"Real world" atypical antipsychotic prescribing practices in public child and adolescent inpatient settings.
This article examines the factors that influence antipsychotic use among youth treated in public inpatient facilities. By combining data from 11 focus groups, a survey of 43 researchers and clinicians, and a chart review of 100 closed patient charts, we investigated the interplay between physicians' and staff members' perceptions of problems related to antipsychotic prescribing, their beliefs concerning optimal approaches, their actual recorded prescribing behaviors, and the discrepancies between their beliefs and their recorded practices. We discovered that antipsychotics are prescribed broadly to treat a variety of conditions, including nonpsychotic disorders among children in public inpatient facilities. Despite overall expert consensus regarding "best practices," physicians described systemic obstacles that prevent the application of these practices, and our data confirmed that best practices are not always followed. Future research should be done with this patient population and should investigate the factors that influence antipsychotic use among inpatient youth.
Pappadopulos
Elizabeth
E
Center for the Advancement of Children's Mental Health, Columbia University/New York State Psychiatric Institute, NY 10032, USA. pj131@columbia.edu
Jensen
Peter S
PS
Schur
Sarah B
SB
MacIntyre
James C
JC
Ketner
Scott
S
Van Orden
Kimberly
K
Sverd
Jeffrey
J
Sardana
Sadhana
S
Woodlock
David
D
Schweitzer
Robert
R
Rube
David
D
D000293:Adolescent; D000374:Aggression / Q000187:drug effects*; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000145:classification; D002648:Child; D019091:Critical Pathways / Q000639:trends; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D006778:Hospitals, Psychiatric; D006779:Hospitals, Public; D006801:Humans; D009518:New York; D010043:Outcome and Process Assessment, Health Care; D011567:Psychiatric Department, Hospital; D012561:Schizophrenia, Childhood / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology
D014150:Antipsychotic Agents