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dc.contributor.authorMy, Linh Nguyen
dc.contributor.authorSunderland, Bruce
dc.contributor.authorLim, Stephen
dc.contributor.authorHattingh, Laetitia
dc.contributor.authorChalmers, Leanne
dc.date.accessioned2021-05-04T01:33:42Z
dc.date.available2021-05-04T01:33:42Z
dc.date.issued2019
dc.identifier.issn2210-7703en_US
dc.identifier.doi10.1007/s11096-019-00930-3en_US
dc.identifier.urihttp://hdl.handle.net/10072/404117
dc.description.abstractBackground 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.en_US
dc.description.peerreviewedYesen_US
dc.languageEnglishen_US
dc.publisherSpringeren_US
dc.relation.ispartofpagefrom1642en_US
dc.relation.ispartofpageto1651en_US
dc.relation.ispartofissue6en_US
dc.relation.ispartofjournalInternational Journal of Clinical Pharmacyen_US
dc.relation.ispartofvolume41en_US
dc.subject.fieldofresearchPharmacology and Pharmaceutical Sciencesen_US
dc.subject.fieldofresearchOther Medical and Health Sciencesen_US
dc.subject.fieldofresearchcode1115en_US
dc.subject.fieldofresearchcode1199en_US
dc.subject.keywordsScience & Technologyen_US
dc.subject.keywordsLife Sciences & Biomedicineen_US
dc.subject.keywordsAntipsychotic loaden_US
dc.subject.keywordsAustraliaen_US
dc.subject.keywordsPharmacyen_US
dc.titleThe hidden magnitude of polypharmacy: using defined daily doses and maximum licensed daily doses to measure antipsychotic loaden_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Articlesen_US
dcterms.bibliographicCitationMy, LN; Sunderland, B; Lim, S; Hattingh, L; Chalmers, L, The hidden magnitude of polypharmacy: using defined daily doses and maximum licensed daily doses to measure antipsychotic load, International Journal of Clinical Pharmacy, 2019, 41 (6), pp. 1642-1651en_US
dcterms.dateAccepted2019-10-22
dc.date.updated2021-05-04T01:32:41Z
gro.hasfulltextNo Full Text
gro.griffith.authorHattingh, Laetitia L.


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