Rationalising Antipsychotic Polypharmacy: A Cross-sectional, Pre- and Post-intervention Comparative Study.
Pharmacist-led intervention associated with higher documentation of antipsychotic polypharmacy prescribing reasons
Rationalising Antipsychotic Polypharmacy: A Cross-sectional, Pre- and Post-intervention Comparative Study.
Antipsychotic polypharmacy, the coprescribing of 2 or more antipsychotics, carries risk but has a valid place in treating schizophrenia.
To evaluate the impact of the intervention through a pre- versus post-intervention comparison of antipsychotic polypharmacy prevalence and prescribing burden, rate of documentation of prescribing reasons, and degree of guideline adherence.
A retrospective, cross-sectional medical record audit was conducted to quantify polypharmacy prevalence, and the burden of its prescribing in terms of defined daily doses (defined daily doses) and maximum licensed daily doses (maximum licensed daily doses).
Prescribing reasons documented in 68.0% of cases post-intervention, versus 36.7% before
Post-intervention antipsychotic polypharmacy prevalence was 39.1% (vs 39.0% at baseline; P = 1.00).
In the post-intervention polypharmacy cohort, mean combined defined daily doses ± SD was 2.63 ± 1.16 (vs 2.84 ± 1.11 at baseline; P = 0.447) and mean combined maximum licensed daily doses ± SD was 136% ± 56% (vs 131% ± 39% at baseline; P = 0.675).
The intervention was not associated with changes in antipsychotic polypharmacy prevalence, magnitude nor degree of guideline adherence, but significantly improved rates of documentation.
Compared with baseline, where prescribing reasons were largely unclear, the improved post-intervention documentation supported prescribers to make informed decisions about polypharmacy rationalisation.