The DEBIT trial: an intervention to reduce antipsychotic polypharmacy prescribing in adult psychiatry wards - a cluster randomized controlled trial.
Psychol Med
; 38(5): 705-15, 2008 May.
Article
en En
| MEDLINE
| ID: mdl-17825122
ABSTRACT
BACKGROUND:
Clinical guidelines advise against prescribing more than one antipsychotic with limited exceptions. Despite this, surveys continue to report high antipsychotic polypharmacy rates. The aim of the study was to investigate the effectiveness of a multi-faceted intervention in reducing prescribing of antipsychotic polypharmacy on general adult psychiatry wards, compared with guidelines alone.METHOD:
A pragmatic cluster randomized controlled trial recruited 19 adult psychiatric units (clusters) from the South West of England. Participants were all ward doctors and nurses. The multi-faceted intervention comprised an educational/CBT workbook; an educational visit to consultants; and a reminder system on medication charts.RESULTS:
The odds of being prescribed antipsychotic polypharmacy in those patients prescribed antipsychotic medication was significantly lower in the intervention than control group when adjusted for confounders (OR 0.43, 95% CI 0.21-0.90, p=0.028). There was considerable between-unit variation in polypharmacy rates and in the change in rates between baseline and follow-up (5 months after baseline).CONCLUSION:
The intervention reduced levels of polypharmacy prescribing compared to guidelines alone although the effect size was relatively modest. Further work is needed to elicit the factors that were active in changing prescribing behaviour.
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Servicio de Psiquiatría en Hospital
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Trastornos Psicóticos
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Antipsicóticos
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Adhesión a Directriz
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Utilización de Medicamentos
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Capacitación en Servicio
Tipo de estudio:
Clinical_trials
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Guideline
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Observational_studies
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Prognostic_studies
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Qualitative_research
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Risk_factors_studies
Límite:
Adult
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Psychol Med
Año:
2008
Tipo del documento:
Article
País de afiliación:
Reino Unido