Abstract:
:Background Antipsychotic polypharmacy ("polypharmacy") is the concurrent prescribing of more than one antipsychotic. It is widely practised, as reported in the literature, and is known to increase the risk of adverse outcomes for patients. Objective To quantify the prevalence and magnitude of polypharmacy in patients with schizophrenia or schizoaffective disorder and identify potential factors contributing to this practice. Setting Armadale Mental Health Service (a public inpatient and outpatient psychiatric facility in Perth, Western Australia). Method A retrospective, cross-sectional study was conducted, evaluating the medical records of adult (18-64 years old) patients fulfilling the established inclusion criteria in the period between August and December 2016. Data collected included the number and doses of antipsychotic(s) prescribed and documented rationale for polypharmacy. Defined daily doses and proportions of maximum licensed daily doses were calculated for all regularly prescribed antipsychotics and were evaluated as measures of antipsychotic load. Main Outcome Measure The percentage prevalence of antipsychotic polypharmacy; defined daily antipsychotic doses and proportions of maximum licensed daily doses. Results Seventy-seven patients were assessed, with a polypharmacy prevalence of 39.0%. Total defined daily doses ranged from 0.9 to 5.9 and maximum licensed daily doses from 0.4 to 2.3. Documented rationales for polypharmacy included poor symptom control, patient's preference, hesitancy to amend other prescribers' management plans, off-label antipsychotic indications and medication cross-titration. Conclusion Antipsychotic polypharmacy occurred in more than one-third of patients. Individual antipsychotics were typically prescribed at doses within the licensed range, however, the total proportion of combined maximum licensed doses and combined daily defined doses often exceeded 100%. Due to suboptimal documentation, prescribing rationale was unclear in the majority of cases. The magnitude of polypharmacy aims to foster a greater appreciation of the prescribed antipsychotic load, increasing clinician self-awareness of prescribing practices and facilitating future opportunities to optimise prescribing.
journal_name
Int J Clin Pharmjournal_title
International journal of clinical pharmacyauthors
Nguyen ML,Sunderland B,Lim S,Hattingh L,Chalmers Ldoi
10.1007/s11096-019-00930-3subject
Has Abstractpub_date
2019-12-01 00:00:00pages
1642-1651issue
6eissn
2210-7703issn
2210-7711pii
10.1007/s11096-019-00930-3journal_volume
41pub_type
杂志文章abstract::Background Tyrosine kinase inhibitors have been demonstrated to improve the survival of patients with chronic myeloid leukaemia. However, medication adherence is vital for patients on chronic treatment. Objective The objective of the current study was to evaluate response to treatment, adherence by patients to tyrosin...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-020-01070-9
更新日期:2020-06-11 00:00:00
abstract::Background There is a lack of data on the prevalence of potentially inappropriate medications (PIMs) in community-dwelling older adults in China. Objective To assess the prevalence of potentially inappropriate medication in community dwelling older adults in China and to investigate risk factors associated with the us...
journal_title:International journal of clinical pharmacy
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abstract::Background Taking regular medication has been shown to have an impact on the daily lives of patients and their families. Objective To explore the medication-related experiences of patients and their families when a child or young person is prescribed regular medication. Setting A specialist U.K. paediatric hospital. M...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-018-0756-z
更新日期:2019-02-01 00:00:00
abstract::Background Rheumatoid arthritis is a chronic, autoimmune disease in which treatment has evolved with a variety of therapeutic classes. Biological disease-modifying antirheumatic drugs have improved therapy; however, the continued long-term use of these drugs with sustained safety and efficacy remains a challenge. Obje...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-020-01171-5
更新日期:2020-10-21 00:00:00
abstract:BACKGROUND:The growth of pharmaceutical expenditure and patients' out of pocket has motivated policy makers to encourage patients to substitution of brands medicines with their generic alternatives called generic substitution. OBJECTIVES:As the patients are final decision makers to accept generic substitution, the aim...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-015-0085-4
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Patients with type 2 diabetes mellitus (T2DM) are frequently admitted to the hospital with severe or acute hyperglycaemia secondary to an acute illness or disease. Uncontrolled glycaemia is a significant problem during severe or acute hyperglycaemia. OBJECTIVE:This study sought to identify demographic, clin...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-012-9682-7
更新日期:2012-12-01 00:00:00
abstract::This commentary identifies studies that have compared commercially available DI databases, and discusses improvements in study methodology that might better guide clinicians in selecting resources for their practice setting. We also provide suggestions for future direction of research in this area with an eye towards ...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章,评审
doi:10.1007/s11096-011-9522-1
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the effects of pharmacotherapy follow-up (PF) on metabolic control and clinical outcomes in type 2 diabetic patients. SETTING:Six community pharmacies (4 intervention and 2 control) in the Curitiba metropolitan region (Brazil). MAIN OUTCOME MEASURE:Glycosylated Haemoglobin A1 (HbA1) and fasting ...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-011-9493-2
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:Information on the use of ankylosing spondylitis (AS) therapies in clinical practice is a key factor in decision making, as more efficient treatments may involve substantial savings while maintaining the clinical benefits for the patient. OBJECTIVE:To assess the mean annual doses and associated costs of the...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-015-0124-1
更新日期:2015-10-01 00:00:00
abstract::It is well known that patient adherence to appropriately prescribed medications is essential for treatment efficacy and positive therapeutic outcomes. It is also understood that patients who are prescribed medications do not necessarily take them as prescribed. Indeed, variation in patients' medication-taking is an ag...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-013-9856-y
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Ocular allergies frequently present in pharmacy practices. However, research into the actual management of ocular allergy in pharmacies is lacking. OBJECTIVE:To determine and quantify history and symptom questioning of a patient with presumed allergic conjunctivitis and management strategies employed by pha...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-012-9742-z
更新日期:2013-04-01 00:00:00
abstract:CASE DESCRIPTION:Hyperkalemia can cause altered cardiac electrical conduction resulting in death. We describe a case of a 23-year old pregnant patient who presented with severe epigastric pain and vomiting. She was severely pre- eclamptic and received initial treatment with intravenous labetalol and decision was taken ...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-014-0021-z
更新日期:2014-12-01 00:00:00
abstract::Background Half of Americans experience mental illness during their lifetime. Significant opportunity exists for community pharmacists to deliver services to these patients; however, personal and practice-related barriers may prevent full engagement. Objective To assess the demographics, practice characteristics, serv...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-018-0619-7
更新日期:2018-10-01 00:00:00
abstract:UNLABELLED:Sequential antimicrobial therapy is an important part of antimicrobial stewardship and intends to improve the timeliness of switch to oral antimicrobials. The aim of this study was to assess the impact of the introduction of guidelines and criteria for switching to oral antimicrobials. SETTING:The study was...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-010-9475-9
更新日期:2011-04-01 00:00:00
abstract::Background Parkinson's disease is the second most common neurodegenerative disorder. Motor and non-motor symptoms seem to precede the diagnosis of Parkinson's disease. Objective To evaluate the incidence of muscle relaxant use in community-dwelling persons with and without Parkinson's disease from 4 years before to 4 ...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-020-01002-7
更新日期:2020-04-01 00:00:00
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journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-018-0744-3
更新日期:2018-12-01 00:00:00
abstract::Background The challenges of under-reporting of adverse drug reactions have been identified as a major setback for the pharmacovigilance system worldwide. Direct reporting by health care consumers has been adopted in some developed and developing countries with a positive impact in improving pharmacovigilance activiti...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章,评审
doi:10.1007/s11096-020-01141-x
更新日期:2020-09-09 00:00:00
abstract:BACKGROUND:Improper disposal of medications potentially poses a significant environmental risk and storage of expired and unused medications in households provides an increased risk of accidental childhood poisonings. OBJECTIVE:The objective of this study was to investigate the storage and disposal habits of medicatio...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-012-9652-0
更新日期:2012-08-01 00:00:00
abstract:CASE:We report a 32-year old relapse case of Visceral leishmaniasis, treated with Paromomycin who belonged from a endemic zone of Bihar state, India. After confirmation, he was treated with Amphotericin B, followed by Liposomal Amphotericin B in full course and even in higher dose. But after each therapy, the patient e...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-011-9544-8
更新日期:2011-10-01 00:00:00
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journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-020-01098-x
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Smoking cessation represents one of the best means of preventing smoking-related complications. In recent years, a majority of hospitals have implemented smoke-free policies, making support for smoker patients a necessary and indispensable task. The clinical pharmacist is well-positioned to provide this kind...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-014-9927-8
更新日期:2014-06-01 00:00:00
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journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-018-0713-x
更新日期:2018-10-01 00:00:00
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journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-012-9713-4
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Oral treatment in women with breast cancer has been increasingly used. However, a potentially negative side of oral medication is poor patient adherence and/or discontinuation, which reduces the treatment effectiveness, accelerating progression of the disease and reducing the patient survival rate. AIM OF T...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s11096-013-9833-5
更新日期:2014-02-01 00:00:00
abstract::Background Pharmacist-physician collaboration can lead to many positive outcomes. However, collaboration between healthcare providers is complex and rarely performed optimally. Objectives To study physician-pharmacist collaboration in hospital settings, from the physician's point of view. Setting Eight regional non-te...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-016-0395-1
更新日期:2016-12-01 00:00:00
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journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-015-0149-5
更新日期:2015-12-01 00:00:00
abstract::Background Pharmacists are increasingly involved in patient care. This new role in a complex healthcare system with demanding patients may lead to moral dilemmas. There has been little research into pharmacy ethics, and existing data are limited by their retrospective nature and small sample sizes. A thematic overview...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-017-0561-0
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:To generate, validate and establish a web-based individualised opioid conversion calculator at the University Hospital Basel and to analyse its value and significance. SETTING:A 700-bed university hospital. METHOD:Published data were screened by a Medline search using the keywords: opioid, rotation, switchi...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-010-9464-z
更新日期:2011-02-01 00:00:00
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journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-014-9994-x
更新日期:2014-12-01 00:00:00
abstract:CASE (DESCRIPTION):We report the case of a 38-year-old woman treated with lamotrigine who experienced multi-organ dysfunction. The patient received the drug at the dose of 100 mg per day. One week later, the treatment was suspended because of an extensive body rash. Twenty-four hours later, the patient appeared drowsy ...
journal_title:International journal of clinical pharmacy
pub_type: 杂志文章
doi:10.1007/s11096-015-0158-4
更新日期:2015-10-01 00:00:00