Guideline adherence in medication management of psychotic disorders: an observational multisite hospital study.
OBJECTIVE
To evaluate guideline adherence in in-patient medication care of psychotic disorders.


METHODS
A total of 508 persons with psychotic disorders were included in a naturalistic multisite hospital study. Subjects were assessed weekly on mental state, social functioning, socioeconomic factors and medication prescriptions.


RESULTS
In total, 17% of individuals were prescribed antipsychotic dosages above the recommended value. Among those with persistent psychotic symptoms, 73% received insufficient antipsychotic drug management. About 58% of patients with depressive symptoms were not treated according to guidelines, and 53% of patients did not receive adequate management of side-effects from antipsychotic medications. Subjects with more than six previous psychiatric hospitalizations (OR 1.80, CI: 1.05-3.08) and those with a prominent thought disorder (OR 2.28, CI: 1.23-4.23) had a higher likelihood of not being treated according to guidelines.


CONCLUSIONS
Individuals with chronic and thought-disordered psychosis may be at a higher risk of receiving medication care not supported by guidelines.
Weinmann
S
S
Department of Psychiatry and Psychotherapy, Heinrich Heine University, Duesseldorf, Germany. stefan.weinmann.de
Janssen
B
B
Gaebel
W
W
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D011307:Drug Prescriptions; D005260:Female; D005858:Germany / Q000453:epidemiology; D017408:Guidelines as Topic; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration; D019370:Observation; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D011785:Quality Assurance, Health Care; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology; D012919:Social Behavior; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology
D014150:Antipsychotic Agents