Background:
Atypical antipsychotics are not as widely used in Australian public mental health as expected from evidence of their efficacy and treatment guidelines recommendations. We assessed the reasons for this from the perspectives of patients, their carers and clinicians.
Methods:
A random sample of people with a diagnosis of schizophrenia attending four public mental health clinics in Melbourne (n = 83), their carers (n = 60) and their clinicians (n = 66) completed a questionnaire on the effectiveness, acceptability and side-effects of current, previous and early antipsy-chotic medicine. Medicine use was determined from clinical records.
Results:
Patients were predominantly single middle-aged women. A significant shift over time toward atypical medicine use had occurred: 66% were currently taking atypicals; compared with early medicines, current medicines were three times more likely to be atypical (odds ratio: 2.95, 95% confidence interval: 1.48–5.88). Major discrepancies were noted in reports of medicines used between patients, carers, clinicians and clinical notes. Doctors made 61% of all recommendations for changes in previous medicines. There were few significant differences in perceived effectiveness, satisfaction and side-effects when comparing types of medicine. Health-related quality of life was associated with reported side-effects, but not with current medicine type.
Conclusions:
There is a mutual lack of information and understanding about antipsychotic medicines between patients, their carers and clinicians. Greater reinforcement of provisions and incentives for collaborative treatment planning may be beneficial. Further studies of the uptake of atypical antipsychotics and their benefits should be conducted in real-world settings.
