Mohamed Ahmed Adel, Almulhim Abdulaziz Saleh, Alnijadi Abdulrahman Abdullah, Abd Aziz Fatimatuzzahra' Binti, Alajmi Khuloud Khaled, Al-Mudhaffar Ahmed Abdullah, Almutairi Mohammad Salem
Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang 11800, Malaysia.
Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al Ahsaa 31982, Saudi Arabia.
J Clin Med. 2025 Apr 24;14(9):2941. doi: 10.3390/jcm14092941.
Inappropriate prescription patterns and polypharmacy are critical challenges facing the optimal management of schizophrenia patients, especially in regard to patient safety. : The purpose of this study was to examine the relationship between patient safety and the existence of incorrect prescription patterns and/or polypharmacy in the medications prescribed to individuals with schizophrenia. This issue is addressed in a broad context, highlighting the purpose of this study. : A cross-sectional study was adopted, involving a prospective analysis of the prescriptions of schizophrenia patients receiving treatment. Prescription patterns deemed inappropriate were evaluated based on evidence-based guidelines. Antipsychotic maximum allowable daily doses were calculated using the British National Formulary Maximum Daily Dose (BNFmax), an online tool. Patient safety outcomes were assessed using the Glasgow Antipsychotic Side-effect Scale (GASS). : A total of 198 patients diagnosed with schizophrenia and receiving treatment consented to participate in the GASS survey. A total of 116 (58.6%) males participated. The mean age of patients was 40.1 (±12.7). Thirty-one (66.2%) reported mild side effects, while 67 (33.8%) reported moderate side effects. Polypharmacy was detected in 103 (52%) patients' prescriptions. The correlation between GASS and BNFmax was positive and statistically significant ( < 0.001). The elevation in GASS score was associated with polypharmacy prescriptions (OR 3.21; 95% CI 1.64-6.29), the presence of first-generation antipsychotics (FGAP) (OR 2.79; 95% CI 0.236-5.951), any combination of antipsychotics containing haloperidol (OR 3.22; 95% CI 1.11-9.32), and olanzapine (OR 3.46; 95% CI 1.36-8.79). : The safety of patients with schizophrenia has been proven to be impacted by the improper use of psychotropic drugs. Following evidence-based guidelines is a cornerstone to ensuring optimal, effective, and safe patient treatment plans.
不恰当的处方模式和多重用药是精神分裂症患者优化管理面临的关键挑战，尤其是在患者安全方面。本研究的目的是探讨患者安全与精神分裂症患者所开药物中不正确处方模式和/或多重用药之间的关系。这个问题是在广泛的背景下提出的，突出了本研究的目的。采用横断面研究，对接受治疗的精神分裂症患者的处方进行前瞻性分析。根据循证指南评估被认为不恰当的处方模式。使用在线工具英国国家处方集最大日剂量（BNFmax）计算抗精神病药物的最大允许日剂量。使用格拉斯哥抗精神病药物副作用量表（GASS）评估患者安全结果。共有198名被诊断为精神分裂症并接受治疗的患者同意参加GASS调查。共有116名（58.6%）男性参与。患者的平均年龄为40.1（±12.7）。31名（66.2%）报告有轻度副作用，而67名（33.8%）报告有中度副作用。在103名（52%）患者的处方中检测到多重用药。GASS与BNFmax之间的相关性为正且具有统计学意义（<0.001）。GASS评分升高与多重用药处方（比值比3.21；95%置信区间1.64 - 6.29）、第一代抗精神病药物（FGAP）的存在（比值比2.79；95%置信区间0.236 - 5.951）、任何含氟哌啶醇的抗精神病药物组合（比值比3.22；95%置信区间1.11 - 9.32）以及奥氮平（比值比3.46；95%置信区间1.36 - 8.79）有关。已证明精神分裂症患者的安全会受到精神药物使用不当的影响。遵循循证指南是确保患者获得最佳、有效和安全治疗方案的基石。
