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Antipsychotic utilisation and polypharmacy in Italian residential facilities: a survey

Published online by Cambridge University Press:  21 March 2011

L. Ghio*
Affiliation:
Psychiatry section, Department of Neuroscience, Ophthalmology and Genetic, University of Genoa, Genoa, Italy
W. Natta
Affiliation:
Psychiatry section, Department of Neuroscience, Ophthalmology and Genetic, University of Genoa, Genoa, Italy
S. Gotelli
Affiliation:
Psychiatry section, Department of Neuroscience, Ophthalmology and Genetic, University of Genoa, Genoa, Italy
L. Ferrannini
Affiliation:
Department of Mental Health, Genoa, Italy
*
*Address for correspondence: Lucio Ghio, Department of Neuroscience, Ophthalmology and Genetics, University of Genoa, Largo Rosanna Benzi 10, 16100 Genoa, Italy. (Email: [email protected])

Abstract

Objective.

To evaluate the prescribing practices in psychiatric residential facilities, with particular focus both on the antipsychotic dose and polypharmacy as well as the variation of antipsychotic patterns during a patient's stay within the facilities.

Methods.

Fifteen residential facilities of Liguria region in Italy were included. Data were collected through a chart review during a one-day census. Frequency of psychotropic patterns was estimated. Different non-parametric tests were used to analyse the changes in prescription patterns as well as the relationship among antipsychotic dose, the number of antipsychotics and anticholinergic use.

Results.

The study sample includes 362 patients, 61.9% males. On the census day 77.5% of patients received psychotropic polypharmacy and 57.2% antipsychotic polypharmacy. Antipsychotic polypharmacy was related to the total antipsychotic daily dose and to anticholinergic use. A trend towards an increase of antipsychotic and psychotropic polypharmacy and higher doses of antipsychotics over the period of stay within the facilities was noted. This tendency was related to the length of stay in the facility.

Conclusions.

Compared to earlier studies in the same clinical environment a significant increase in the use of psychotropic and antipsychotic polypharmacy was observed. The risk of prescribed polypharmacy seems to be related to time spent in the facility.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2011

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