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Understanding antipsychotic non-classical prescriptions: a quantitative and qualitative approach
Antonio Veronese1, Valerio Vivenza, Michela Nosè
1Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy. antonio.veronese@medicina.univr.it
Epidemiologia E Psichiatria Sociale
|October 18, 2008
Summary
Most non-classical antipsychotic prescriptions are clinically sound, often inherited or to manage psychotic symptoms. Problematic doctor-patient relationships, however, lead to clinically unsound prescriptions.
Area of Science:
- Psychiatry
- Clinical Pharmacology
Background:
- Few studies explore reasons for non-classical antipsychotic prescriptions.
- Understanding these prescriptions is crucial in naturalistic clinical settings.
Purpose of the Study:
- To understand the clinical rationale behind non-classical antipsychotic prescribing.
- To explore clinicians' perspectives using mixed-methods research.
Main Methods:
- Extracted antipsychotic prescriptions from a psychiatric case register (2005).
- Defined non-classical prescriptions (concurrent use, off-label indications/doses).
- Collected reasons via clinician brainstorming, categorizing them as clinically sound or not sound.
Main Results:
- 376 non-classical prescriptions for 259 patients were identified.
- Common reasons included inherited prescriptions and symptom management.
- Over 60% were deemed clinically sound; unsound prescriptions linked to poor patient-clinician relationships.
Conclusions:
- Clinically unsound prescriptions reflect poor doctor-patient dynamics.
- Lack of individualized treatment plans and focus on prescription monitoring characterize unsound cases.
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