Factors predicting the use of multiple psychotropic medications.
BACKGROUND
Recent studies have questioned the appropriateness of some types of psychotropic medication prescribing, especially by general practitioners. The purpose of this study is to investigate factors that predict prescribing of multiple psychotropic medications, a class that may represent more complicated cases.


METHODS
This study analyzed data from the 1989 National Ambulatory Medical Care Survey (NAMCS). Multiple logistic regression methods were used to determine variables that predicted the provision or ordering of multiple psychotropic medications during a single office visit.


RESULTS
Patients who visited psychiatrists were six times more likely to receive psychotropics in combination than patients visiting general practitioners. Patients diagnosed as manic were four times more likely to receive multiple psychotropics, and those diagnosed as schizophrenic were three times more likely Patients visiting physicians in the Northeast and South were significantly less likely to receive psychotropics in combination than patients in the Midwest.


CONCLUSIONS
Although general practice physicians contribute to the use of multiple psychotropic medications, patients visiting psychiatric specialists are much more likely to be provided combination therapy.
Department of Pharmaceutical economics and policy, USC School of Pharmacy, Los Angeles 90033.
M B
MB
Nichol
G L
GL
Stimmel
S C
SC
Lange
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000928:Antidepressive Agents / Q000008:administration & dosage; D001714:Bipolar Disorder / Q000188:drug therapy; D004359:Drug Therapy, Combination; D004363:Drug Utilization; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011336:Probability; D011570:Psychiatry / Q000706:statistics & numerical data; D011619:Psychotropic Drugs / Q000008:administration & dosage*; D012559:Schizophrenia / Q000188:drug therapy; D014481:United States
D000928:Antidepressive Agents; D011619:Psychotropic Drugs