The prescription of psychotropic drugs in psychiatric residential facilities: a national survey in Italy

Tomasi, Rodolfo; Girolamo, Giovanni de; Santone, Giovanni; Picardi, Angelo; Micciolo, Rocco; Semisa, Domenico; Fava, Silva

doi:10.1111/j.1600-0447.2005.00657.x

Cited by 25 publications

(26 citation statements)

References 53 publications

(72 reference statements)

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“…Consistent with prior reports (Biancosino et al, 2005; Brunot et al, 2002; Castberg and Spigset, 2008; Fourrier et al, 2000; Kreyenbuhl et al, 2007b; Lelliott et al, 2002; Millier et al, 2011; Morrato et al, 2007; Stroup et al, 2009; Tibaldi et al, 1997), APP was associated with variables that indicate patients had higher illness severity and, possibly refractoriness (Barbui et al, 2006b; Tomasi et al, 2006), including schizophrenia diagnosis, inpatient status, greater LAI use and shorter follow-up. Moreover, the fact that cross-sectional studies and those with shorter follow-up tended to have higher APP rates, suggests that at least some of the APP was either part of cross-titration or transient.…”

Section: Discussionsupporting

confidence: 86%

Prevalence and correlates of antipsychotic polypharmacy: A systematic review and meta-regression of global and regional trends from the 1970s to 2009

Gallego

Bonetti

Zhang

et al. 2012

Schizophrenia Research

270

281

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Objective To assess the prevalence and correlates of antipsychotic polypharmacy (APP) across decades and regions. Methods Electronic PubMed/Google Scholar search for studies reporting on APP, published from 1970-05/2009. Median rates and interquartile ranges (IQR) were calculated and compared using non-parametric tests. Demographic and clinical variables were tested as correlates of APP in bivariate and meta-regression analyses. Results Across 147 studies (1,418,163 participants, 82.9% diagnosed with schizophrenia [IQR=42–100%]), the median APP rate was 19.6% (IQR=12.9–35.0%). Most common combinations included first-generation antipsychotics (FGAs)+second-generation antipsychotics (SGAs) (42.4%, IQR=0.0–71.4%) followed by FGAs+FGAs (19.6%, IQR=0.0–100%) and SGAs+SGAs (1.8%, IQR=0.0–28%). APP rates were not different between decades (1970–1979:28.8%, IQR=7.5–44%; 1980–1989:17.6%, IQR=10.8–38.2; 1990–1999:22.0%, IQR=11–40; 2000–2009:19.2% IQR=14.4–29.9, p=0.78), but between regions, being higher in Asia and Europe than North America, and in Asia than Oceania (p<0.001). APP increased numerically by 34% in North America from the 1980s 12.7%) to 2000s (17.0%) (p=0.94) and decreased significantly by 65% from 1980 (55.5%) to 2000 (19.2%) in Asia (p=0.03), with non-significant changes in Europe. APP was associated with inpatient status (p<0.001), use of FGAs (p<0.0001) and anticholinergics (<0.001), schizophrenia (p=0.01), less antidepressant use (p=0.02), greater LAIs use (p=0.04), shorter follow-up (p=0.001) and cross-sectional vs. longitudinal study design (p=0.03). In a meta-regression, inpatient status (p<0.0001), FGA use (0.046), and schizophrenia diagnosis (p=0.004) independently predicted APP (N=66, R2=0.44, p<0.0001). Conclusions APP is common with different rates and time trends by region over the last four decades. APP is associated with greater anticholinergic requirement, shorter observation time, greater illness severity and lower antidepressant use.

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Section: Discussionsupporting

confidence: 86%

Prevalence and correlates of antipsychotic polypharmacy: A systematic review and meta-regression of global and regional trends from the 1970s to 2009

Gallego

Bonetti

Zhang

et al. 2012

Schizophrenia Research

270

281

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“…5,7,36,40,47,53–55,61–65 Only risk of relapse was not increased in APP patients in 1 2-year study. 47 In addition, patients with APP showed less treatment improvement, 20 had less illness insight, 46,47 greater treatment resistance, 55,66 a history of violence, 60 and more negative symptoms. 35 The effect of comorbidities was assessed.…”

Section: Resultsmentioning

confidence: 99%

Antipsychotic Polypharmacy

Correll

Gallego

2012

Psychiatric Clinics of North America

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“…[8] [9] Men received more psychotropic prescriptions than women. [10] [11] It is observed that female patients with psychotic disorder present with more severe mental deterioration in an advanced stage of the illness. This may be due to the lack of awareness by their family members and relatives or it may be due to higher depressive episodes in females due to increased hormonal influences.…”

Section: Discussionmentioning

confidence: 99%

Drug Utilization Study of Psychotropic Drugs Prescribed in Psychiatry Opd of L. N. Medical College Associated J. K. Hospital, Bhopal District, Madhya Pradesh

Chaturvedi¹,

Sharma²

2016

jemds

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BACKGROUNDUtilization pattern of drugs varies from place to place and is influenced by differing patient characteristics, type of disea se prevalent, cultural and environmental influences, socioeconomic states, availability of newer drugs and prescribing habit of physicians. Psychiatric disorders are one of the major causes of morbidity. Development of newer drugs like SSRIs and atypical antipsychotics has altered the treatment paradigms. Various factors like cost of drugs, local paradigms, etc. play a role in the selection of drug therapy and hence affect the outcome. Keeping this in mind, we conducted a study to delineate the various drugs used in psychiatric disorders. Psychotropic drugs have had a remarkable impact in psychiatric practice. However, their utilization in actual clinical practice, effectiveness and safety in real life situation needs continuous studies. So our aim to study the prevalence of psychiatric morbidity and analyse drug prescribing pattern in various psychiatric illnesses.

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The prescription of psychotropic drugs in psychiatric residential facilities: a national survey in Italy

Abstract: Psychotropic drug prescription patterns for severe patients living in RFs are characterized by substantial rates of polypharmacy. Specific guidelines may be helpful for long-stay patients living in RFs, who exhibit complex care needs.

Cited by 25 publications

References 53 publications

Prevalence and correlates of antipsychotic polypharmacy: A systematic review and meta-regression of global and regional trends from the 1970s to 2009

Prevalence and correlates of antipsychotic polypharmacy: A systematic review and meta-regression of global and regional trends from the 1970s to 2009

Antipsychotic Polypharmacy

Drug Utilization Study of Psychotropic Drugs Prescribed in Psychiatry Opd of L. N. Medical College Associated J. K. Hospital, Bhopal District, Madhya Pradesh

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