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首页> 外文期刊>Nordic journal of psychiatry. >Potentially inappropriate prescriptions in patients admitted to a psychiatric hospital
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Potentially inappropriate prescriptions in patients admitted to a psychiatric hospital

机译：精神病医院住院患者的处方可能不适当

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Background Very little is known about the general appropriateness of prescribing for psychiatric patients. Aims To identify prevalence and types of potentially inappropriate prescribing (PIP) of psychotropic and somatic medications, to assess the severity of potential clinical consequences and to identify possible predictive factors of PIP in a sample of adult psychiatric in-patients. Methods A descriptive, cross-sectional design using medication reviews by clinical pharmacologists to identify PIP during a 3-month period. The setting was in-patient units in a psychiatric department of a Danish university hospital during a 3-month period (September 2013-November 2013). Patients medication lists (n = 207) were reviewed at the time of admission and all identified PIPs were assessed for potential consequences by clinical pharmacologists. Results There were 349 PIP identified in 1291 prescriptions. The proportion of patients found to have at least one PIP was 123/207 (59%) and the proportions of patients with at least one PIP assessed to be potentially serious or fatal was 69/207 (33%) and 24/207 (12%), respectively. Interactions between drugs 125/207 (36%) and too high doses of drugs 56/207 (16%) were the most frequent PIP. Predictive factors for PIP were polypharmacy (>5 prescriptions) and having one or more somatic diagnoses. Conclusion PIP is common in psychiatric patients and potentially fatal. Particularly polypharmacy (>5 prescriptions) and concomitant somatic illness were associated with the probability of PIP. Improving the quality of prescribing might benefit from an interprofessional approach and thus better training of physicians and nurses is needed in order to minimize PIP.
机译：背景技术对于精神病患者开处方的一般适用性知之甚少。目的确定精神药物和躯体药物的普遍性和潜在不适当处方（PIP）的类型，评估潜在临床后果的严重性，并确定成人精神病住院患者样本中PIP的可能预测因素。方法采用描述性的横断面设计，使用临床药理学家进行的药物审查来确定3个月内的PIP。设置为三个月（2013年9月至2013年11月）丹麦大学医院精神科的住院单元。入院时对患者用药清单（n = 207）进行了审查，并由临床药理学家评估了所有确定的PIP的潜在后果。结果1291处方中鉴定出349个PIP。被发现至少有一个PIP的患者比例为123/207（59％），被评估为可能严重或致命的至少一个PIP的患者比例为69/207（33％）和24/207（12 ％）， 分别。药物125/207（36％）与过高剂量的药物56/207（16％）之间的相互作用是最常见的PIP。 PIP的预测因素是多药店（> 5个处方）并且具有一种或多种躯体诊断。结论PIP在精神病患者中很常见，并且可能致命。特别是多药房（> 5个处方）和伴随的躯体疾病与PIP的可能性有关。跨学科的方法可能会提高处方质量，因此需要对医师和护士进行更好的培训，以最大程度地降低PIP。

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