Prescribing practices in psychiatric hospitals in Eastern Europe

• Published in: European psychiatry Vol. 26; no. 7; pp. 414 - 418
• Main Authors: Jordanova, V, Maric, N.P, Alikaj, V, Bajs, M, Cavic, T, Iosub, D, Mihai, A, Szalontay, A, Sartorius, N
• Format: Journal Article
• Language: English
• Published: Paris Elsevier SAS 01.10.2011; Elsevier
• Subjects: Adult; Biological and medical sciences; Drug Utilization - standards; Drug Utilization - statistics & numerical data; Europe, Eastern; Evidence-based practice; Female; Hospitals, Psychiatric - standards; Humans; Internal Medicine; International Classification of Diseases; Male; Medical sciences; Mental Disorders - diagnosis; Mental Disorders - drug therapy; Middle Aged; Monotherapy; Needs Assessment; Patterns; Polypharmacy; Practice Patterns, Physicians' - standards; Practice Patterns, Physicians' - statistics & numerical data; Prescription Drugs - administration & dosage; Prescription Drugs - adverse effects; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotropic Drugs - administration & dosage; Psychotropic Drugs - adverse effects; Psychotropic prescribing; Eastern Europe; Europe; Europe, Eastern; Psychotropic prescribing; Polypharmacy; Patterns; Monotherapy; Evidence-based practice; Psychiatric hospital; Drug combination; Treatment; Medical prescription; Psychotropic; Pharmacotherapy; Combined treatment
• ISSN: 0924-9338; 1778-3585
• DOI: 10.1016/j.eurpsy.2010.05.005

Abstract Background There has been no evidence about the prescribing practices in psychiatric care in Eastern Europe. Aims To examine the patterns of psychotropic prescribing in five countries of Eastern Europe. Method We conducted a one-day census of psychiatric treatments used in eight psychiatric hospitals in Albania, Croatia, Macedonia, Serbia and Romania. We examined clinical records and medication charts of 1304 patients. Results The use of polypharmacy was frequent across all diagnostic groups. Only 6.8% of patients were on monotherapy. The mean number of prescribed drugs was 2.8 (SD 0.97) with 26.5% receiving two drugs, 42.1% receiving three drugs and 22.1% being prescribed four or more psychotropic drugs. Typical antipsychotics were prescribed to 63% and atypical antipsychotics to 40% of patients with psychosis. Older generations of antidepressants were prescribed to 29% of patients with depression. Anxiolitic drugs were prescribed to 20.4% and benzodiazepines to 68.5% of patients. One third of patients received an anticholinergic drug on a regular basis. Conclusions Older generation antipsychotics and antidepressants were used more frequently than in the countries of Western Europe. Psychotropic polypharmacy is a common practice. There is a need for adopting more evidence-based practice in psychiatric care in these countries.