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 26 publications

(23 citation statements)

References 32 publications

(40 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…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

View full text Add to dashboard Cite

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.

show abstract

“…Polypharmacy is associated with undesired physical health outcomes such as death [1]. Given the serious consequences and the social and health care costs involved, epidemiologists have shown an increasing interest in understanding mental health correlates of polypharmacy across diverse populations [2]. This is particularly important because polypharmacy has unequal correlates across ethnic groups [3].…”

Section: Introductionmentioning

confidence: 99%

Polypharmacy and Depressive Symptoms in U.S.-Born Mexican American Older Adults

Assari

Wisseh

Saqib

et al. 2019

Psych

View full text Add to dashboard Cite

Background: Although some studies have suggested a link between polypharmacy and poor mental health, less is known about the association between polypharmacy and depressive symptomology among U.S.-born older Mexican Americans. Aim: This study aimed to test the association between polypharmacy and depressive symptoms in U.S.-born older Latino Americans. Materials and methods: Data came from the Sacramento Area Latino Study on Aging (SALSA 2008). A total of 691 U.S.-born older (age >= 65) Mexican Americans entered this analysis. Polypharmacy was the independent variable. Level of depressive symptoms was the outcome. Age, gender, socioeconomic status (education, income, and employment), retirement status, health (chronic medical conditions, self-rated health, and activities of daily living), language, acculturation, and smoking were the covariates. A linear regression model was used to analyze the data. Results: We found a positive association between polypharmacy and depressive symptoms, which was above and beyond demographic factors, socioeconomic status, physical health, health behaviors, language, acculturation, and health insurance. Conclusion: Polypharmacy is linked to depressive symptoms in U.S.-born older Mexican Americans. More research is needed to test the effects of reducing inappropriate polypharmacy on mental well-being of first and second generation older Mexican Americans. There is also a need to study the role of drug-drug interaction in explaining the observed link between polypharmacy and depressive symptoms.

show abstract

“…[10] ÇAT alan grupta erkek cinsiyetin daha fazla olması literatürle de uyumludur. [17,18] Araştırmacılar, bu durumu, erkek psikotik bozukluk hastalarının hastalık belirtilerinin daha şiddetli olması şeklinde yorumlamışlardır. [17] Bu araştırma, geri dönük bir araştırmadır, sonuçları tüm evrene genellenemez, bilgilerin hatalı girilmesi, eksik olması gibi araştırma yönteminin özelliklerinin içerdiği bazı kısıtlılıkları bünyesinde barındırmaktadır.…”

Section: Discussionunclassified

Bir Eğitim ve Araştırma Hastanesinde Yatan Psikotik Bozukluk Tanılı Hastaların Sosyodemografik ve Klinik Özellikleri

Delibaş

İkiz²

2018

Journal of Contemporary Medicine

View full text Add to dashboard Cite

Bir eğitim ve araştırma hastanesinde yatan psikotik bozukluk tanılı hastaların sosyodemografik ve klinik özellikleri Sociodemographic and clinical characteristics diagnosed patients of psychotic disorder in a training and research hospital Amaç: Psikotik bozukluklar, ciddi yeti yitimi ile giden ağır ruhsal hastalıklardır. Ülkemizde yatan hasta grubunun büyük çoğunluğunu bu tanı grubundaki hastalar oluşturmaktadır. Bu çalışmada bir eğitim araştırma hastanesi psikiyatri kliniğinde yatarak tedavi edilen psikoz hastalarının sosyodemografik, klinik ve tedavi özelliklerinin araştırılması amaçlanmıştır. Gereç ve Yöntem: Çalışmamızda kliniğimizde 01.01.1995-31.12.2008 tarihleri arasında yatarak tedavi gören psikotik bozukluk tanılı hastaların, "Yatan Hasta Kayıt Formundan" elde edilen verileri geriye dönük olarak değerlendirildi. Bulgular: Belirtilen süre içerisinde toplam 876 hasta psikoz tanısıyla yatırılmıştı. Hastaların ortalama yaş aralığı 34.4±11.8'di. %41.5'i kadın (s=363), %58.5'i erkek (n=512) idi. Psikiyatrik tanı dağılımları DSM-IV sınıflandırma sistemine göre; şizofreni %60.5, başka türlü adlandırılamayan psikotik bozukluk %11.3 vesanrısal bozukluk %8.2 oranında saptandı. Ortalama yatış süresi 37.5±27.1 gündü. Çoklu antipsikotik kullanan hastalar, tek antipsikotik alanlara göre daha sık tekrarlayıcı yatışları vardı (p=0.001), yatış süresi açısından iki grup arasında fark yoktu (p=0.52). Sonuç: Kliniğimizde yatan psikoz hastaları ortalama bir ay süreyi aşan zaman diliminde yatırılmıştır. Çoklu antipsikotik kullanım oranları literatürde bildirilen oranlara göre daha az olduğu bulunmuştur. Psikoz hastalarının sosyodemografik ve kullanılan tedavi özelliklerine yönelik uzunlamasına izlem çalışmalarının yapılması önerilir. Anahtar Sözcükler: Çoklu ilaç kullanımı; polifarmasi; psikotik bozukluk; yatan hasta. Introduction: Psychotic disorders are severe mental illnesses with severe disability. The majority of the inpatient group in our country constitutes the patients in this diagnosis group. Identification of characteristics related to inpatient psychosis patients is important in determining future mental health policies. In this study, it was aimed to investigate the sociodemographic, clinical and treatment characteristics of psychotic patients who were treated in a psychiatry clinic. Methods: In our study, the data obtained from the "Inpatient Patient Enrollment Form" of patients diagnosed with inpatient psychotic disorder between January 1, 1995-December 31, 2008 were evaluated retrospectively. Results: A total of 876 patients were diagnosed with psychosis within the specified period. The mean age range of the patients was 34.4±11.8. 41.5% were female (n=363) and 58.5% were male (n=512). According to DSM-IV classification system of psychiatric diagnoses; schizophrenia was found to be 60.5%, psychotic disorder otherwise unknown 11.3% anddelusional disorder 8.2%.The mean duration of hospitalization was 37.5±27.1 days. Patients using multiple antipsychotics had more frequent recurrent admission (p=0.001) than patien...

show abstract

“…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

View full text Add to dashboard Cite

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.

show abstract

“…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

View full text Add to dashboard Cite

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.

show abstract

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 26 publications

References 32 publications

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

Polypharmacy and Depressive Symptoms in U.S.-Born Mexican American Older Adults

Bir Eğitim ve Araştırma Hastanesinde Yatan Psikotik Bozukluk Tanılı Hastaların Sosyodemografik ve Klinik Özellikleri

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

Contact Info

Product

Resources

About