Patterns of antipsychotics' prescription in Portuguese acute psychiatric wards: A cross-sectional study.
This study aimed to establish the prescribing patterns of antipsychotics in acute psychiatric wards across Portugal, to determine the prevalence of polypharmacy and "high-doses" treatment, and to identify possible predictors. Twelve acute psychiatric inpatient units and 272 patients were included. The majority (87.5%) was treated with antipsychotics regardless of diagnosis, and 41.6% had at least two antipsychotics prescribed in combination. Age, use of depot antipsychotics, and antipsychotic "high-doses" were significant predictors of antipsychotic polypharmacy. Excluding 'as required' prescriptions, 13.8% of the patients were prescribed "high-doses" of antipsychotics. When antipsychotics 'as required' prescriptions were considered, 49.2% of the patients were on antipsychotic "high-doses". Age, use of depot antipsychotics, previous psychiatric hospitalization and involuntary admission were significant predictors of antipsychotic "high-doses". These results show that in Portugal the antipsychotics prescribing practices in psychiatric inpatient units diverge from those that are universally recommended, entailing important clinical and economic implications. It seems advisable to optimize the prescription of these drugs, in order to prevent adverse effects and improve the quality of the services provided.
Departamento de Psiquiatria e Saúde Mental, Hospital Sousa Martins, Unidade Local de Saúde da Guarda, Guarda, Portugal. Electronic address: joao.camposmendes@gmail.com.
João
J
Campos Mendes
Department of Biostatistics and Informatics, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.
Sofia
S
Azeredo-Lopes
Chronic Diseases Research Center (CEDOC), NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.
Graça
G
Cardoso
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003692:Delayed-Action Preparations; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy*; D008875:Middle Aged; D015999:Multivariate Analysis; D019338:Polypharmacy; D011174:Portugal; D010818:Practice Patterns, Physicians'; D011567:Psychiatric Department, Hospital; D012307:Risk Factors; D055815:Young Adult
D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations
Antipsychotics; High-doses; Polypharmacy; Psychiatric inpatient units