Prescribing practices in psychiatric hospitals in Eastern Europe.
BACKGROUND
There has been no evidence about the prescribing practices in psychiatric care in Eastern Europe.


OBJECTIVE
To examine the patterns of psychotropic prescribing in five countries of Eastern Europe.


METHODS
We conducted a one-day census of psychiatric treatments used in eight psychiatric hospitals in Albania, Croatia, Macedonia, Serbia and Romania. We examined clinical records and medication charts of 1304 patients.


RESULTS
The use of polypharmacy was frequent across all diagnostic groups. Only 6.8% of patients were on monotherapy. The mean number of prescribed drugs was 2.8 (SD 0.97) with 26.5% receiving two drugs, 42.1% receiving three drugs and 22.1% being prescribed four or more psychotropic drugs. Typical antipsychotics were prescribed to 63% and atypical antipsychotics to 40% of patients with psychosis. Older generations of antidepressants were prescribed to 29% of patients with depression. Anxiolitic drugs were prescribed to 20.4% and benzodiazepines to 68.5% of patients. One third of patients received an anticholinergic drug on a regular basis.


CONCLUSIONS
Older generation antipsychotics and antidepressants were used more frequently than in the countries of Western Europe. Psychotropic polypharmacy is a common practice. There is a need for adopting more evidence-based practice in psychiatric care in these countries.
Jordanova
V
V
Imperial College London, Charing Cross Hospital Campus, The Claybrook Centre, St. Dunstan's Road, London W6 8RP, UK. vj22@le.ac.uk
Maric
N P
NP
Alikaj
V
V
Bajs
M
M
Cavic
T
T
Iosub
D
D
Mihai
A
A
Szalontay
A
A
Sartorius
N
N
D000328:Adult; D004363:Drug Utilization / Q000592:standards* / Q000706:statistics & numerical data; D005061:Europe, Eastern; D005260:Female; D006778:Hospitals, Psychiatric / Q000592:standards; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy*; D008875:Middle Aged; D020380:Needs Assessment; D019338:Polypharmacy; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000706:statistics & numerical data; D055553:Prescription Drugs / Q000008:administration & dosage / Q000009:adverse effects; D011619:Psychotropic Drugs / Q000008:administration & dosage / Q000009:adverse effects
D055553:Prescription Drugs; D011619:Psychotropic Drugs