Adesola Ao, Anozie Ig, Erohubie P, James Bo
Department of Clinical Services, Federal Psychiatric Hospital, Benin City, Nigeria.
Ann Med Health Sci Res. 2013 Jan;3(1):62-6. doi: 10.4103/2141-9248.109499.
High dose antipsychotic prescribing is common in psychiatric care, despite a lack of its benefit from research evidence. While several studies have explored the prevalence and factors associated with high dose antipsychotic prescribing, no such report has emanated from a developing country like Nigeria.
The aims of this study were to determine the prevalence of high dose prescribing among in-patients at a tertiary psychiatric hospital and to determine the pattern of antipsychotic drugs prescribed.
An audit of in-patients at a regional tertiary psychiatric facility was carried out. We examined case notes and conducted oral interviews where necessary, on all patients receiving antipsychotics using a proforma designed for the study.
The prevalence of high dose prescribing was 38% (65/171) using a prescribed daily dose/defined daily dose ratio of 1.5. The rate of antipsychotic polypharmacy was 7% (12/171). The atypical antipsychotic, olanzapine was the most commonly prescribed antipsychotic in monotherapy. Predictors of high dose prescribing were diagnoses (P = 0.04), polypharmacy (P = 0.04), a history of previous in-patient care (P = 0.02), and use of anticholinergic drugs (P = 0.01).
High dose prescribing was common among in-patients audited. Further studies are needed to examine factors that promote "high dose" prescribing.
尽管缺乏研究证据表明其有益，但高剂量抗精神病药物处方在精神科护理中很常见。虽然有几项研究探讨了高剂量抗精神病药物处方的患病率及相关因素，但像尼日利亚这样的发展中国家尚未有此类报告。
本研究的目的是确定一家三级精神病医院住院患者中高剂量处方的患病率，并确定抗精神病药物的处方模式。
对一家地区三级精神病机构的住院患者进行了审计。我们检查了病历，并在必要时对所有接受抗精神病药物治疗的患者进行了口头访谈，使用的是为该研究设计的表格。
使用规定日剂量/限定日剂量比为1.5时，高剂量处方的患病率为38%（65/171）。抗精神病药物联合用药率为7%（12/171）。非典型抗精神病药物奥氮平是单一疗法中最常用的抗精神病药物。高剂量处方的预测因素为诊断（P = 0.04）、联合用药（P = 0.04）、既往住院治疗史（P = 0.02）和使用抗胆碱能药物（P = 0.01）。
在接受审计的住院患者中，高剂量处方很常见。需要进一步研究以检查促进“高剂量”处方的因素。
