Bir üniversite hastanesinde yatarak tedavi gören hastalarda çoklu ilaç kullanımı: Geriye dönük bir çalışma / Polypharmacy among inpatients of a university psychiatry clinic: a retrospective study

Çilli

et al. 2017

CPEMH

Background:This study investigates the antipsychotic use patterns of patients with schizophrenia and its correlations in their daily drug use patterns.Methods:Patients with schizophrenia who have regular records at two different community counselling centres (CCS) were included in the study. Information about their medications and sociodemographic data was recorded through face-to-face interviews and supporting information about their drug use patterns was obtained from their relatives/caregivers/nurse. The Clinical Global Impression Scale (severity of illness) and the General Assessment of Functionality scales were also administered.Results:Patients with schizophrenia used 2.0 ± 0.81 antipsychotics daily and 3.52 ± 2.55 pills (1–18). Seventy-one percent of the patients used two or more kinds of psychotropic drugs. The most frequently used antipsychotics were quetiapine, a second generation antipsychotic, and haloperidol, a typical antipsychotic. Clinical severity, regular visits to a CCS and use of depot antipsychotics were independent predictors for polypharmacy.Conclusion:The rate of polypharmacy use is high in Turkey. There are multiple risk factors related with polipharmacy. New studies should focus risk factors for preventing polypharmacy.

Section: Discussionmentioning

confidence: 99%

Antipsychotic Use Pattern in Schizophrenia Outpatients: Correlates of Polypharmacy

Çilli

et al. 2017

CPEMH

“…On the contrary, a much larger percentage of outpatients were treated with antidepressants of any kind compared with inpatients (54.1% vs 20.9%, Table 3 ). The use of antipsychotic medications for the treatment of several major psychiatric diseases, including depression, 5 is becoming common practice. The present data suggest that inpatients suffering from depression are more often managed by using psychotropic medications, which may necessitate a high level of care for their appropriate prescription and dosing.…”

Section: Discussionmentioning

confidence: 99%

“… 1 – 4 A proper evaluation of the difference between actual practice and a theoretical, gold standard-oriented approach may help to avoid several erroneous trends that may negatively affect patient outcomes and other pharmacoeconomic issues. For example, some international studies have reported an increase in the practice of polypharmacy, that is, the use of four or more medications specially by the elderly population, 5 and the prescription of new and expensive medications and low-dose and off-label drugs to women and children. 4 Most of the studies that evaluated use of psychotropic drugs have reported a high rate of prescriptions for multiple drugs, which usually occurs when there was no improvement in clinical symptoms.…”

Section: Introductionmentioning

confidence: 99%

Patterns of psychotropic medication use in inpatient and outpatient psychiatric settings in Saudi Arabia

Alosaimi

Alhabbad

Abalhassan

et al. 2016

NDT

ObjectiveTo study the pattern of psychotropic medication use and compare this pattern between inpatient and outpatient psychiatric settings in Saudi Arabia.MethodThis cross-sectional observational study was conducted between July 2012 and June 2014 on patients seeking psychiatric advice at major hospitals in five main regions of Saudi Arabia. Male (n=651) and female (n=594) patients who signed the informed consent form and were currently or had been previously using psychotropic medications, irrespective of the patient’s type of psychiatric diagnosis and duration of the disease, were included. A total of 1,246 patients were found to be suitable in the inclusion criteria of whom 464 were inpatients while 782 were outpatients.ResultsSeveral studied demographic factors have shown that compared with outpatients, inpatients were more likely to be male (P=0.004), unmarried (P<0.001), have less number of children (1–3; P=0.002), unemployed (P=0.001), have a lower family income (<3,000 SR; P<0.001), live in rural communities (P<0.001), have a lower body mass index (P=0.001), and are smokers (P<0.001); however, there were no differences with regard to age or educational levels. The current frequency of use of psychotropic medications in overall patients was antipsychotics (76.6%), antidepressants (41.4%), mood stabilizers (27.9%), and antianxiety (6.2%). However, compared to outpatients, the current use of medications for inpatients was more frequent (93.8% vs 89.9%, P=0.019) with inpatients more likely to be treated with multiple medications (2.1 vs 1.8 medications). A similar trend was observed in the case of antipsychotics, high potency first-generation antipsychotics, second-generation antipsychotics, mood stabilizers, and antianxiety medicines where inpatients were more frequently treated with these medications for all psychiatric diagnoses when compared with outpatients. On the contrary, in the case of antidepressant treatment, an opposite trend was observed with more number of treated outpatients in comparison to inpatients. Among elderly patients, 75.9% received antipsychotics, mainly second-generation formulations (67.2%), whereas only 41% received antidepressants and 13.8% received mood stabilizers.ConclusionBased upon the present study data, it is concluded that among all the psychotropic medications, antipsychotics were heavily used and the frequency was found to be significantly high in the case of inpatients compared with outpatients. Such a practice may lead to multiple negative consequences among the Saudi psychiatric patient population. Further, extensive use of sodium valproate in the case of bipolar disorder, and also among females either in childbearing age or during pregnancy is also the cause of concern and warrants logical use. Overall, this study may help in assessing the burden of psychiatric illness within specific patient demographics and might be effectively used to strategically plan health resources allocation, generate new treatment hypothesis, or be used as a source of evidence that could f...

“…Anticholinergic drug requirement was increased if several APD agents were used. According to studies performed in our country with hospitalized and outpatient schizophrenia patients, the prevalence of APPP use is 38-74% (16,17,18,19,20,27,28,29). APPP use is common almost in every clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Antipsychotic Use Pattern in People with Psychotic Disorder Living in Board and Care Facilities

Erşan¹,

Yıldız

2015

Arch Neuropsychiatr