RESUMO
We test the hypothesis of increasing prevalence of low-dose antipsychotic use (300 mg/d chlorpromazine-equivalent) in East Asia and examine clinical correlates of conservative dosing. Rates of low-dose antipsychotic prescription were determined for 4535 patients with DSM-IV diagnosis of schizophrenia in six East Asian countries and territories, with comparisons analysed for 2004 vs. 2001. Between 2001 (n=2399 subjects) and 2004 (n=2136 subjects), prescription rates for low doses of antipsychotic drugs (APDs) increased from 24.8% to 44.0% (p<0.001). Low doses were more likely among older patients (p=0.005), during first-lifetime hospitalizations (p<0.001), and among patients with less prominent delusions, hallucinations or disorganized speech (all p<0.05). Multivariate modelling indicated that low doses were strongly associated with older age, first admission, sampling year (2004>2001), less use of antipsychotic polytherapy (all p<0.001) and depot antipsychotics (p=0.009). Conservative dosing of APDs was increasingly prevalent in East Asia. Our findings suggest characteristics of patients who may be particularly likely to require low antipsychotic doses.
Assuntos
Antipsicóticos/administração & dosagem , Antipsicóticos/uso terapêutico , Esquizofrenia/tratamento farmacológico , Adulto , Fatores Etários , Análise de Variância , Estudos Transversais , Ásia Oriental , Feminino , Humanos , Masculino , Análise de Regressão , Psicologia do Esquizofrênico , Fatores SocioeconômicosRESUMO
BACKGROUND: Faculty development in medical education is crucial for maintaining academic vitality. The authors conducted a needs assessment survey in Singapore to determine the educational needs and priorities of clinical faculty. METHODS: This study implemented a questionnaire-based, anonymous, multi-institutional survey with stratified random sampling. Each question was anchored with two statements on a 9-point scale. Respondents were asked to determine their current knowledge and the knowledge they would need in future. RESULTS: The response rate was 81.9%. Overall, the participants' current knowledge was rated either "modest" (scale 4-6) or "substantial" (scale 7-9), irrespective of teaching experience. Participants reported higher knowledge in areas related to teaching and modest knowledge in educational concepts and assessment. They reported a need for higher knowledge in most areas to function well as a teacher. CONCLUSION: The need for faculty development is universal and independent of teaching experience in this group. Teaching faculty from the institutes studied understood the need for improved knowledge in pedagogical knowledge.