Prevalence of and factors associated with antipsychotic polypharmacy in patients with serious mental illness: Findings from a cross-sectional study in an upper-middle-income country

Armstrong, Kerryn S.; Temmingh, Henk

doi:10.1590/1516-4446-2016-2015

Cited by 27 publications

(30 citation statements)

References 32 publications

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“…12 The frequent use of haloperidol in this and other studies underscores the important role of this drug in antipsychotic polytherapy, as well as concerns regarding its prescription patterns in the treatment of mental health. 13 Identifying the main potential interactions at the CAPS is important in guiding the multidisciplinary team, and monitoring the signs, symptoms and toxic effects of drug interactions on priority groups of users, until their inclusion in all the services. Analysis of potential drug interactions should be part of therapeutic planning for CAPS users, especially those at greater risk of polytherapy, 3 children and the elderly.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Potential Drug Interactions in Brazilian Mental Health Services: Prevalence and Associated Factors

Silva¹,

Lima²,

Ruas³

2018

JYP

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Background: In the mental health field, the psychotropic polypharmacy is frequently observed, a significant risk factor for the occurrence of drug interactions. Objective: Identify potential drug interactions on the prescriptions of mental health services users and describe the associated factors. Methods: A cross-sectional study was conducted in 11 services. Sociodemographic data and information about the use of drug were obtained through interviews of users, analysis of prescriptions and medical charts, using a semi-structured questionnaire. Potential drug interactions were identified using the Micromedex® database, the association with sociodemographic characteristics and aspects related to the medicines prescribed were analyzed using the prevalence ratio. Results: The number of medicines prescribed ranged from 0 to 9, with an average of 3.38 (SD=1.76) per user, the most prescribed being haloperidol (12.3%), clonazepam (8.2%) and biperiden (7.9%). The proportion of interactions considering the number of users interviewed was 35.1%. The most frequent between potential interactions were haloperidol and fluoxetine (9.1%); haloperidol and carbamazepine (8.8%); and carbamazepine and chlorpromazine (5.9%). The highest prevalence ratio (PR) for the occurrence of potential interactions was in women (PR=1.36; 95% CI 1.08:1.71), users who had reported improper medicine use (PR=1.36; 95% CI: 1.07:1.72) and those with more than 5 prescribed medicines (PR=1.87; 95% CI: 1.49:2.33). Conclusion: Potential drug interactions were observed in more than one-third of the user's Brazilian mental health services. The profile of interactions detected could guide the pharmacotherapeutic follow-up of priority users, and help the multidisciplinary team identify signs and symptoms that can influence the treatment of users.

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Section: Discussionmentioning

confidence: 99%

Analysis of Potential Drug Interactions in Brazilian Mental Health Services: Prevalence and Associated Factors

Silva¹,

Lima²,

Ruas³

2018

JYP

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“…The adverse sequelae arising from concomitant antipsychotic use have resulted in a bourgeoning field of research investigating correlates of antipsychotic polypharmacy. The literature has identified a number of factors associated with antipsychotic polypharmacy, including younger age, male sex, schizophrenia and psychotic disorders, longer inpatient stay, and greater number of hospital admissions (8,17). A variety of clinical and medication variables were also found to be related to antipsychotic polypharmacy (e.g., greater illness severity, higher total dose of antipsychotics, treatment with a depot antipsychotic) (8).…”

Section: Introductionmentioning

confidence: 99%

The Prevalence and Factors Associated With Antipsychotic Polypharmacy in a Forensic Psychiatric Sample

Farrell

Brink

2020

Front. Psychiatry

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Despite clinical guidelines limiting the use of multiple concomitant antipsychotics to the most exceptional and treatment resistant cases, the prevalence of antipsychotic polypharmacy has been increasing worldwide. There has been minimal research investigating the prevalence of antipsychotic polypharmacy in forensic psychiatric samples and the correlates associated with antipsychotic polypharmacy. This crosssectional study aimed to establish the prevalence of antipsychotic polypharmacy in a forensic psychiatric inpatient sample and to investigate the demographical, clinical, and forensic factors associated with polypharmacy. All patients (N = 142) were prescribed at least one antipsychotic at the time of the study. Antipsychotic polypharmacy was prescribed to 54.93% of patients. Logistic regression results indicated increased length of hospitalization, high/medium security level, treatment with clozapine, and depot antipsychotic prescription were predictive of being placed on an antipsychotic polypharmacy regimen. The results suggest that those who are prescribed multiple antipsychotics are long stay patients who present with higher clinical complexity. The results from this study can be used to inform clinical practice leaders about the prevalence of antipsychotic polypharmacy in a forensic psychiatric institution. More research is needed to understand the clinical justifications for prescribing multiple antipsychotics in a forensic psychiatric sample and ways to safely reduce the prevalence of antipsychotic polypharmacy.

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“…Given the various undesired health outcomes associated with polypharmacy, 1 there is an interest in epidemiological studies that determine the distribution of polypharmacy in society. 2 These epidemiological studies highlight the sub-sections of the society and population that are most strongly affected by polypharmacy. 3,4 Based on the observations of these studies, similar to many other health outcomes, polypharmacy is not distributed at random, but it is more common in the sections of society with the greatest social and health needs.…”

Section: Introductionmentioning

confidence: 99%

Social Determinants of Polypharmacy in First Generation Mexican Immigrants in the United States

Assari

Saqib

Wisseh

et al. 2019

Int J Travel Med Glob Health

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Introduction: Socioeconomic status (SES) indicators are among the main social determinants of health and illness. Less, however, is known about the role of SES in the epidemiology of polypharmacy in immigrant Latino Americans living in the United States. This research studied the association between three SES indicators, education, income, and employment, and polypharmacy in older first generation Latino American immigrant adults. Methods: Data was obtained from the Sacramento Area Latino Study on Aging (SALSA, 1996-2008). A total of 632 older first generation Mexican-American immigrants to the U.S. entered this analysis. The independent variables were education, income, and employment. Polypharmacy was the outcome. Age, gender, physical health, smoking, and drinking were the covariates. Binary logistic regression was used to analyze the data. Results: Employment was associated with lower odds of polypharmacy. The association between education and polypharmacy was above and beyond demographic factors, physical health, health behaviors, and health insurance. Neither education nor income were associated with polypharmacy. Other determinants of polypharmacy were poor self-rated health (SRH) and a higher number of chronic medical conditions (CMCs). Conclusion: Employment appears to be the major SES determinant of polypharmacy in older foreign-born Mexican Americans. Unemployed older Mexican American immigrants with multiple chronic diseases and those who have poor SRH have the highest need for an evaluation of polypharmacy. Given the age group of this population, most of them have health insurance, which provides an opportunity for reducing their polypharmacy.

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Prevalence of and factors associated with antipsychotic polypharmacy in patients with serious mental illness: Findings from a cross-sectional study in an upper-middle-income country

Cited by 27 publications

References 32 publications

Analysis of Potential Drug Interactions in Brazilian Mental Health Services: Prevalence and Associated Factors

Analysis of Potential Drug Interactions in Brazilian Mental Health Services: Prevalence and Associated Factors

The Prevalence and Factors Associated With Antipsychotic Polypharmacy in a Forensic Psychiatric Sample

Social Determinants of Polypharmacy in First Generation Mexican Immigrants in the United States

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