Luthra Shalini, Duggan Lorna, Agrawal Aanchal, Kaur Gurpreeti, Luthra Neeru
Central Queensland Hospital and Health Service, Rockhampton, Australia.
Mental Health Alcohol and Other Drugs Services, Central Queensland Hospital and Health Service, Rockhampton, Australia.
Int J Appl Basic Med Res. 2023 Apr-Jun;13(2):70-76. doi: 10.4103/ijabmr.ijabmr_504_22. Epub 2023 Jul 17.
Antipsychotic medication is widely recognized as a critical intervention in both acute and ongoing treatments of schizophrenia. Guidelines endorse the routine practice of monotherapy with antipsychotic medication at the minimum effective dose. Despite the recommendations, high-dose antipsychotic prescribing and polytherapy appear to be common practice.
The objective of this study was to determine the prevalence of high-dose antipsychotic prescribing in adult patients with schizophrenia in a regional Queensland hospital and to know if the prescribing practices are in keeping with the international guidelines and with the local policy introduced in December 2017.
This was a cross-sectional survey/clinical audit of 358 adult patients with schizophrenia open to the service in both community and inpatient settings. The individual prescribing practices of psychiatrists were also examined.
A minority (15%) were prescribed high doses (high-dose single agent and high dose by polytherapy) and 20% were prescribed polytherapy (including high dose and within normal dose range).
Eighty-five percent of the patients with the diagnosis of schizophrenia open to the service were prescribed antipsychotic within the dose range. In this respect, prescribing was aligned with current evidence-based guidelines.
抗精神病药物被广泛认为是精神分裂症急性和持续治疗中的关键干预措施。指南认可使用最低有效剂量的抗精神病药物进行单药治疗的常规做法。尽管有这些建议，但高剂量抗精神病药物处方和联合治疗似乎仍是常见做法。
本研究的目的是确定昆士兰州一家地区医院成年精神分裂症患者中高剂量抗精神病药物处方的患病率，并了解处方做法是否符合国际指南以及2017年12月出台的当地政策。
这是一项对358名在社区和住院环境中接受该服务的成年精神分裂症患者进行的横断面调查/临床审计。还检查了精神科医生的个人处方做法。
少数患者（15%）接受了高剂量处方（高剂量单药和联合高剂量），20%的患者接受了联合治疗（包括高剂量和正常剂量范围内）。
85%诊断为精神分裂症并接受该服务的患者接受了剂量范围内的抗精神病药物处方。在这方面，处方符合当前的循证指南。
