Polypharmacy and psychotropic drug loading in patients with schizophrenia in Asian countries: Fourth survey of Research on Asian Prescription Patterns on antipsychotics

Yang, Shuyu; Chen, Lian‐Yu; Najoan, Eunice; Kallivayalil, Roy Abraham; Viboonma, Kittisak; Jamaluddin, Ruzita; Javed, Afzal; Hoa, Duong Thi Quynh; Iida, Hitoshi; Sim, Kang; Swe, Thiha; He, Yanling; Park, Yong Chon; Ahmed, Helal Uddin; Alwis, Angelo de; Chiu, Helen F. K.; Sartorius, Norman; Tan, C.H.; Chong, Mian‐Yoon; Shinfuku, Naotaka; Lin, Shih‐Ku

doi:10.1111/pcn.12676

Cited by 54 publications

(67 citation statements)

References 30 publications

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“…The phenotype of mental illness and psychiatric symptoms' manifestation forms have changed throughout eras, cultures, and societies. 5,53,54 From the end of the 19th century to the beginning of the 20th century, Europe experienced a period of great tension between nations and ethnic groups resulting in forms of social chaos. It is during this period that hysteria seemed to be of epidemic proportions, especially among the ladies of society.…”

Section: Emergence Of Hikikomori From the World Historical Viewpointmentioning

confidence: 99%

Hikikomori : Multidimensional understanding, assessment, and future international perspectives

Kato

Kanba

Teo

2019

Psychiatry Clin Neurosci

173

271

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Hikikomori, a severe form of social withdrawal, has long been observed in Japan mainly among youth and adolescents since around the 1970s, and has been especially highlighted since the late 1990s. Moreover, hikikomori‐like cases have recently been reported in many other countries. Hikikomori negatively influences not only the individual's mental health and social participation, but also wider education and workforce stability, and as such is a novel urgent global issue. In this review, we introduce the history, definition, diagnostic evaluation, and interventions for hikikomori and also the international prevalence of hikikomori outside Japan. We propose a hypothesis regarding the globalization of hikikomori based on domestic and international perspectives. In addition, we introduce our latest assessment system for hikikomori (including the latest version of the ‘proposed diagnostic criteria of hikikomori for the future DSM/ICD diagnostic systems’) and propose therapeutic strategies, including family approaches and individualized therapies. Finally, we present future challenges that may lead to solutions for an internationalized hikikomori.

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Section: Emergence Of Hikikomori From the World Historical Viewpointmentioning

confidence: 99%

Hikikomori : Multidimensional understanding, assessment, and future international perspectives

Kato

Kanba

Teo

2019

Psychiatry Clin Neurosci

173

271

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“…Consequently, pharmacotherapies for psychiatric disorders in Japan differed from those recommended by treatment guidelines in other countries. [9][10][11][12][13][14] For example, although most guidelines recommended antipsychotic monotherapy for schizophrenia, the number of antipsychotics used in Japan was higher than that used in other countries. In addition, the use of benzodiazepines as adjunctive treatment for major depressive disorder, which is not recommended in most guidelines, was higher in Japan than in the USA.…”

Section: Resultsmentioning

confidence: 99%

Improvement of psychiatrists’ clinical knowledge of the treatment guidelines for schizophrenia and major depressive disorders using the ‘Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE)’ project: A nationwide dissemination, education, and evaluation study

Takaesu

Watanabe

Numata

et al. 2019

Psychiatry Clin Neurosci

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Aim Although treatment guidelines for pharmacological therapy for schizophrenia and major depressive disorder have been issued by the Japanese Societies of Neuropsychopharmacology and Mood Disorders, these guidelines have not been well applied by psychiatrists throughout the nation. To address this issue, we developed the ‘Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE)’ integrated education programs for psychiatrists to disseminate the clinical guidelines. Additionally, we conducted a systematic efficacy evaluation of the programs. Methods Four hundred thirteen out of 461 psychiatrists attended two 1‐day educational programs based on the treatment guidelines for schizophrenia and major depressive disorder from October 2016 to March 2018. We measured the participants’ clinical knowledge of the treatment guidelines using self‐completed questionnaires administered before and after the program to assess the effectiveness of the programs for improving knowledge. We also examined the relation between the participants’ demographics and their clinical knowledge scores. Results The clinical knowledge scores for both guidelines were significantly improved after the program. There was no correlation between clinical knowledge and participant demographics for the program on schizophrenia; however, a weak positive correlation was found between clinical knowledge and the years of professional experience for the program on major depressive disorder. Conclusion Our results provide evidence that educational programs on the clinical practices recommended in guidelines for schizophrenia and major depressive disorder might effectively improve participants’ clinical knowledge of the guidelines. These data are encouraging to facilitate the standardization of clinical practices for psychiatric disorders.

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“…Likewise, another nationwide survey on the management of oral anticancer agents in community pharmacies reported that an average of zero or one to five medications were dispensed per week. 24) For most respondents, fewer than 40% of the patients they managed were cancer patients, and the number of cancer patients was not high. This low encounter rate with cancer patients may be related to pharmacists' low rate of board certification, which may result in no association between the success rate for reducing inappropriate medications and the board certification or years of pharmacist experience.…”

Section: Discussionmentioning

confidence: 99%

A Nationwide Survey of Community Pharmacist Contributions to Polypharmacy in Opioid-Using and Non-using Cancer Patients in Japan

Suzuki

Uchida

Suga

et al. 2019

Biological & Pharmaceutical Bulletin

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No nationwide study on polypharmacy in palliative care among Japanese community pharmacies has yet been conducted. We conducted an online questionnaire survey for community pharmacist members of The Japanese Society for Pharmaceutical Palliative Care and Sciences regarding their contributions to cancer patients who regularly used six or more drugs, including opioids, in service during the two-month period from October to November 2017. Of 579 community pharmacists, 83 responded to the survey (14.3%). Among them, 47.0 and 27.7% of respondents replied that more than 40% of opioid-using and non-using cancer patients were prescribed six or more regular medications, respectively. The proportion of patients with polypharmacy was marginally higher among opioid-using than non-using patients. Additionally, 31.3 and 22.9% of respondents replied that a low or moderate rate of opioid-using and non-using patients with polypharmacy received inappropriate prescriptions, respectively, including "unnecessary medications," "adverse drug reactions" and "duplication of pharmacological effect." The proportion of patients who received inappropriate prescriptions was significantly higher among opioid-using than non-using patients. Furthermore, 37.3 and 19.3% of respondents replied that pharmacist's recommendations contributed to drug reduction in opioidusing and non-using patients with polypharmacy who received inappropriate prescriptions, respectively. The responders with higher confidence in palliative care showed more success rate for reducing inappropriate medications. Our findings suggest that opioid use can be associated with an increased risk of polypharmacy in cancer patients, and that recommendations by a population of community pharmacists can reduce inappropriate medications and improve adverse drug reactions in both opioid-using and non-using cancer patients with polypharmacy.

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Polypharmacy and psychotropic drug loading in patients with schizophrenia in Asian countries: Fourth survey of Research on Asian Prescription Patterns on antipsychotics

Abstract: Differences in psychiatrist training as well as the civil culture and health insurance system of each country may have contributed to the differences in these rates. The concept of drug loading can be applied to other medical fields.

Cited by 54 publications

References 30 publications

Hikikomori : Multidimensional understanding, assessment, and future international perspectives

Hikikomori : Multidimensional understanding, assessment, and future international perspectives

A Nationwide Survey of Community Pharmacist Contributions to Polypharmacy in Opioid-Using and Non-using Cancer Patients in Japan

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