QUALYOP Project 2: monitoring the dismantling of Italian psychiatric hospitals. Psychotropic drug use in 1072 inpatients

The prescription of psychotropic drugs in psychiatric residential facilities: a national survey in Italy

“…Many drug utilization studies have shown considerable variations in prescribing patterns of psychotropic drugs, with high rates of polypharmacy (1, 2); these patterns have been confirmed over time by studies performed in different settings and different nations, also sampling large patient populations and/or extending observation periods (3–15).…”

“…Even in Italy several psychotropic drug utilization studies carried out in a variety of mental health services have consistently shown questionable prescribing practices, with high rates of polypharmacy and frequently weak correlations between diagnoses and medication regimes (1, 3, 5, 7, 11, 12, 15–19). However, data about prescribing practices for patients living in psychiatric residential facilities (RFs), which in Italy have completely replaced mental hospitals (MHs) for the care of long‐term patients, are completely missing, although such facilities care for a large number of individuals (more than 15 000 in the year 2000) (20).…”

Drug epidemiology in Italy: methods and ethical issues. The example of psychiatry

“…So far, data on the inpatient population and information on psychiatrists' prescribing behaviour has been collected and disseminated. 11,12 The follow-up phase of the project is still in progress because in 1996 the deadline for closure was delayed to March 1998.…”

“…The ratio between the daily dose prescribed and the De®ned Daily Dose (DDD) of that drug gave an overall utilization of 1.76 (range 0.1 to 22.0) DDD for benzodiazepines, 1.21 (0.1 to 15.8) DDD for neuroleptic drugs and 0.9 (0.1 to 2.0) DDD for antidepressants. 12 The most interesting and worrying ®nding was the wide variability among hospitals in the use of psychotropic drugs, even after adjusting for patient-related variables. In some facilities up to six neuroleptic drugs were administered concurrently; the combined use of neuroleptic, antidepressant and benzodiazepine drugs was very common, and overall dosages were excessive in some cases.…”

“…In October 1996 the Bergamo section of Societa Á Italiana di Medicina Generale (Italian Society of General Practitioners) asked for a seminar on benzo- 12 scienti®c scienti®c scienti®c and international organization organization organization journals, and reports were sent to the proponent of the study BDZ use among Researchers of an Researchers of an Researchers of an Study results were GP patients 16 independent independent independent published in national scienti®c scienti®c scienti®c and international organization and organization organization and journals by researchers GPs GPs and GPs, and data were presented at a GP meeting BDZ, benzodiazepines; GP, general practitioner.…”