Antipsychotic prescribing in people admitted to hospital with dementia or delirium

2021 ◽  
Author(s):  
William A. Tumusiime ◽  
Caitlin J. Hardman ◽  
Juanita L. Breen
Keyword(s):  
Antipsychotic Prescribing

scholarly journals Challenges and pitfalls of antipsychotic prescribing in people with learning disability

2017 ◽  
Vol 67 (661) ◽  
pp. 372-373 ◽  
Author(s):  
Regi T Alexander ◽  
Rohit Shankar ◽  
Sally A Cooper ◽  
Sabyasachi Bhaumik ◽  
Richard Hastings ◽  
...  
Keyword(s):  
Learning Disability ◽  
Antipsychotic Prescribing

scholarly journals A description of antipsychotic prescribing patterns based on race in the inpatient behavioral health setting

2021 ◽  
Vol 11 ◽  
pp. 204512532110232
Author(s):  
Thomas Maestri ◽  
David Anderson ◽  
Jose Calderon-Abbo ◽  
Taylor Waguespack ◽  
Margarita Echeverri
Keyword(s):  
Mental Health ◽  
Family Support ◽  
Prescribing Patterns ◽  
Screening Tests ◽  
Diagnostic Process ◽  
Inpatient Setting ◽  
Antipsychotic Medications ◽  
Lipid Panel ◽  
Admission Status ◽  
Antipsychotic Prescribing

Background and aims: A growing body of research shows that race contributes to disparities in mental health services utilization and influences the clinical diagnostic process. To our knowledge, no studies on current practice in the Unites States have documented whether these disparities impact the prescription of antipsychotic medications across individual patients based on race. Consequently, this study aims to describe the prescribing patterns of antipsychotic medications in the inpatient setting based on patients’ race, and to explore appropriateness of therapy based on Food and Drug Administration labeling and avoidance of inappropriate polypharmacy. Methods: Single-centered, retrospective, chart review of 398 psychiatric patients in the inpatient setting and who had a psychiatric diagnosis that warranted a prescription for an antipsychotic medication at the time of discharge. Frequencies were computed to describe differences in demographic variables (race, health insurance type, age, and gender), medical conditions (diagnosis, commodities, hospitalization status, antipsychotic medications, etc.), and screening tests (lipid panel, hemoglobin, urine and illicit drug use). Logistic regression, analysis of variance, and hypothesis tests were used to analyze the data. Results: Significant differences were not found in total chlorpromazine equivalent dose equivalencies by race or insurance. However, patients of involuntary admission status, past medication trials, a diagnosis of schizophrenia or bipolar disorder, and who lacked family support had higher total daily doses of antipsychotics upon discharge. Inappropriate therapy was significantly related to differences in increasing age and a diagnosis of insomnia. Conclusion: This single-centered study described patterns of antipsychotic prescribing based on race in an inpatient psychiatry facility. Future studies, using larger and more diverse sample populations, are recommended to elucidate the role that patients’ race, admission status, and family support play in the dose and appropriateness of antipsychotics prescribed for mental health care.

scholarly journals The links between the amount of antipsychotic medication prescribed at GP practice level, local demographic factors and medication selection

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S165-S166
Author(s):  
Adrian Heald ◽  
Mike Stedman ◽  
Sanam Farman ◽  
Mark Davies ◽  
Roger Gadsby ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Antipsychotic Medication ◽  
Demographic Factors ◽  
Mental Illnesses ◽  
World Health ◽  
Pharmacological Intervention ◽  
Practice Population ◽  
General Practices ◽  
Antipsychotic Prescribing

AimsTo examine the factors that relate to antipsychotic prescribing in general practices across England and how these relate to cost changes in recent years.BackgroundAntipsychotic medications are the first-line pharmacological intervention for severe mental illnesses(SMI) such as schizophrenia and other psychoses, while also being used to relieve distress and treat neuropsychiatric symptoms in dementia.Since 2014 many antipsychotic agents have moved to generic provision. In 2017_18 supplies of certain generic agents were affected by substantial price increases.MethodThe study examined over time the prescribing volume and prices paid for antipsychotic medication by agent in primary care and considered if price change affected agent selection by prescribers.The NHS in England/Wales publishes each month the prescribing in general practice by BNF code. This was aggregated for the year 2018_19 using Defined Daily doses (DDD) as published by the World Health Organisation Annual Therapeutic Classification (WHO/ATC) and analysed by delivery method and dose level. Cost of each agent year-on-year was determined.Monthly prescribing in primary care was consolidated over 5 years (2013-2018) and DDD amount from WHO/ATC for each agent was used to convert the amount to total DDD/practice.ResultDescriptionIn 2018_19 there were 10,360,865 prescriptions containing 136 million DDD with costs of £110 million at an average cost of £0.81/DDD issued in primary care. We included 5,750 GP Practices with practice population >3000 and with >30 people on their SMI register.Effect of priceIn 2017_18 there was a sharp increase in overall prices and they had not reduced to expected levels by the end of the 2018_19 evaluation year. There was a gradual increase in antipsychotic prescribing over 2013-2019 which was not perturbed by the increase in drug price in 2017/18.RegressionDemographic factorsThe strongest positive relation to increased prescribing of antipsychotics came from higher social disadvantage, higher population density(urban), and comorbidities e.g. chronic obstructive pulmonary disease(COPD). Higher %younger and %older populations, northerliness and non-white (Black and Minority Ethnic (BME)) ethnicity were all independently associated with less antipsychotic prescribing.Prescribing FactorsHigher DDD/general practice population was linked with higher %injectable, higher %liquid, higher doses/prescription and higher %zuclopenthixol. Less DDD/population was linked with general practices using higher %risperidone and higher spending/dose of antipsychotic.ConclusionHigher levels of antipsychotic prescribing are driven by social factors/comorbidities. The link with depot medication prescriptions, alludes to the way that antipsychotics can induce receptor supersensitivity with consequent dose escalation.

Antipsychotic Prescribing and Safety Monitoring Practices in Children and Youth: A Population-Based Study in Alberta, Canada

2018 ◽  
Vol 38 (5) ◽  
pp. 449-455 ◽  
Author(s):  
Wenxin Chen ◽  
Monica Cepoiu-Martin ◽  
Antonia Stang ◽  
Diane Duncan ◽  
Chris Symonds ◽  
...  
Keyword(s):  
Safety Monitoring ◽  
Population Based ◽  
Children And Youth ◽  
Population Based Study ◽  
Antipsychotic Prescribing
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