Year: 2011
Type: dissertation
Study design: Observational Study
Abstract: Background: Many factors affect the prescribing of medication to patients with schizophrenia including variables that relate to physicians and may result in marked variance in the choice of drugs, dosages, drug combinations, route of administration and the use of antipsychotic, anticholinergic, sedative and other adjuvant drugs.Clinical practice guidelines were developed to address this variance and for other reasons, including the management of side-effects, drug innovation, rising costs, information overload, changes in treatment goals and the management of medication non-adherence.There are advantages and disadvantages to using clinical practice guidelines including those pertaining to context and cultural norms, but they remain the best method of assessing prescribing quality.Many guidelines are based on the results of randomised clinical trials (with a single drug)or are the consensus of experts in the field.Despite the development and publication of these guidelines over the past two decades, they are frequently not adhered to resulting in much variance in treatment. Aims and objectives:The aim of the study was to determine to what extent the prescribing of psychotropic drugs in the treatment of schizophrenia was consistent with the most recent version of each of five guidelines that originate outside South Africa (two from the United States and one each from Canada, the United Kingdom, and Australia and New Zealand); and one that was developed locally.Methodology: A retrospective, cross-sectional prescription chart review with data sampling at three time points (on hospital admission, at fourteen days thereafter and on hospital discharge) was undertaken.A sample population was drawn over a three year period during which the patients' physician had access to the same drug formulary.Seventy patients met the study selection criteria in terms of age, diagnosis and receipt of antipsychotic medication during hospital stay and on discharge.Seventy patients met the study selection criteria, and their prescriptions for psychotropic medication (exclusively) were examined for a number of parameters including: drug class, drug name, dose, route of administration and whether the medication was to be administered routinely or 'as needed'. Drug Dose2.3.4.Route of administration: Depot antipsychotic formulation 2.3.5.Adjuvant medication 2.4.The use of prescribing data in routine clinical settings 2.4.1.The need for studies in routine clinical settings 2.4.2.The value of collecting prescribing data 2.5.Clinical Practice Guidelines 2.5.1.The value of clinical practice guidelines in improving the quality of care 2.5.2.Setting, context and cultural issues 2.5.3.History, methodology and application of the guidelines used 2.5.4.Comparative evaluation of clinical practice guidelines 2.6 Overview of literature review
Author: Russell Wayne King
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2269715334