A pilot study testing a medication algorithm to reduce polypharmacy.
BACKGROUND
Polypharmacy is common in the treatment of persons with severe mental illness, yet it is not an evidence-based practice. To address this, an attempt was made to reduce medications for patients already receiving polypharmacy during an episode of acute psychiatric hospitalization.


METHODS
A medication-reduction algorithm was developed , based on the best available evidence regarding indications for and efficacy of medications and principles of collaborative care. A feasibility pilot study was conducted using a matched case-control design for 12 patients treated with the algorithm and 12 patients treated as usual.


RESULTS
The intervention patients were discharged on significantly fewer medications than controls; symptom reduction and length of stay did not differ significantly.


CONCLUSIONS
A collaborative approach to reducing polypharmacy may reverse the trend to add medications during hospitalization.
Mistler
L A
LA
Department of Psychiatry, Dartmouth Medical School, Hanover, New Hampshire, USA. lisa.a.mistler@dartmouth.edu
Mellman
T A
TA
Drake
R E
RE
D000328:Adult; D000465:Algorithms; D014150:Antipsychotic Agents / Q000008:administration & dosage*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D019338:Polypharmacy; D011618:Psychotic Disorders / Q000188:drug therapy*
D014150:Antipsychotic Agents