Evaluation of a multifaceted intervention to limit excessive antipsychotic co-prescribing in schizophrenia out-patients

被引:21
作者
Baandrup, L. [1 ]
Allerup, P. [2 ]
Lublin, H. [1 ]
Nordentoft, M. [3 ]
Peacock, L. [4 ]
Glenthoj, B. [1 ]
机构
[1] Copenhagen Univ Hosp, Psychiat Ctr Glostrup, Ctr Neuropsychiatr Schizophrenia Res, DK-2600 Glostrup, Denmark
[2] Univ Aarhus, Sch Educ, Copenhagen NV, Denmark
[3] Univ Copenhagen Hosp, Psychiat Ctr Bispebjerg, DK-2100 Copenhagen NV, Denmark
[4] Copenhagen Univ Hosp, Psychiat Ctr Nordsjaelland, Helsingore, Denmark
关键词
schizophrenia; intervention studies; practice guideline; IMPLEMENTATION STRATEGIES; MEDICATION ALGORITHM; POLYPHARMACY; GUIDELINE; PATTERNS; PREVALENCE; QUETIAPINE; TRENDS; IMPACT;
D O I
10.1111/j.1600-0447.2010.01553.x
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Objective: To evaluate the effect of a multifaceted educational intervention on the frequency of antipsychotic co-prescribing in adult schizophrenia out-patients. Method: Controlled quasi-experimental study performed in two Danish municipalities matched for baseline prevalence of antipsychotic polypharmacy, socioeconomic status and functional level of patients. The intervention was aimed at psychiatric healthcare providers and consisted of 1 day of didactic lectures, six 3-h educational outreach visits and an electronic reminder during drug prescribing. Results: Between-group use of antipsychotic polypharmacy was compared at baseline (intervention group, N = 232/control group, N = 351) and after 1 year of intervention (intervention group, N = 216/control group, N = 386). The prevalence of antipsychotic polypharmacy at follow-up was not significantly different between treatment settings when adjusting for differences in case-mix (P = 0.07). Conclusion: This multifaceted educational intervention failed to reduce the frequency of antipsychotic co-prescribing, but it suggested that future efforts to improve prescribing practice should address organizational barriers to implementation.
引用
收藏
页码:367 / 374
页数:8
相关论文
共 45 条
[1]  
[Anonymous], 2001, Cochrane Database Syst Rev, DOI DOI 10.1002/14651858.CD003030
[2]  
[Anonymous], 2002, SCHIZ COR INT TREATM
[3]   Polypharmacy in the Elderly Maximizing Benefit, Minimizing Harm [J].
Ballentine, Noel H. .
CRITICAL CARE NURSING QUARTERLY, 2008, 31 (01) :40-45
[4]   Does the Addition of a Second Antipsychotic Drug Improve Clozapine Treatment? [J].
Barbui, Corrado ;
Signoretti, Alessandra ;
Mule, Serena ;
Boso, Marianna ;
Cipriani, Andrea .
SCHIZOPHRENIA BULLETIN, 2009, 35 (02) :458-468
[5]   Treatment of sleep dysfunction and psychiatric disorders [J].
Becker P.M. .
Current Treatment Options in Neurology, 2006, 8 (5) :367-375
[6]  
Bero LA, 1998, BMJ-BRIT MED J, V317, P465
[7]   Antipsychotic polypharmacy in the ambulatory care setting, 1993-2000 [J].
Botts, S ;
Hines, H ;
Littrell, R .
PSYCHIATRIC SERVICES, 2003, 54 (08) :1086-1086
[8]   Targeting Suboptimal Prescribing in the Elderly: A Review of the Impact of Pharmacy Services [J].
Castelino, Ronald L. ;
Bajorek, Beata V. ;
Chen, Timothy F. .
ANNALS OF PHARMACOTHERAPY, 2009, 43 (06) :1096-1106
[9]   Metabolic Consequences of Using Low-Dose Quetiapine for Insomnia in Psychiatric Patients [J].
Cates, Marshall E. ;
Jackson, Cherry W. ;
Feldman, Jacqueline M. ;
Stimmel, Amanda E. ;
Woolley, Thomas W. .
COMMUNITY MENTAL HEALTH JOURNAL, 2009, 45 (04) :251-254
[10]  
Checkland Kath, 2007, J Health Serv Res Policy, V12, P95, DOI 10.1258/135581907780279657