asked if they considered FoVOx scores accurate and useful. A modified thematic analysis was conducted, and clinicians were surveyed about current risk assessment practice on discharge. Results: Of 90 consecutive discharges, 84 were included in the final analysis. The median FoVOx probability score was 11% risk of violent recidivism in two years after discharge. We estimated that 12 (14%) individuals reoffended since discharge; all were in the medium or high risk FoVOx categories. Clinical assessment of risk agreed with the FoVOx categories in around half the cases. Clinicians were more likely to provide lower risk categories compared with FoVOx ones. FoVOx was considered to be an accurate representation of risk in 67% of cases; clinicians revised their view on some patient’s risk assessment after being informed of their FoVOx scores. Completing FoVOx was reported to be helpful in the majority of cases. Reasons included improved communication with other agencies, reassurance to clinical teams, and identifying additional factors not fully considered. 10 of the 11 respondents reported that FoVOx was practical, and seven of 11 reported that they would use it in the future, highlighting its brevity and speed of use compared to existing risk assessment tools. Conclusions: Senior clinicians in this regional forensic psychiatric service found the FoVOx risk assessment tool feasible, practical, and easy to use. Its use addressed a lack of consistency around risk assessment at the point of discharge and, if used routinely, could assist in clinical decision-making. Frontiers Media S.A. 2019-12-13 /pmc/articles/PMC6928566/ /pubmed/31920751 http://dx.doi.org/10.3389/fpsyt.2019.00901 Text en Copyright © 2019 Cornish, Lewis, Parry, Ciobanasu, Mallett and Fazel http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Cornish, Robert
Lewis, Alexandra
Parry, Owen Curwell
Ciobanasu, Oana
Mallett, Susan
Fazel, Seena
A Clinical Feasibility Study of the Forensic Psychiatry and Violence Oxford (FoVOx) Tool
title A Clinical Feasibility Study of the Forensic Psychiatry and Violence Oxford (FoVOx) Tool
title_full A Clinical Feasibility Study of the Forensic Psychiatry and Violence Oxford (FoVOx) Tool
title_fullStr A Clinical Feasibility Study of the Forensic Psychiatry and Violence Oxford (FoVOx) Tool
title_full_unstemmed A Clinical Feasibility Study of the Forensic Psychiatry and Violence Oxford (FoVOx) Tool
title_short A Clinical Feasibility Study of the Forensic Psychiatry and Violence Oxford (FoVOx) Tool
title_sort clinical feasibility study of the forensic psychiatry and violence oxford (fovox) tool
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6928566/
https://www.ncbi.nlm.nih.gov/pubmed/31920751
http://dx.doi.org/10.3389/fpsyt.2019.00901
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