Characteristics of clinical-pharmacological recommendations in psychiatry in Germany.

IF 1.1 4区医学 Q4 PSYCHIATRY

International Journal of Psychiatry in Medicine Pub Date : 2024-05-01 Epub Date: 2023-05-16 DOI:10.1177/00912174231177230

Sebastian Schröder, Martin Schulze Westhoff, Tabea Pfister, Stefan Bleich, Felix Wedegärtner, Tillmann Hc Krüger, Johannes Heck, Adrian Groh

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引用次数: 0

Abstract

Objective: Psychiatric patients in general, and elderly psychiatric patients in particular, are at risk of adverse drug reactions due to comorbidities and inappropriate polypharmacy. Interdisciplinary and clinical-pharmacologist-led medication reviews may contribute to medication safety in the field of psychiatry. In this study, we reported the frequency and characteristics of clinical-pharmacological recommendations in psychiatry, with a particular focus on geriatric psychiatry.

Method: A clinical pharmacologist, in collaboration with the attending psychiatrists and a consulting neurologist, conducted interdisciplinary medication reviews in a general psychiatric ward with a geropsychiatric focus at a university hospital over a 25-week period. All clinical and pharmacological recommendations were recorded and evaluated.

Results: A total of 316 recommendations were made during 374 medication reviews. Indications/contraindications of drugs were the most frequently discussed topics (59/316; 18.7 %), followed by dose reductions (37/316; 11.7 %), and temporary or permanent discontinuation of medications (36/316; 11.4 %). The most frequent recommendations for dose reduction involvedbenzodiazepines (9/37; 24.3 %). An unclear or absent indication was the most common reason for recommending temporary or permanent discontinuation of the medication (6/36; 16.7 %).

Conclusion: Interdisciplinary clinical pharmacologist-led medication reviews represented a valuable contribution to medication management in psychiatric patients, particularly the elderly ones.

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精神病学临床药理学建议的特点。

目的：一般来说，精神病患者，尤其是老年精神病患者，由于合并症和不适当的多种药物治疗而面临药物不良反应的风险。由跨学科和临床药理学家主导的用药审查可能有助于精神科领域的用药安全。在这项研究中，我们报告了精神病学中临床药理学建议的频率和特点，尤其关注老年精神病学：方法：一名临床药理学家与精神科主治医生和一名神经科会诊医生合作，在一家大学医院的普通精神科病房进行了跨学科用药审查，该病房以老年精神科为重点，为期 25 周。所有临床和药物治疗建议均被记录和评估：结果：在 374 次药物回顾中，共提出了 316 项建议。药物的适应症/禁忌症是最常讨论的话题（59/316；18.7%），其次是减少剂量（37/316；11.7%）以及暂时或永久停药（36/316；11.4%）。最常见的减量建议涉及苯二氮卓类药物（9/37；24.3%）。建议暂时或永久停药的最常见原因是适应症不明确或不存在（6/36；16.7%）：跨学科临床药理学家主导的用药审查对精神病患者，尤其是老年患者的用药管理做出了宝贵贡献。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Psychiatry in Medicine 医学-精神病学

CiteScore

3.00

自引率

5.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The International Journal of Psychiatry in Medicine (IJPM) bridges the gap between clinical psychiatry research and primary care clinical research. Providing a forum for addressing: The relevance of psychobiological, psychological, social, familial, religious, and cultural factors in the development and treatment of illness; the relationship of biomarkers to psychiatric symptoms and syndromes in primary care...