[Antipsychotic Polypharmacy in the Treatment of Patients with Schizophrenia in Nine Psychiatric Hospitals of the Landschaftsverband Rheinland, Germany]. / Antipsychotische Polypharmazie in der Behandlung von Patientinnen und Patienten mit Schizophrenie am Beispiel von neun psychiatrischen Fachkliniken des Landschaftsverbandes Rheinland.
Psychiatr Prax
; 48(5): 250-257, 2021 Jul.
Article
em De
| MEDLINE
| ID: mdl-33472267
ABSTRACT
BACKGROUND:
Antipsychotics are the cornerstone in the treatment of schizophrenia and are primarily recommended as monotherapy by evidence-based guidelines. Nevertheless, antipsychotic polypharmacy (APP) is prevalent in routine practice and APP is also used as a quality indicator since 2016 in quality management programs.OBJECTIVE:
Based on routine data of nine psychiatric hospitals of the Landschaftsverband Rheinland (LVR)/Germany the prevalence of APP was determined and correlated with factors of routine healthcare in order to monitor the adoption of APP and to discuss its feasibility as a quality indicator. MATERIALS ANDMETHODS:
All cases with schizophrenia (ICD-10 F20.x; ≥â18 years) discharged between June 1st, 2016, and June 1st, 2017, (in-patient and day clinic) were extracted from an established research database shared by all nine hospitals and analyzed regarding APP prevalence at the time of discharge.RESULTS:
Based on 6,788 cases, the prevalence of APP was 55.5â% with an average of 2.4 antipsychotics (SDâ=â0.6) administered simultaneously. In multivariate analyses, significant predictors for APP were gender (maleâ>âfemale), the number of days in hospital (longâ>âshort), involuntary treatment (noâ>âyes) and the location of the hospital.CONCLUSIONS:
We found a high proportion of polypharmacy in inpatient schizophrenia patients and significant differences between hospitals. The use of the results as a quality indicator (criteriaâ≥â2 antipsychotics) remains dependent on the background of the individual treatment courses, which cannot be adequately represented by the existing routine data. The LVR has been using the quality indicator of ≥â3 antipsychotics since 2018, which is discussed as a more appropriate approach for future evaluations.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Esquizofrenia
/
Antipsicóticos
Tipo de estudo:
Guideline
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
País/Região como assunto:
Europa
Idioma:
De
Ano de publicação:
2021
Tipo de documento:
Article