The prevalence of antipsychotic polypharmacy in schizophrenic patients discharged from psychiatric units in Poland

Jaracz, Jan; Tetera-Rudnicka, Edyta; Kujath, Dominika; Raczyńska, Agnieszka; Stoszek, Sebastian; Czernaś, Wojciech; Wierzbiński, Piotr; Moniakowski, Adam; Jaracz, Krystyna; Rybakowski, Janusz

doi:10.1016/j.pharep.2014.02.024

Cited by 15 publications

(11 citation statements)

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“…Female patients had higher risk of polypharmacy. Similar results have been reported elsewhere ( 28 , 47 , 48 ) but not invariably ( 49 , 50 ). Schizophrenia has earlier onset in men than in women and earlier onset is associated with a more severe course of illness ( 5 ).…”

Section: Discussionsupporting

confidence: 92%

Medication Gaps and Antipsychotic Polypharmacy in Previously Hospitalized Schizophrenia Patients: An Electronic Cohort Study in Three Canadian Provinces

et al. 2022

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BackgroundReal world evidence about antipsychotics focuses on rehospitalization. Modeling the time course of pharmacotherapy would show patients' adherence to medications and physicians' adherence to medication guidelines. We aimed to calculate the cumulative time spent in second generation antipsychotics (SGAs), gaps, antipsychotic polypharmacy, and clozapine in discharged schizophrenia patients.MethodsHospitalization and pharmacy dispensing data from 2008–2018 in Manitoba, Saskatchewan, and British Columbia were linked and an electronic cohort (N = 2,997) was created (mean follow-up: 49 months, SD = 38). Cohort members were required to have a minimum of 6 weeks medicated with aripiprazole, olanzapine, paliperidone, quetiapine, risperidone, or ziprasidone.ResultsThe multistate model predicted that schizophrenia patients accumulated 44 months in SGA monotherapy, 4 months in polypharmacy, 11 months in medication gaps and 17 days in clozapine over a 5-year period. The majority of transitions were between SGA and medication gap. Accumulated time in medication gaps was seven times as much as in clozapine. Each 10% delay in SGA initiation post-discharge was associated with a 2, 1, and 6% higher risk for polypharmacy (95% CI: 1.01–1.02), gap (95% CI: 1.01–1.01), and clozapine (95% CI: 1.04–1.08), respectively.InterpretationSchizophrenia patients accumulated more time unmedicated and in polypharmacy compared to clozapine. Either treatment guidelines for schizophrenia are not followed, or real-world challenges hamper their implementation.

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Section: Discussionsupporting

confidence: 92%

Medication Gaps and Antipsychotic Polypharmacy in Previously Hospitalized Schizophrenia Patients: An Electronic Cohort Study in Three Canadian Provinces

et al. 2022

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“…Our finding that previous treatment with at least one nonindex antipsychotic drug was associated with an increased risk of hospitalization is similar to findings from previous studies [40]. Severely ill patients who are more difficult to treat due to nonresponse may cycle through several different antipsychotics in an attempt to properly control symptoms.…”

Section: Discussionsupporting

confidence: 89%

Hospitalization risk factors in antipsychotic-treated schizophrenia, bipolar I disorder or major depressive disorder

et al. 2019

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Aim: To examine hospitalization risk factors in antipsychotic-treated patients with schizophrenia, bipolar I disorder (BD-I) or major depressive disorder (MDD). Patients & methods: Using Truven Health MarketScan® Commercial, Medicaid and Medicare Supplemental data (01/01/2012–06/30/2016), logistic regression models were performed to identify risk factors for both psychiatric and all-cause hospitalization in three separate analyses. Results: Significant risk factors included prior hospitalization (schizophrenia: odds ratio [95% CI]: 2.83 [2.50–3.21; psychiatric]; 2.58 [2.31–2.87; all-cause]; BD-I: 2.42 [2.23–2.63]; 2.09 [1.96–2.23]; MDD: 2.81 [2.49–3.16]; 2.21 [2.03–2.40]), previous antipsychotic treatment (schizophrenia: 1.71 [1.52–1.93]; 1.31 [1.18–1.46]; BD-I: 1.33 [1.23–1.44]; 1.22 [1.14–1.30]; MDD: 1.31 (1.11–1.54); 1.17 (1.04–1.32) and substance abuse (schizophrenia: 1.42 [1.27–1.60]; 1.37 [1.23–1.53]; BD-I: 1.72 [1.58–1.86]; 1.61 [1.50–1.72]; MDD: 1.90 [1.68–2.15] and 1.55 [1.41–1.71]). Conclusion: Prior hospitalization, previous antipsychotic treatment and substance abuse were associated with increased hospitalization risk in schizophrenia, BD-I or MDD.

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“…The results of some studies suggest that the addition of an antidepressant to antipsychotics may have a be neficial effect on negative symptoms, if only by possibly reducing secondary symptoms resulting from depressed mood (Cerveri et al, 2019). In the study group, poly therapy in the form of an antipsychotic drug combined with an antidepressant was used in 23-32% of patients, confirming the relatively high popularity of this method (Jaracz et al, 2014). In the statistical analysis performed, there was no significant association between the mode of pharmacotherapy and the frequency of negative symp toms.…”

Section: ( Resultsmentioning

confidence: 75%

Relationships between the pharmacological treatment method and negative symptoms, depression, social functioning and quality of life in schizophrenia patients during 11–15 years after a first psychiatric hospitalisation

Jaracz¹,

Górna²,

Kiejda³

et al. 2022

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hospitalised for the first time 11 to 15 years ago. Depres sive symptoms, social functioning, and quality of life were also scrutinised. Methods. 56 patients were assessed one month after the hospitalisation (Time 1), and then as follows: 1 year later, 4-6, 7-11 and 11-15 years after Time 1. The following measures were used: Marder's Negative Symptoms Fac tor Score (NSFS), Calgary Depression Scale for Schizo phrenia (CDSS), Social Functioning (SFS) and WHOQoL -Bref scales. Results. Most patients received antipsychotic medica tions throughout the whole observation period (85.7-94.6%). Out of them, 69.6-77.6% were treated with an tipsychotics only and 22.9-32.4% with antipsychotics + antidepressants. There were no significant relationships between the mode of treatment and the frequency of negative symptoms or significant differences between the compared groups regarding the mean scores of the CDSS, SFS, and WHOQoL at any time point of the observation. Conclusions. The way of treatment in terms of mono therapy (antipsychotics only) vs polytherapy (+ anti depressants) did not differentiate the frequency of Original article / Artykuł oryginalnyRelationships between the pharmacological treatment method and negative symptoms, depression, social functioning and quality of life in schizophrenia patients during 11-15 years after a first psychiatric hospitalisation Zależność pomiędzy sposobem leczenia farmakologicznego a objawami negatywnymi, depresją, funkcjonowaniem społecznym i jakością życia chorych na schizofrenię w okresie 11-15 lat po pierwszej hospitalizacji psychiatrycznej

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The prevalence of antipsychotic polypharmacy in schizophrenic patients discharged from psychiatric units in Poland

Cited by 15 publications

References 44 publications

Medication Gaps and Antipsychotic Polypharmacy in Previously Hospitalized Schizophrenia Patients: An Electronic Cohort Study in Three Canadian Provinces

Medication Gaps and Antipsychotic Polypharmacy in Previously Hospitalized Schizophrenia Patients: An Electronic Cohort Study in Three Canadian Provinces

Hospitalization risk factors in antipsychotic-treated schizophrenia, bipolar I disorder or major depressive disorder

Relationships between the pharmacological treatment method and negative symptoms, depression, social functioning and quality of life in schizophrenia patients during 11–15 years after a first psychiatric hospitalisation

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