Development of a registry for monitoring psychotropic drug prescriptions: aims, methods and implications for ordinary practice and research

Abstract

In psychiatry, individual-based registries have provided key information on risks and benefits associated with the use of psychotropic drugs but they have rarely been employed for monitoring and evaluating the everyday prescribing of psychopharmacological treatments. This article describes the cultural background that gave impetus to the idea of registering all prescriptions of psychotropic drugs dispensed by physicians working in the South Verona community mental health service, and presents the methodology employed to develop such a registry in a community psychiatric service where a psychiatric case register (PCR) has been operating since 1978. We developed a registry including every patient receiving psychotropic medications in ordinary practice. This registry is linked to the PCR in order to obtain data on social and demographic characteristics, clinical symptoms, diagnosis, use of services, and outcomes. No exclusion criteria are allowed--anyone receiving treatment is automatically included. This system, which can link drug and service-use data with hard outcome indicators, can generate information on the proportion of subjects discontinuing treatment, switching medication because of side-effects, recovery or inefficacy, as well as on the proportion of subjects failing to return to the physician, and the proportion of patients who improve. The innovative aspect of this approach is that this registry is developed, organized and used by physicians interested in monitoring their clinical practice and in providing patients, relatives and the public with accurate information on drug use in their specific context of care.

Is Neuregulin 1 Involved in Determining Cerebral Volumes in Schizophrenia? Preliminary Results Showing a Decrease in Superior Temporal Gyrus Volume

“…To quantify the antipsychotic dose for each patient, the medication history was evaluated for each patient using case records from 1997 to 2002, and using the South Verona Psychotropic Drug Registry from 2003 to 2005 [57] . For each antipsychotic prescribed, the ratio between the prescribed daily dose and the defined daily dose (http://www.whocc.no/atcddd) was calculated; for multiple prescriptions, the sum of the ratios for each prescription was calculated [58] .…”

The advantages and barriers in the implementation of a substance dependence treatment information system (SDTIS)

“…Finally, they concluded that the presence of monitoring systems, which are able to link drug and service-user data with outcome indicators is a basic quality requirement for modem psychiatric services and the presence of interest in monitoring ordinary practice is necessary. [ 10 ] One of important abilities of an information system, which is mentioned in this research, is being linked with other information systems.…”

Understanding antipsychotic non-classical prescriptions: a quantitative and qualitative approach

“…The PCR, however, does not routinely collect information on prescriptions of psychotropic drug. In an effort to fill this lack of data, in 2003 a psychotropic drug registry (PDR) was developed and implemented (Barbui et al, 2005). The registry can be accessed using most Internet browsers from any personal computer located within the psychiatric service.…”

“…Information stored in the PDR is regularly cross-checked with information stored in patients' clinical records. In case of inconsistencies, the treating physician is contacted for updating the system (Barbui et al, 2005;Bonetto et al, 2006).…”