title: Guideline adherence in medication management of psychotic disorders: an observational multisite hospital study.
abstract: 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.
authors.affiliation: Department of Psychiatry and Psychotherapy, Heinrich Heine University, Duesseldorf, Germany. stefan.weinmann.de
authors.forename: S
authors.initials: S
authors.lastname: Weinmann
authors.forename: B
authors.initials: B
authors.lastname: Janssen
authors.forename: W
authors.initials: W
authors.lastname: Gaebel
mesh_terms: 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
chemical_list: D014150:Antipsychotic Agents