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Psychotropic drug utilization and audit in two Italian psychiatric services

Published online by Cambridge University Press:  09 July 2009

Giovanni De Girolamo*
Affiliation:
Servizi Psichiatrici, Cremona, Italy; Institute of Psychiatry, London; Postgraduate School of Psychiatry, 2nd Medical School, University of Naples, Italy
*
1Address for correspondence: Dr G. de Girolamo, Servizi Psichiatrici, USSL 51, 26100 Cremona, Italy.

Synopsis

The utilization of psychotropic drugs is a topic of increasing interest. This paper describes a study of psychotropic drug use in two acute psychiatric in-patient services in Cremona, northern Italy. Almost all patients surveyed received one or more psychotropic drugs, and there was evidence of a substantial level of polypharmacy. Women patients were prescribed more psychotropic drugs than the men, while the relationship between drug prescription and psychiatric diagnosis differed between the two services. During the second phase of the study, the medical staff were aware that their prescribing was being monitored. However, this knowledge appeared to have little effect on their patterns of prescribing. The findings of Barton (1978) are thus not supported.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1987

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References

Barton, J. L. (1978). A study of the effect of computer feedback on polypharmacy. Journal of Clinical Psychiatry 39, 690692.Google ScholarPubMed
Bellantuono, C., Camisassa, A., Colombo, F., Re, E. & Tognoni, G. (1978). Terapia farmacologica in psichiatria. In Alii del Seminario su ‘Revisione critica della terapia farmacologica in psichiatria’(ed. Bellantuono, C., Colombo, F., Righetti, A. and Tognoni, G.), pp. 100114. Istituto Mario Negri: Milan.Google Scholar
Bellantuono, C., Reggi, V., Tognoni, G. & Muscettola, G. (1981). Comparison of practice in hospitals and community mental health centers. In Epidemiological Impact of Psychotropic Drugs (ed. Tognoni, G., Bellantuono, C. and Lader, M.), pp. 171181. Elsevier: Amsterdam.Google Scholar
Benson, P. (1966). The prescription of discretionary antipsychotics medication by state mental hospital psychiatrists. Journal of Health and Social Behaviour 27, 2843.CrossRefGoogle Scholar
Craig, T. J. & Behar, R. (1980). Trends in the prescription of psychotropic drugs (1970–1977) in a state hospital. Comprehensive Psychiatry 21, 336345.CrossRefGoogle ScholarPubMed
Craig, T. J. & Mehta, R. M. (1984). Clinician-computer interaction: automated review of psychotropic drugs. American Journal of Psychiatry 141, 267270.Google ScholarPubMed
Diamond, H., Tislow, R., Snyder, T. & Rickels, K. (1976). Peer review of prescribing patterns in a CMHC. American Journal of Psychiatry 133, 697699.Google Scholar
Edwards, S. & Kumar, V. (1984). A survey of prescribing of psychotropic drugs in a Birmingham psychiatric hospital. British Journal of Psychiatry 145, 502507.CrossRefGoogle Scholar
Famuyiwa, O. O. (1983). Psychotropic drug prescription in Nigeria. Acta Psychiatrica Scandinavica 68, 7381.CrossRefGoogle ScholarPubMed
Fiorio, R. & Bellantuono, C. (1985). L'uso degli psicofarmaci in una prospettiva epidemiologica. In L'approccio epidemiologico in psychiatria (ed. Tansella, M.), pp. 480502. Boringhieri: Turin.Google Scholar
Gillis, J. S., Lipkin, J. O. & Moran, T. J. (1981). Drug therapy decisions. A social judgement analysis. Journal of Nervous and Mental Disease 169, 439447.CrossRefGoogle Scholar
Gottschalk, L. A., Bates, D. E., Fox, R. A. & James, J. M. (1971). Psycho-active drug use. Archives of General Psychiatry 25, 395397.CrossRefGoogle Scholar
Greenblatt, D. J., Shader, R. I. & Koch-Weser, J. (1975). Psychotropic drug use in the Boston area. Archives of General Psychiatry 32, 518521.CrossRefGoogle ScholarPubMed
Harris, C. M., Fry, J., Jarman, B. & Woodman, E. (1985). Prescribing – a case for prolonged treatment. Journal of the Royal College of General Practitioners 35, 284287.Google ScholarPubMed
Hemminki, E. (1974). The effect of a doctor's personal characteristics and working circumstances on the prescribing of psychotropic drugs. Medical Care 12, 351356.CrossRefGoogle ScholarPubMed
Hemminki, E. (1975). Review of literature on the factors affecting drug prescribing. Social Science & Medicine 9, 111115.CrossRefGoogle ScholarPubMed
Laska, E., Varga, E., Wanderling, J., Simpson, G., Logeman, G. W. & Shah, B. K. (1973). Patterns of psychotropic drug use for schizophrenia. Diseases of the Nervous System 34, 294305.Google ScholarPubMed
Magni, G., De Leo, D., Canton, G., Palazzolo, O., Antonielli, F. & Rosaro, P. (1984). Psychotropic drug user in an Italian general hospital. Pharmacopsychiatry 17, 116121.CrossRefGoogle Scholar
Magni, G., Schifano, F., De Leo, D., De Dominicis, G., Renesto, V. & Vianello, S. (1985). Evaluation of use patterns of psychotropic drugs in an Italian geriatric hospital. Neuropsychobiology 13, 3843.CrossRefGoogle Scholar
Mason, A. S., Nerviano, V. & De Burger, R. A. (1977). Patterns of antipsychotic drug use in four south eastern state hospitals. Diseases of the Nervous System 38, 541545.Google Scholar
Michel, K. & Kolakowska, T. (1981). A survey of prescribing psychotropic drugs in two psychiatric hospitals. British Journal of Psychiatry 136, 217221.CrossRefGoogle Scholar
Morgan, R. & Gopalaswamy, A. K. (1984). Psychotropic drugs: another survey of prescribing patterns. British Journal of Psychiatry 144, 298301.CrossRefGoogle ScholarPubMed
Mosher, L. (1982). Revolutionary mental health law: an assessment. American Journal of Psychiatry 139, 199203.Google ScholarPubMed
Murray, J., Dunn, G., Williams, P. & Tarnopolsky, A. (1981). Factors affecting the consumption of psychotropic drugs. Psychological Medicine 11, 551560.CrossRefGoogle ScholarPubMed
Perns, C. & Kemali, D. (1985). Focus on the Italian psychiatric reform. Acta Psychiatrica Scandinavica Supplementum 316.Google Scholar
Quitkin, F. M. (1985). The importance of dosage in prescribing antidepressants. British Journal of Psychiatry 147, 593597.CrossRefGoogle ScholarPubMed
Racco, M. & Loreti, P. (1985). Un farmaco per I'uomo. ISIS News 78, 6–24.Google Scholar
Schmidt, L. G., Niemeyer, R. & Müller-Oerlinghausen, B. (1983). Drug prescribing pattern of a psychiatric university hospital in Germany. Pharmacopsychiatry 16, 3542.CrossRefGoogle ScholarPubMed
Schroeder, N. H., Caffey, E. M. & Lorei, T. W. (1977). Antipsychotic drug use: physician prescribing practices in relation to current recommendations. Diseases of the Nervous System 38, 114116.Google ScholarPubMed
Schulz, P., Strasser, O., Glauser, D. & Fischer, W. (1984). Prescribing patterns in outpatients' psychiatric clinic. European Archives of Psychiatric and Neurological Sciences 234, 220223.CrossRefGoogle ScholarPubMed
Schüssler, G. & Müller-Oerlinghausen, B. (1984). Polypharmacy in psychiatric practice. Comprehensive Psychiatry 6, 556574.Google Scholar
Siciliani, O., Bellantuono, C., Williams, P. & Tansella, M. (1985). Self-reported use of psychotropic drugs and alcohol abuse in South Verona. Psychological Medicine 15, 821826.CrossRefGoogle ScholarPubMed
Siegel, C., Laska, E. & Fischer, S. (1983). Clinical review: computerization and implementation. Journal of Psychiatric Treatment and Evaluation 5, 321324.Google Scholar
Swett, C. (1979). Patterns of drug use in psychiatric inpatient wards. Journal of Clinical Psychiatry 40, 464468.Google ScholarPubMed
Tansella, M. & Williams, P. (1987). The Italian experience and its implications. Psychological Medicine 17, 283289.CrossRefGoogle ScholarPubMed
Tansella, M., De Salvia, D. & Williams, P. (1987). The Italian psychiatric reform: some quantitative evidence. Social Psychiatry 22, 3748.CrossRefGoogle ScholarPubMed
Tognoni, G., Bellantuono, C., Bollini, P., Bonati, M. & Reggi, V. (1982). La terapia farmacologica come strumento di valutazione in psychiatria. In Servizi sanitari e psichiatria (ed. Kemali, D., Morosini, P. L. and Amati, A.), pp. 153170. II Pensiero Scientifico: Rome.Google Scholar
Williams, P., Bellantuono, C., Fiorio, R. & Tansella, M. (1986). Psychotropic drug use in Italy: national trends and regional differences. Psychological Medicine 16, 841850.CrossRefGoogle ScholarPubMed
Wilson, W. H., Ban, T. A. & Guy, W. (1985). Pharmacotherapy of chronic hospitalized schizophrenics: prescription practices. Neuropsychobiology 14, 7582.CrossRefGoogle ScholarPubMed
Winstead, D. K., Blackwell, B., Eilers, M. K. & Anderson, A. (1976). Psychotropic drug use in five city hospitals. Diseases of the Nervous System 37, 504509.Google ScholarPubMed
Yosselson-Superstine, S., Sternik, D. & Liebenzon, D. (1979). Prescribing patterns in psychiatric hospitals in Israel. Acta Psychiatrica Scandinavica 60, 477482.CrossRefGoogle ScholarPubMed