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Prescribing practices in psychiatric hospitals in Eastern Europe

Published online by Cambridge University Press:  16 April 2020

V. Jordanova ,
N.P. Maric ,
V. Alikaj ,
M. Bajs ,
T. Cavic ,
D. Iosub ,
A. Mihai ,
A. Szalontay  and
N. Sartorius
V. Jordanova*
Affiliation:
Imperial College London, Charing Cross Hospital Campus, The Claybrook Centre, St. Dunstan's Road, LondonW6 8RP, United Kingdom
N.P. Maric
Affiliation:
Institute of Psychiatry, KSS and School of Medicine, University of Belgrade, Serbia
V. Alikaj
Affiliation:
University Hospital “Mother Teresa”, Tirana, Albania
M. Bajs
Affiliation:
Clinical Hospital Center Zagreb, Zagreb, Croatia
T. Cavic
Affiliation:
Institute for Neuropsychiatry “Dr Laza Lazarevic”, Belgrade, Serbia
D. Iosub
Affiliation:
Department of Psychiatry, Hospital Centre, 67170Brumath, France
A. Mihai
Affiliation:
University of Medicine and Pharmacy, Targu Mures, Romania
A. Szalontay
Affiliation:
University of Medicine and Pharmacy, Iasi, Romania
N. Sartorius
Affiliation:
University of Geneva, Geneva, Switzerland
*
⁎Corresponding author. E-mail address: vj22@le.ac.uk(V. Jordanova).
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Abstract

Background

There has been no evidence about the prescribing practices in psychiatric care in Eastern Europe.

Aims

To examine the patterns of psychotropic prescribing in five countries of Eastern Europe.

Method

We conducted a one-day census of psychiatric treatments used in eight psychiatric hospitals in Albania, Croatia, Macedonia, Serbia and Romania. We examined clinical records and medication charts of 1304 patients.

Results

The use of polypharmacy was frequent across all diagnostic groups. Only 6.8% of patients were on monotherapy. The mean number of prescribed drugs was 2.8 (SD 0.97) with 26.5% receiving two drugs, 42.1% receiving three drugs and 22.1% being prescribed four or more psychotropic drugs. Typical antipsychotics were prescribed to 63% and atypical antipsychotics to 40% of patients with psychosis. Older generations of antidepressants were prescribed to 29% of patients with depression. Anxiolitic drugs were prescribed to 20.4% and benzodiazepines to 68.5% of patients. One third of patients received an anticholinergic drug on a regular basis.

Conclusions

Older generation antipsychotics and antidepressants were used more frequently than in the countries of Western Europe. Psychotropic polypharmacy is a common practice. There is a need for adopting more evidence-based practice in psychiatric care in these countries.

Keywords

Psychotropic prescribingPatternsMonotherapyPolypharmacyEvidence-based practice
Type
Original article
Information
European Psychiatry , Volume 26 , Issue 7 , October 2011 , pp. 414 - 418
Copyright
Copyright © European Psychiatric Association 2010

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References

British Medical Association & Royal Pharmaceutical Society of Great Britain. British National Formulary. BMJ Books & Pharmaceutical Press; 2005.Google Scholar
Centorrino, F.Goren, J.L.Hennen, J.Salvatore, P.Kelleher, J.P.Baldessarini, R.J.Multiple versus single antipsychotic agents for hospitalized psychiatric patients: case-control study of risks versus benefits. Am J Psychiatry 2004; 161: 700–706CrossRefGoogle ScholarPubMed
Divac, N.Jasovic, M.Djukic, L.Vujnovic, M.Babic, M.Bajcetic, M.Benzodiazepines utilization and self-medication as correlates of stress in the population of Serbia. Pharmacoepidemiol Drug Saf 2004; 13: 315–322CrossRefGoogle ScholarPubMed
Divac, N.Jasović-Gasić, M.Samardzić, R.Lacković, M.Prostran, M.Antipsychotic polypharmacy at the University Psychiatric Hospital in Serbia. Pharmacoepidemiol Drug Saf 2007; 16: 1250–1251CrossRefGoogle ScholarPubMed
Foster, K.Meltzer, H.Gill, B.Hinds, K.The circumstances of adults with a psychotic disorder. Int Rev Psychiatry 2003; 15: 84–90CrossRefGoogle ScholarPubMed
Gater, R.Jordanova, V.Maric, N.Alikaj, V.Bajs, M.Cavic, T.et al.Pathways to psychiatric care in Eastern Europe. Br J Psychiatry 2005; 186: 529–535CrossRefGoogle ScholarPubMed
Hallahan, B.Murray, I.McDonald, C.Benzodiazepine and hypnotic prescribing in an acute adult psychiatric in-patient unit. Psych Bull 2009; 33: 12–14CrossRefGoogle Scholar
Harrington, M.The results of a multi-centre audit of the prescribing of antipsychotic drugs for in-patients in the UK. Psych Bull 2002; 26: 414–418CrossRefGoogle Scholar
Holloway, F.Prescribing for the long-term mentally ill. A study of treatment practices. Br J Psychiatry 1988; 152: 511–515CrossRefGoogle ScholarPubMed
Ito, H.Koyama, A.Higuchi, T.Polypharmacy and excessive dosing: psychiatrists’ perceptions of antipsychotic drug prescription. Br J Psychiatry 2005; 187: 243–247CrossRefGoogle ScholarPubMed
Johnson, S.Kuhlmann, R.The European Service Mapping Schedule (ESMS): development of an instrument for the description and classification of mental health services. EPCAT Group. Acta Psychiatr Scand 2002; 405: 14–23Google Scholar
Jones, P.B.Barnes, T.R.Davies, L.Dunn, G.Lloyd, H.Hayhurst, K.P.et al.Randomized controlled trial of the effect on quality of life of second vs first–generation antipsychotic drugs in schizophrenia: cost utility of the latest antipsychotic drugs in Schizophrenia study (CUtLASS 1). Arch Gen Psychiatry 2006; 63: 1079–1087CrossRefGoogle ScholarPubMed
Kiivet, R.A.Llerena, A.Dahl, M.L.Rootslane, L.Sánchez Vega, J.Eklundh, T.et al.Patterns of drug treatment of schizophrenic patients in Estonia, Spain and Sweden. Br J Clin Pharmacol 4051995 467–476[Nov]CrossRefGoogle ScholarPubMed
Leucht, S.Corves, C.Arbter, D.Engel, R.R.Li, C.Davis, J.M.Second-generation versus first-generation antipsychotic drugs for schizophrenia: a meta-analysis. Lancet 37396572009 31–41CrossRefGoogle ScholarPubMed
Lieberman, J.A.Stroup, S.McEvoy, J.P.Swartz, M.S.Rosenheck, R.A.Perkins, D.O.et al.For the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Investigators. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med 2005; 353: 1209–1223CrossRefGoogle ScholarPubMed
Moratto, E.H.Dodd, S.Oderda, G.Haxby, D.G.Allen, R.Valuck, R.J.Prevalence, utilization patterns, and predictors of antipsychotic polypharmacy: experience in a multistate Medicaid population, 1998–2003. Clin Ther 12912007 83–195Google Scholar
National Institute for Health and Clinical Excellence (2004; NICE).Google Scholar
Paton, C.Lelliott, P.Harrington, M.Okocha, C.Sensky, T.Duffett, R.Patterns of antipsychotic and anticholinergic prescribing for hospital inpatients. J Psychopharmacol 2003; 17: 223–229CrossRefGoogle ScholarPubMed
Peacock, L.Gerlach, J.Clozapine treatment in Denmark: concomitant psychotropic medication and hematologic monitoring in a system with liberal usage practices. J Clin Psychiatry 5521994 44–49Google Scholar
Rittmannsberger, H.Meise, U.Schauflinger, K.Horvath, E.Donat, H.Hinterhuber, H.Polypharmacy in psychiatric treatment. Patterns of psychotropic drug use in Austrian psychiatric clinics. Eur Psychiatry 1999; 14: 33–40CrossRefGoogle ScholarPubMed
Sim, K.Su, A.Fujii, S.Yang, S.Y.Chong, M.Y.Ungvari, G.S.et al.Antipsychotic polypharmacy in patients with schizophrenia: a multicentre comparative study in East Asia. Br J Clin Pharmacol 2004; 58: 178–183CrossRefGoogle ScholarPubMed
Taylor, D.Mace, S.Mir, S.Kerwin, R.A prescription survey of the use of atypical antipsychotics for hospital inpatients in the United Kingdom. Int J Psychiatry Clin Pract 2000; 4: 41–46Google Scholar
Uchida, N.Chong, M.Y.Tan, C.H.Nagai, H.Tanaka, M.Lee, M.S.et al.International study on antidepressant prescription pattern at 20 teaching hospitals and major psychiatric institutions in East Asia: analysis of 1898 cases from China, Japan, Korea, Singapore and Taiwan. Psychiatry Clin Neurosci 2007; 61: 522–528CrossRefGoogle Scholar
Wheeler, A.Kairuz, T.Sheridan, J.McPhee, E.Sedative-hypnotic treatment in an acute psychiatric setting: comparison with best practice guidance. Pharm World Sci 2007; 29: 603–610CrossRefGoogle Scholar
World Health Organization. The ICD-10 classification of mental and behavioral disorders. Geneva: World Health Organization; 1992.Google Scholar
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