Changes in Antipsychotic Medication in Clients of Assertive Community Treatment in Japan: A One-Year Follow Up

Satake, Naoko; Hazama, Kyoko; Sono, Tamaki; Takahashi, Makoto; Ito, Junichiro

doi:10.2174/1745017901107010001

Cited by 5 publications

(3 citation statements)

References 11 publications

(12 reference statements)

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“…Although most studies defined polypharmacy as any time with more than one AP (Xiang et al, 2007, Satake et al, 2011, others have set specific time requirements such as setting at least 14 days of concurrent AP use (Ganguly et al, 2004). Moreover, differences in study methods can generate different results too (Faries et al, 2005, Xiang et al, 2007, Karaoğlan Kahiloğullari et al, 2008.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Analysis of Antipsychotic Medication Use with Concomitant Clinical Evaluation in Outpatient Psychiatry Department in Palestine

Ihbeasheh¹,

Jarar²,

Sweileh³

2014

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The objective of this paper was to study antipsychotic medication use in the outpatient psychiatry department in Palestine. Methodology: This is a cross sectional study carried out in Palestine on schizophrenic patients aged between 20 -65 whose medications have not been changed in the past six months and they did not have an acute attack in the last year. Information regarding antipsychotic medications use was obtained from patients' medical files; patients' psychiatric symptoms were evaluated using the Expanded Brief Psychiatric Rating Scale (BPRS-E).Results: More than half (53.1%) of 150 patients were on antipsychotic polypharmacy (APP) with average daily dose of 546.9 ± 254.9 mg chlorpromazine equivalents. The average number (mean ± SD) of medications a patient received was 1.7 ± 0.7. One third of patients on APP regimen received atypical antipsychotic and all of them received at least one conventional antipsychotic. Factors significantly and positively associated with APP were: use of anticholinergic agents (P<0.001), conventional antipsychotics (P<0.001), depot formulations (P<0.001) and prescribing higher doses of antipsychotics (P<0.001). Discussion and Conclusion: Antipsychotic polypharmacy in this study was common. Adherence to international guidelines in the treatment of schizophrenia is recommended.

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Section: Discussionmentioning

confidence: 99%

A Retrospective Analysis of Antipsychotic Medication Use with Concomitant Clinical Evaluation in Outpatient Psychiatry Department in Palestine

Ihbeasheh¹,

Jarar²,

Sweileh³

2014

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“…Discrepancies in prevalence of antipsychotic combination across studies may be accounted for by differences in the definition of antipsychotic combination. Although most studies defined combination as any time with more than one antipsychotic [21,22], others have set specific time requirements, such as at least 14 days of concurrent antipsychotic use [23]. Other potential reasons for variations in the prevalence of antipsychotic combination across studies include availability and type of medical insurance for schizophrenia patients as well as clinical experience and knowledge of psychopharmacology by medical practitioners [24].…”

Section: Discussionmentioning

confidence: 99%

Conformance to schizophrenia treatment guidelines in North West-Bank, Palestine: focus on antipsychotic dosing and polytherapy

et al. 2013

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BackgroundAnalysis of the prescribing patterns of antipsychotic drugs can improve therapeutic outcomes. The purpose of this study was to evaluate the prescribing pattern of antipsychotics and its conformance to international treatment guidelines.MethodsA cross sectional study at primary psychiatric centers was carried out. Patients’ medical files were used to obtain demographic, medication and clinical information. International guidelines for schizophrenia were used to create conformance indicators. All statistical analyses were conducted using Statistical Package for Social Sciences.Results250 patients were included in this study. A total of 406 antipsychotic agents were used; 348 (85.7%) were first generation antipsychotics (FGA). The prevalence of antipsychotic combination was 50.4% (n=126). There was no significant difference in positive (p=0.3), negative (p=0.06) and psychopathology (p=0.5) scores of schizophrenia symptoms among patients on monotherapy versus those on antipsychotic combination. Furthermore, no significant difference was observed in the annual cost of antipsychotic monotherapy versus combination therapy. One hundred and five patients (42%) were using optimum dose of (300 – 600 mg CPZeq) while the remaining were using sub or supra therapeutic doses. Analysis showed that use of depot, use of anticholinergic agents and increasing amount of total CPZeq were significant factors associated with antipsychotic combination.ConclusionsThis study indicated that antipsychotic prescribing was not in conformance with international guidelines with respect to maintenance dose and combination therapy. Type of antipsychotic treatment regimen, combination versus monotherapy, was not associated with better clinical or economic outcome.

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“…Researchers have reported the outcomes of ACT implemented at various sites in Japan, ACT reduces hospital days [ 13 ], decreases the dosage of antipsychotics [ 14 ], and increases social functioning, self-efficacy and service satisfactions [ 15 ]. However Japan has no nation-wide implementation program for ACT.…”

Section: Introductionmentioning

confidence: 99%

Community outreach for patients who have difficulties in maintaining contact with mental health services: longitudinal retrospective study of the Japanese outreach model project

et al. 2014

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BackgroundJapan still has the highest ratio of beds devoted to psychiatric patients in the world. In 2011, in order to reduce re-hospitalization of patients who became disconnected from regular contact with outpatient medical services, the Japanese Ministry established the Japanese Outreach Model Project (JOMP). In this study, we will explicate the JOMP project protocol and investigate the rate and length of hospital admission, impairments of social function and problematic behavior at the follow-up period (6- and 12-month) and time of services provided by JOMP.MethodThis longitudinal retrospective study used survey data collected from 32 outreach teams of 21 prefectures in Japan during September 2011 to July 2013. The outcome variables were assessed at baseline, 6-month and 12-month as to whether or not participants had been admitted to the hospital. Data from 162 participants with mental illness who had difficulties in maintaining contact with mental health services were analyzed. Repeated measures analysis of variance provided a significant effect of the intervention over time.ResultsThe rate of hospital admission of JOMP participants was 24.1% at 6-months and 27.2% at the 12-month follow-up. The average length of hospital-stay at baseline and 12-months was 38.7 days (SD 84.7). Compared with the baseline, the average score of the Global Assessment Functioning and the Social Behavioral Schedule were significantly improved after the 6-month and 12-month follow-up. The activity log showed that among the most often delivered JOMP services were to “prevent exacerbation of somatic symptoms” and “care for families”.ConclusionThese results suggest that JOMP has a strong potential to both reduce readmission rates and the length of hospital stay compared with the Japanese regular outpatient care by public insurance, and improve social function and problematic behavior. The JOMP teams provided long-term support for families. As of April 2014 JOMP was included in the National Health Insurance program in a limited way therefore an evaluation of JOMP team fidelity on readmissions must be examined.

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Changes in Antipsychotic Medication in Clients of Assertive Community Treatment in Japan: A One-Year Follow Up

Cited by 5 publications

References 11 publications

A Retrospective Analysis of Antipsychotic Medication Use with Concomitant Clinical Evaluation in Outpatient Psychiatry Department in Palestine

A Retrospective Analysis of Antipsychotic Medication Use with Concomitant Clinical Evaluation in Outpatient Psychiatry Department in Palestine

Conformance to schizophrenia treatment guidelines in North West-Bank, Palestine: focus on antipsychotic dosing and polytherapy

Community outreach for patients who have difficulties in maintaining contact with mental health services: longitudinal retrospective study of the Japanese outreach model project

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