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NRI Researchers Investigate Polypharmacy Prescribing Practices

Current best practices call for psychiatric patients to be discharged on as few antipsychotic medications as possible, but a recent study conducted by NRI researchers Glorimar Ortiz, Vera Hollen and Lucille Schacht—and published by Wolters Kluwer Health—finds that a large number of individuals with serious mental illness, particularly with a diagnosis of schizophrenia, are being prescribed multiple antipsychotic medications.

The cross-sectional study looked at all discharges for adult patients from state psychiatric inpatient hospitals during the 2011 calendar year. Data for 86,034 patients from age 18 through 64 were analyzed. The NRI researchers found the prevalence of antipsychotic polypharmacy to be 12 percent. Further, of discharged patients prescribed at least one antipsychotic medication, fully 18 percent were on antipsychotic polypharmacy.

“The study is unique because it is the first time that data on the use of antipsychotic medications are analyzed using a large sample of discharges from state psychiatric inpatient hospitals. Since our study included data from hospitals in 46 states and territories, regional data analysis was also possible,” explained Glorimar Ortiz, Senior Researcher and Statistician with NRI.

Ortiz added, “There are a group of characteristics that increase the likelihood of being discharged on multiple antipsychotic medications, with the strongest factors being a diagnosis of schizophrenia and longer hospitalizations. Clinicians could use this information to develop and implement quality initiatives that could help further reduce the use of antipsychotic polypharmacy.”

The study concludes that clinicians continue to prescribe multiple antipsychotic medications for reasons other than those with empirical evidence to support the practice. The full study can be found in the July issue of the Journal of Psychiatric Practice or on NRI's website here.