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Related Concept Videos

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Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
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The term "psychosis" refers to a spectrum of mental disorders characterized by abnormal thoughts, perceptions, and behaviors. It can manifest as mood disorders, dementia, delirium with psychotic features, substance-induced psychosis with psychotic features, brief psychotic disorder, delusional disorder, schizoaffective disorder, and schizophrenia. Among all these disorders, schizophrenia is the most common psychotic disorder, affecting 1% of the worldwide population. Psychotic...
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Implementation of a Real-Time Psychosis Risk Detection and Alerting System Based on Electronic Health Records using CogStack
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Antipsychotic management in general practice: serial cross-sectional study (2011-2020).

Alan Woodall1, Alex Gampel2, Lauren E Walker3

  • 1Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool; clinical lead for integrated care, Powys Teaching Health Board, Bronllys, Powys.

The British Journal of General Practice : the Journal of the Royal College of General Practitioners
|September 20, 2024
PubMed
Summary
This summary is machine-generated.

Long-term antipsychotic use is rising, with fewer patients receiving essential psychiatrist reviews. This trend increases cardiometabolic risks and necessitates urgent intervention for patient safety.

Keywords:
antipsychoticscardiometabolic risk factorscross-sectional studiesgeneral practicemedication reviewpsychiatry

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Area of Science:

  • Psychiatry and General Practice
  • Public Health
  • Pharmacovigilance

Background:

  • Long-term antipsychotic medication use is associated with significant cardiometabolic disease risks.
  • Regular review by psychiatrists is crucial for managing ongoing antipsychotic needs and mitigating risks.

Purpose of the Study:

  • To analyze trends in antipsychotic prescribing within general practice settings.
  • To determine the proportion of patients on long-term antipsychotics who receive annual reviews from psychiatrists.

Main Methods:

  • A serial cross-sectional study utilized linked general practice and hospital data from Wales between 2011 and 2020.
  • Adult patients (≥18 years) registered with Welsh general practices were analyzed for antipsychotic prescription frequency, psychiatrist review rates, and disease register status.

Main Results:

  • The prevalence of adults on long-term antipsychotics increased from 1.055% in 2011 to 1.448% in 2020.
  • The proportion of patients receiving annual psychiatrist reviews decreased from 59.6% to 52.0% during the study period.
  • Prescribing to patients on serious mental illness registers declined, with more patients managed by GPs without specialist oversight.

Conclusions:

  • Increasing long-term antipsychotic use, coupled with reduced psychiatrist involvement and monitoring, poses significant patient risks.
  • Patients managed by general practitioners without regular specialist review or on unmonitored registers may miss crucial cardiometabolic monitoring and deprescribing opportunities.
  • Urgent attention is required to address these concerning trends in antipsychotic management to ensure patient safety and optimize care.