Details

Autor(en) / Beteiligte

• Schmidt-Kraepelin, Christian
• Meisenzahl-Lechner, Eva
• Kujovic, Milenko
• Cordes, Joachim
• Engelke, Christina
• Riesbeck, Mathias
• Zielasek, Jürgen
• Engemann, Sandra
• Vrinssen, Jürgen
• Lehmann, Isabell
• Tönnesen-Schlack, Anita
• Banger, Markus
• Grümmer, Martine
• Scherbaum, Norbert
• Muysers, Jutta
• Rinckens, Stephan
• Marggraf, Ralph
• Gouzoulis-Mayfrank, Euphrosyne

Titel

Antipsychotic Polypharmacy in the Treatment of Patients with Schizophrenia in Nine Psychiatric Hospitals of the Landschaftsverband Rheinland, Germany

Ist Teil von

• Psychiatrische Praxis, 2021-07, Vol.48 (5), p.250

Ort / Verlag

Germany

Erscheinungsjahr

2021

Quelle

MEDLINE

Beschreibungen/Notizen

• Antipsychotics are the cornerstone in the treatment of schizophrenia and are primarily recommended as monotherapy by evidence-based guidelines. Nevertheless, antipsychotic polypharmacy (APP) is prevalent in routine practice and APP is also used as a quality indicator since 2016 in quality management programs. Based on routine data of nine psychiatric hospitals of the Landschaftsverband Rheinland (LVR)/Germany the prevalence of APP was determined and correlated with factors of routine healthcare in order to monitor the adoption of APP and to discuss its feasibility as a quality indicator. All cases with schizophrenia (ICD-10 F20.x; ≥ 18 years) discharged between June 1st, 2016, and June 1st, 2017, (in-patient and day clinic) were extracted from an established research database shared by all nine hospitals and analyzed regarding APP prevalence at the time of discharge. Based on 6,788 cases, the prevalence of APP was 55.5 % with an average of 2.4 antipsychotics (SD = 0.6) administered simultaneously. In multivariate analyses, significant predictors for APP were: gender (male > female), the number of days in hospital (long > short), involuntary treatment (no > yes) and the location of the hospital. We found a high proportion of polypharmacy in inpatient schizophrenia patients and significant differences between hospitals. The use of the results as a quality indicator (criteria ≥ 2 antipsychotics) remains dependent on the background of the individual treatment courses, which cannot be adequately represented by the existing routine data. The LVR has been using the quality indicator of ≥ 3 antipsychotics since 2018, which is discussed as a more appropriate approach for future evaluations.