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Patterns and Predictors of Off-Label Drug Prescribing in Psychiatric Practice: A Qualitative Study
Sadia Shakeel1, Shagufta Nesar2, Hina Rehman3
1Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Dow College of Pharmacy, Dow University of Health Sciences, Karachi 74200, Pakistan.
Psychiatrists commonly use off-label drug prescribing (OLDP) in their practice, often without informing patients. While aware of OLDP, their attitudes vary, highlighting a need for further education to mitigate risks.
Area of Science:
- Psychiatry
- Clinical Pharmacology
- Medical Ethics
Background:
- Off-label drug prescribing (OLDP) requires strong scientific evidence for optimal patient outcomes.
- Physician knowledge and attitude significantly influence adherence to OLDP prerequisites.
Purpose of the Study:
- To investigate psychiatrists' perceptions and practices regarding off-label drug prescribing in clinical settings.
Main Methods:
- Qualitative study involving semi-structured interviews with 14 psychiatrists.
- Thematic content analysis was used to analyze interview data, achieving saturation at the 12th interview.
Main Results:
- Six major themes emerged, including knowledge, attitudes, and practices related to OLDP.
- Off-label use of benzodiazepines (e.g., clonazepam, diazepam, lorazepam) for mania, depression, and OCD is common.
- Most psychiatrists did not inform patients about off-label prescriptions, despite general awareness.
Conclusions:
- Psychiatrists demonstrate awareness of OLDP but exhibit diverse attitudes towards its use.
- Targeted education and sensitization are crucial in areas with limited knowledge to prevent risks associated with OLDP.
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