Alan Woodall, Alex Gampel, Lauren E Walker, Frances S Mair, Sally Sheard, Pyers Symon, Iain Buchan
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引用次数: 0
Abstract
Background: Long-term use of antipsychotics confers increased risk of cardiometabolic disease. Ongoing need should be reviewed regularly by psychiatrists.
Aim: To explore trends in antipsychotic management in general practice, and the proportions of patients prescribed antipsychotics receiving psychiatrist review.
Design and setting: Serial cross-sectional study using linked general practice and hospital data in Wales (2011-2020).
Method: Participants were adults (aged ≥18 years) registered with general practices in Wales. Outcome measures were prevalence of patients receiving ≥6 antipsychotic prescriptions annually, the proportion of patients prescribed antipsychotics receiving annual psychiatrist review, and the proportion of patients prescribed antipsychotics who were registered on the UK serious mental illness, depression, and/or dementia registers, or not on any of these registers.
Results: Prevalence of adults prescribed long-term antipsychotics increased from 1.055% (95% confidence interval [CI] = 1.041 to 1.069) in 2011 to 1.448% (95% CI = 1.432 to 1.464) in 2020. The proportion receiving annual psychiatrist review decreased from 59.6% (95% CI = 58.9 to 60.4) in 2011 to 52.0% (95% CI = 51.4 to 52.7) in 2020. The proportion of overall antipsychotic use prescribed to patients on the serious mental illness register decreased from 50.0% (95% CI = 49.4 to 50.7) in 2011 to 43.6% (95% CI = 43.0 to 44.1) by 2020.
Conclusion: Prevalence of long-term antipsychotic use is increasing. More patients are managed by GPs without psychiatrist review and are not on monitored disease registers; they thus may be less likely to undergo cardiometabolic monitoring and miss opportunities to optimise or deprescribe antipsychotics. These trends pose risks for patients and need to be addressed urgently.
期刊介绍:
The British Journal of General Practice is an international journal publishing research, editorials, debate and analysis, and clinical guidance for family practitioners and primary care researchers worldwide.
BJGP began in 1953 as the ‘College of General Practitioners’ Research Newsletter’, with the ‘Journal of the College of General Practitioners’ first appearing in 1960. Following the change in status of the College, the ‘Journal of the Royal College of General Practitioners’ was launched in 1967. Three editors later, in 1990, the title was changed to the ‘British Journal of General Practice’. The journal is commonly referred to as the ''BJGP'', and is an editorially-independent publication of the Royal College of General Practitioners.