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Ann Acad Med Singapore. 2006 Jul;35(7):457-60.

Reducing polypharmacy through the introduction of a treatment algorithm: use of a treatment algorithm on the impact on polypharmacy.

Author information

1
Department of Early Psychosis Intervention, Institute of Mental Health, Singapore. Siow_Ann_CHONG@imh.com.sg

Abstract

INTRODUCTION:

Polypharmacy is very common in the psychiatric setting despite the lack of evidence to justify its use. The objective of this study was to review the prescription patterns in a tertiary mental health institute in Asia and evaluate the impact of a treatment algorithm for patients with first-episode psychosis (FEP) on the use of polypharmacy.

MATERIALS AND METHODS:

A treatment algorithm was implemented for patients accepted into an Early Psychosis Intervention Programme (EPIP) and the prescription patterns of these patients were compared with a comparator group (pre-EPIP) before the use of the algorithm. The prescribing pattern was established at 2 points: at baseline after the diagnosis was made, and 3 months later.

RESULTS:

There were 68 subjects in the comparator group and 483 EPIP patients; the latter were on the average younger. None in the comparator group was diagnosed to have an affective psychosis. There was a significant reduction in the rate of antipsychotic polypharmacy, prolonged use of benzodiazepines and anticholinergic medication in EPIP patients. This group also had an increase in the use of second-generation antipsychotics and received lower doses of antipsychotics.

CONCLUSION:

The implementation of a treatment algorithm coupled with audit has changed the trend towards polypharmacy among patients with FEP.

PMID:
16902720
[Indexed for MEDLINE]
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