title: Antipsychotic utilisation and polypharmacy in Italian residential facilities: a survey.
abstract: OBJECTIVE
  To evaluate the prescribing practices in psychiatric residential facilities, with particular focus both on the antipsychotic dose and polypharmacy as well as the variation of antipsychotic patterns during a patient's stay within the facilities.
  
  
  METHODS
  Fifteen residential facilities of Liguria region in Italy were included. Data were collected through a chart review during a one-day census. Frequency of psychotropic patterns was estimated. Different non-parametric tests were used to analyse the changes in prescription patterns as well as the relationship among antipsychotic dose, the number of antipsychotics and anticholinergic use.
  
  
  RESULTS
  The study sample includes 362 patients, 61.9% males. On the census day 77.5% of patients received psychotropic polypharmacy and 57.2% antipsychotic polypharmacy. Antipsychotic polypharmacy was related to the total antipsychotic daily dose and to anticholinergic use. A trend towards an increase of antipsychotic and psychotropic polypharmacy and higher doses of antipsychotics over the period of stay within the facilities was noted. This tendency was related to the length of stay in the facility.
  
  
  CONCLUSIONS
  Compared to earlier studies in the same clinical environment a significant increase in the use of psychotropic and antipsychotic polypharmacy was observed. The risk of prescribed polypharmacy seems to be related to time spent in the facility.
authors.affiliation: Department of Neuroscience, Ophthalmology and Genetic, University of Genoa, Genoa, Italy. lu.ghio@libero.it
authors.forename: L
authors.initials: L
authors.lastname: Ghio
authors.forename: W
authors.initials: W
authors.lastname: Natta
authors.forename: S
authors.initials: S
authors.lastname: Gotelli
authors.forename: L
authors.initials: L
authors.lastname: Ferrannini
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D018680:Cholinergic Antagonists / Q000627:therapeutic use*; D003625:Data Collection; D039721:Diagnostic and Statistical Manual of Mental Disorders; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007558:Italy; D007902:Length of Stay; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy*; D008875:Middle Aged; D019338:Polypharmacy; D012111:Residence Characteristics; D012112:Residential Facilities
chemical_list: D014150:Antipsychotic Agents; D018680:Cholinergic Antagonists