title: [Evaluation of therapeutical appropriateness in psychiatric treatment of schizophrenia, by integrating computer data records with clinical audit results].
abstract: OBJECTIVE
  The aim is to evaluate prescriptive patterns of atypical antipsychotic drugs for the treatment of schizophrenia in the LHU Caserta in 2011-2013, and to indicate potentially inappropriate therapy; to plan or schedule corrective/preventive activities to support the continuous improvement of health services.
  
  
  METHODS
  Retrospective cohort study, based on integration of health records and clinical audit. The study was performed in the following steps: data retrieval and analysis; comparison of data with international literature; editing of the Diagnostic-Therapeutic Path. The analysis was performed by using the administrative database of drug prescriptions and treatment plans in the SANIARP portal, a web platform available to specialist facilities and private and public pharmacies of LHU Caserta. The subject of our analysis was to gain information about the diagnosis and treatment of users of atypical antipsychotics in the LHU of Caserta in the years 2011-2013.
  
  
  RESULTS
  We identified 2,768 patients with at least one prescription of atypical antipsychotics and diagnosis coded in the study period. Schizophrenia is the most frequent diagnosis (31.1%) and the most common drug in use is olanzapine (29.1%). About 70% of schizophrenics were on monotherapy with no change in drug, 23.6% were under polytherapy and 7.9% made a switch.
  
  
  CONCLUSIONS
  Our findings were a starting point for editing Diagnostic and Therapeutic Paths aimed at raising the awareness of the scientific community about the appropriateness of diagnosis and treatment in schizophrenia. Pharmacological treatment of schizophrenia should be focused on improving the overall quality of life aimed at remission and possible recovery, although difficult.
authors.affiliation: Servizio Controllo Interno di Gestione e Sistema Informativo, ASL Caserta.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Farina
authors.affiliation: Centro Interdipartimentale di Ricerca in Farmacoeconomia e Farmacoutilizzazione (CIRFF), Università di Napoli Federico II.
authors.forename: Enrica
authors.initials: E
authors.lastname: Menditto
authors.affiliation: Servizio Controllo Interno di Gestione e Sistema Informativo, ASL Caserta.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Corea
authors.affiliation: Servizio Controllo Interno di Gestione e Sistema Informativo, ASL Caserta.
authors.forename: Sonia
authors.initials: S
authors.lastname: Manna
authors.affiliation: Servizio Controllo Interno di Gestione e Sistema Informativo, ASL Caserta.
authors.forename: Claudia
authors.initials: C
authors.lastname: Pagliaro
authors.affiliation: Servizio Controllo Interno di Gestione e Sistema Informativo, ASL Caserta.
authors.forename: Chiara
authors.initials: C
authors.lastname: Troncone
authors.affiliation: Servizio Controllo Interno di Gestione e Sistema Informativo, ASL Caserta.
authors.forename: Claudio
authors.initials: C
authors.lastname: Linguiti
authors.affiliation: Centro Interdipartimentale di Ricerca in Farmacoeconomia e Farmacoutilizzazione (CIRFF), Università di Napoli Federico II.
authors.forename: Valentina
authors.initials: V
authors.lastname: Orlando
authors.affiliation: Centro Interdipartimentale di Ricerca in Farmacoeconomia e Farmacoutilizzazione (CIRFF), Università di Napoli Federico II.
authors.forename: Daria
authors.initials: D
authors.lastname: Putignano
authors.affiliation: Dipartimento di Scienze Biomediche Avanzate,Università di Napoli Federico II.
authors.forename: Daniele Ugo
authors.initials: DU
authors.lastname: Tari
authors.affiliation: ASL Caserta, UOSM Distretto 13, Caserta.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Buffardi
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use*; D000068180:Aripiprazole; D001569:Benzodiazepines / Q000627:therapeutic use*; D054869:Clinical Audit; D003986:Dibenzocycloheptenes; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004359:Drug Therapy, Combination; D005260:Female; D006576:Heterocyclic Compounds, 4 or More Rings; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D000077152:Olanzapine; D000068882:Paliperidone Palmitate; D010879:Piperazines / Q000627:therapeutic use*; D011613:Psychotherapy / Q000379:methods; D011788:Quality of Life; D000069348:Quetiapine Fumarate; D012189:Retrospective Studies; D018967:Risperidone; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000534:rehabilitation; D013844:Thiazoles / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D003986:Dibenzocycloheptenes; D006576:Heterocyclic Compounds, 4 or More Rings; D010879:Piperazines; D013844:Thiazoles; D001569:Benzodiazepines; D000069348:Quetiapine Fumarate; C092292:ziprasidone; D000068180:Aripiprazole; C522667:asenapine; D018967:Risperidone; D000077152:Olanzapine; D000068882:Paliperidone Palmitate