Antipsychotic Polypharmacy and High Doses in a Rural Portuguese Community Mental Health Service

Detalhes bibliográficos
Autor(a) principal: Ramos, Sara
Data de Publicação: 2021
Outros Autores: Cruz, Diana, Jesus, Bianca, Correia, João, Vaz, Isabel, Mendes, João
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.51338/rppsm.2021.v7.i3.163
Resumo: Introduction: Antipsychotic polypharmacy (APP) and high dose (APHD) remain a common practice in the treatment of severe mental illness, even though they are not supported by current international guidelines. Methods: We aimed to establish the prescribing patterns of antipsychotics in a community mental health service in a rural setting, to determine the prevalence of APP and APHD treatment and to identify associated factors. Results: We identified 284 patients. APP was present in 46.5% patients and was associated to younger age, single status, more previous psychiatric admissions, and anticholinergic prescription. Prescription of APHD was observed in 14.4% patients and was associated with previous inpatient admissions, being prescribed with a first generation long‑acting injectable antipsychotic and anticholinergics. We also found that APP and APHD were mutually associated. Conclusion: Despite current guidelines, we found prevalences of APP and APHD of 46.5% and 14.4%, respectively. Further studies are necessary to better evaluate the antipsychotic prescription patterns in Portugal.
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spelling Antipsychotic Polypharmacy and High Doses in a Rural Portuguese Community Mental Health ServicePolifarmácia e Sobredosagem Antipsicótica num Serviço Comunitário do Interior de PortugalAntipsychotic AgentsCommunity Mental Health CentersInappropriate PrescribingPolypharmacyAntipsicóticosCentros Comunitários de Saúde MentalPrescrição InadequadaPolimedicaçãoIntroduction: Antipsychotic polypharmacy (APP) and high dose (APHD) remain a common practice in the treatment of severe mental illness, even though they are not supported by current international guidelines. Methods: We aimed to establish the prescribing patterns of antipsychotics in a community mental health service in a rural setting, to determine the prevalence of APP and APHD treatment and to identify associated factors. Results: We identified 284 patients. APP was present in 46.5% patients and was associated to younger age, single status, more previous psychiatric admissions, and anticholinergic prescription. Prescription of APHD was observed in 14.4% patients and was associated with previous inpatient admissions, being prescribed with a first generation long‑acting injectable antipsychotic and anticholinergics. We also found that APP and APHD were mutually associated. Conclusion: Despite current guidelines, we found prevalences of APP and APHD of 46.5% and 14.4%, respectively. Further studies are necessary to better evaluate the antipsychotic prescription patterns in Portugal.Introdução: A polifarmácia e a sobredosagem antipsicóticas permanecem uma prática comum no tratamento de doenças mentais graves, embora as normas mais atuais não o recomendem. Métodos: Procurou‑se identificar os padrões de prescrição antipsicótica num serviço comunitário com enquadramento rural, de forma a determinar a prevalência de polifarmácia e sobredosagem antipsicótica e fatores associados. Resultados: Foram identificados 284 doentes. A polifármacia antipsicótica foi observada em 46,5% dos doentes e associava‑se a idades mais jovens, ser solteiro, internamentos psiquiátricos prévios e prescrição de anticolinérgicos. Por outro lado, a sobredosagem antipsicótica foi encontrada em 14,4% dos doentes e associava‑se a internamentos psiquiátricos prévios, estar medicado com um antipsicótico injetável de primeira geração de longa duração de ação e com um anticolinérgico. Observou‑se também que a sobredosagem e a polifármacia estavam associadas. Conclusão: Apesar das recomendações internacionais, identificaram‑se prevalências de polifarmácia e sobredosagem antipsicótica de 46,5% e 14,4%, respetivamente. São necessários mais estudos para melhor caracterizar os padrões de prescrição antipsicótica em Portugal.Sociedade Portuguesa de Psiquiatria e Saúde Mental2021-09-08T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.51338/rppsm.2021.v7.i3.163oai:ojs.www.revistapsiquiatria.pt:article/163Revista Portuguesa de Psiquiatria e Saúde Mental; Vol. 7 No. 3 (2021); 109-116Revista Portuguesa de Psiquiatria e Saúde Mental; Vol. 7 N.º 3 (2021); 109-1162184-54172184-5522reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.revistapsiquiatria.pt/index.php/sppsm/article/view/163https://doi.org/10.51338/rppsm.2021.v7.i3.163https://www.revistapsiquiatria.pt/index.php/sppsm/article/view/163/92Direitos de Autor (c) 2021 Revista Portuguesa de Psiquiatria e Saúde Mentalinfo:eu-repo/semantics/openAccessRamos, SaraCruz, DianaJesus, BiancaCorreia, JoãoVaz, IsabelMendes, João2022-09-06T09:37:40Zoai:ojs.www.revistapsiquiatria.pt:article/163Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T15:37:12.662481Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Antipsychotic Polypharmacy and High Doses in a Rural Portuguese Community Mental Health Service
Polifarmácia e Sobredosagem Antipsicótica num Serviço Comunitário do Interior de Portugal
title Antipsychotic Polypharmacy and High Doses in a Rural Portuguese Community Mental Health Service
spellingShingle Antipsychotic Polypharmacy and High Doses in a Rural Portuguese Community Mental Health Service
Ramos, Sara
Antipsychotic Agents
Community Mental Health Centers
Inappropriate Prescribing
Polypharmacy
Antipsicóticos
Centros Comunitários de Saúde Mental
Prescrição Inadequada
Polimedicação
title_short Antipsychotic Polypharmacy and High Doses in a Rural Portuguese Community Mental Health Service
title_full Antipsychotic Polypharmacy and High Doses in a Rural Portuguese Community Mental Health Service
title_fullStr Antipsychotic Polypharmacy and High Doses in a Rural Portuguese Community Mental Health Service
title_full_unstemmed Antipsychotic Polypharmacy and High Doses in a Rural Portuguese Community Mental Health Service
title_sort Antipsychotic Polypharmacy and High Doses in a Rural Portuguese Community Mental Health Service
author Ramos, Sara
author_facet Ramos, Sara
Cruz, Diana
Jesus, Bianca
Correia, João
Vaz, Isabel
Mendes, João
author_role author
author2 Cruz, Diana
Jesus, Bianca
Correia, João
Vaz, Isabel
Mendes, João
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Ramos, Sara
Cruz, Diana
Jesus, Bianca
Correia, João
Vaz, Isabel
Mendes, João
dc.subject.por.fl_str_mv Antipsychotic Agents
Community Mental Health Centers
Inappropriate Prescribing
Polypharmacy
Antipsicóticos
Centros Comunitários de Saúde Mental
Prescrição Inadequada
Polimedicação
topic Antipsychotic Agents
Community Mental Health Centers
Inappropriate Prescribing
Polypharmacy
Antipsicóticos
Centros Comunitários de Saúde Mental
Prescrição Inadequada
Polimedicação
description Introduction: Antipsychotic polypharmacy (APP) and high dose (APHD) remain a common practice in the treatment of severe mental illness, even though they are not supported by current international guidelines. Methods: We aimed to establish the prescribing patterns of antipsychotics in a community mental health service in a rural setting, to determine the prevalence of APP and APHD treatment and to identify associated factors. Results: We identified 284 patients. APP was present in 46.5% patients and was associated to younger age, single status, more previous psychiatric admissions, and anticholinergic prescription. Prescription of APHD was observed in 14.4% patients and was associated with previous inpatient admissions, being prescribed with a first generation long‑acting injectable antipsychotic and anticholinergics. We also found that APP and APHD were mutually associated. Conclusion: Despite current guidelines, we found prevalences of APP and APHD of 46.5% and 14.4%, respectively. Further studies are necessary to better evaluate the antipsychotic prescription patterns in Portugal.
publishDate 2021
dc.date.none.fl_str_mv 2021-09-08T00:00:00Z
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dc.identifier.uri.fl_str_mv https://doi.org/10.51338/rppsm.2021.v7.i3.163
oai:ojs.www.revistapsiquiatria.pt:article/163
url https://doi.org/10.51338/rppsm.2021.v7.i3.163
identifier_str_mv oai:ojs.www.revistapsiquiatria.pt:article/163
dc.language.iso.fl_str_mv eng
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dc.relation.none.fl_str_mv https://www.revistapsiquiatria.pt/index.php/sppsm/article/view/163
https://doi.org/10.51338/rppsm.2021.v7.i3.163
https://www.revistapsiquiatria.pt/index.php/sppsm/article/view/163/92
dc.rights.driver.fl_str_mv Direitos de Autor (c) 2021 Revista Portuguesa de Psiquiatria e Saúde Mental
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Direitos de Autor (c) 2021 Revista Portuguesa de Psiquiatria e Saúde Mental
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Sociedade Portuguesa de Psiquiatria e Saúde Mental
publisher.none.fl_str_mv Sociedade Portuguesa de Psiquiatria e Saúde Mental
dc.source.none.fl_str_mv Revista Portuguesa de Psiquiatria e Saúde Mental; Vol. 7 No. 3 (2021); 109-116
Revista Portuguesa de Psiquiatria e Saúde Mental; Vol. 7 N.º 3 (2021); 109-116
2184-5417
2184-5522
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