Prescribing Patterns for Inpatients With Schizophrenia Spectrum Disorders in a Psychiatric Hospital in Slovenia: Results of 16-Month Prospective, Non-Interventional Clinical Research

Bole, Cvetka Bačar; Pišlar, Mitja; Mrhar, Aleš; Tavčar, Rok

doi:10.24869/psyd.2017.155

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…Additionally, non-adherence with treatment recommendations amongst those with schizophrenia includes antipsychotic treatment with multiple antipsychotics (antipsychotic polypharmacy = APP). For example, in one Slovenian psychiatric hospital, three antipsychotics were concomitantly prescribed to 22% of patients and two antipsychotics to 47% of patients [ 32 , 33 ]. In psychiatric hospitals, different antipsychotic polypharmacy combinations, including combinations of low-dose antipsychotics, have been observed [ 34 ].…”

Section: Gaps In the Pharmacological Management Of Mental Illnessesmentioning

confidence: 99%

Clinical pharmacy services in mental health in Europe: a commentary paper of the European Society of Clinical Pharmacy Special Interest Group on Mental Health

Stuhec,

Hahn,

Taskova

et al. 2023

Int J Clin Pharm

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A large proportion of the world’s disease burden is attributable to mental illnesses. Although effective interventions are available, many patients still have limited access to evidence-based treatments. Aside from access, treatment gaps, including inappropriate medication selection and monitoring, are also routinely recognised. Mental health clinical pharmacists can help address these gaps and enable patients to receive optimised pharmaceutical care, particularly appropriate medication selection and monitoring. The European Society of Clinical Pharmacy (ESCP) Special Interest Group on Mental Health was established to improve standardised service provision in mental health settings across Europe. The Special Interest Group identified significant barriers (predominantly associated with reimbursement and position within the multidisciplinary team) to effective pharmaceutical care amongst those with mental illnesses. This commentary presents recommendations to address these gaps through improved mental health clinical pharmacy service provision.

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Section: Gaps In the Pharmacological Management Of Mental Illnessesmentioning

confidence: 99%

Clinical pharmacy services in mental health in Europe: a commentary paper of the European Society of Clinical Pharmacy Special Interest Group on Mental Health

Stuhec,

Hahn,

Taskova

et al. 2023

Int J Clin Pharm

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show abstract

“…The present study is the follow-up analysis of the cohort of patients with SSDs described in our previous publications [ 32 , 33 ]. The patient cohort was first analyzed in 2014 with the aim of determining the prevalence of pDDIs, risk rating and the association of demographic characteristics and pharmacotherapy with pDDIs or clinically expressed symptoms and signs.…”

Section: Introductionmentioning

confidence: 99%

Potential Drug-Drug Interactions among Patients with Schizophrenia Spectrum Disorders: Prevalence, Association with Risk Factors, and Replicate Analysis in 2021

et al. 2023

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Background and Objectives: Patients with schizophrenia are often exposed to polypharmacotherapy, which may lead to drug—drug interactions. The aim of the study was to investigate the prevalence of potential drug—drug interactions (pDDIs) in hospitalized patients with schizophrenia spectrum disorders and to identify factors associated with pDDIs and manifested symptoms and signs. Materials and Methods: This cross-sectional observational study included 311 inpatients admitted to a psychiatric hospital. The LexiComp drug interaction program was used to identify pDDIs in 2014. Factors associated with the prevalence of pDDIs and factors related to clinically observed symptoms and signs were assessed using multivariable regression. In addition, replicate analysis of pDDI was performed using 2021 program updates. Results: The prevalence of pDDIs was 88.7%. Our study showed that more than half of the patients received at least one drug combination that should be avoided. The most common pDDIs involved combinations of two antipsychotics or combinations of antipsychotics and benzodiazepines, which can lead to cardio-respiratory depression, sedation, arrhythmias, anticholinergic effects, and neuroleptic malignant syndrome. The number of prescribed drugs was a risk factor for pDDIs (OR 2.85; 95% CI 1.84–5.73). All groups of clinically observed symptoms and signs were associated with the number of drugs. In addition, symptoms and signs characteristic of the nervous system and psychiatric disorders were associated with antipsychotic dosage (IRR 1.33; 95% CI 1.12–1.58), which could contribute to the development of extrapyramidal syndrome, insomnia, anxiety, agitation, and bipolar mania. The 2021 version of the drug interaction program showed a shift in drug interactions toward a lower risk rating, implying less severe patient management and possibly less alert fatigue. Conclusions: Patients with schizophrenia spectrum disorders are at high risk of developing drug—drug interactions. Optimization of drug therapy, patient monitoring, and use of drug interaction programs could help to prevent pDDIs and subsequent adverse drug events.

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Positive evidence for clinical pharmacist interventions during interdisciplinary rounding at a psychiatric hospital

Štuhec

Tement

2021

Sci Rep

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Clinical pharmacists have not yet become an integral part of interdisciplinary ward rounds in most psychiatric hospitals across the European Union. This retrospective observational pre-post study examined the impact of clinical pharmacist recommendations in an interdisciplinary medical team during psychiatric hospital rounding. The study included all patients in a Slovenian psychiatric hospital who were hospitalized 2019–2020. The clinical pharmacist made 315 recommendations for a total of 224 participants (average age M = 59.4, median = 56). Psychiatrists accepted 295 (93.7%) of the recommendations. After the recommendations, the number of expressed and potential drug-related problems decreased in 166 (93.8%) and 129 (93.8%) interventions, respectively. Three months after discharge, 222 accepted recommendations were continued (70.5%). The most common recommendations were related to antipsychotics (19.4%, N = 61) followed by antidepressants (16.8%, N = 53). Including a clinical pharmacist in the interdisciplinary ward rounds at a psychiatric hospital reduced the number of expressed and potential drug-related problems with a very high recommendation acceptance rate. These results are the first in Central Europe to explore the benefits of including a clinical pharmacist in ward rounding.

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Prescribing Patterns for Inpatients With Schizophrenia Spectrum Disorders in a Psychiatric Hospital in Slovenia: Results of 16-Month Prospective, Non-Interventional Clinical Research

Cited by 3 publications

References 14 publications

Clinical pharmacy services in mental health in Europe: a commentary paper of the European Society of Clinical Pharmacy Special Interest Group on Mental Health

Clinical pharmacy services in mental health in Europe: a commentary paper of the European Society of Clinical Pharmacy Special Interest Group on Mental Health

Potential Drug-Drug Interactions among Patients with Schizophrenia Spectrum Disorders: Prevalence, Association with Risk Factors, and Replicate Analysis in 2021

Positive evidence for clinical pharmacist interventions during interdisciplinary rounding at a psychiatric hospital

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