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PIII‐47
Author(s) -
Westphal J.,
nenmacher C.,
Gregoire D.
Publication year - 2006
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1016/j.clpt.2005.12.255
Subject(s) - medicine , polypharmacy , drug , pharmacy , antipsychotic , antipsychotic drug , cross sectional study , emergency medicine , adverse effect , psychiatry , pharmacology , schizophrenia (object oriented programming) , family medicine , pathology
BACKGROUND Little is known on the prevalence and patterns of drug‐drug combinations (DDCs) in psychiatry. We report the results of a 1‐day cross‐sectional study of hazardous/contraindicated (H/C) DDCs in a teaching psychiatric hospital comprising 410 adult beds. METHODS All ongoing drug regimens for the inpatients were retrieved from our computerized physician drug‐order entry (CPOE) system. This system included a screening program that warned the prescriber against H/C DDC. Drug regimens were reviewed by the pharmacy department. Only drugs prescribed on a regular schedule were considered. The screening tool used was the THERIAQUE knowledge base, derived from that of the French Agency for Health Products. RESULTS The 402 inpatients present on the study day were included. In total, 73 H/C DDCs were recorded, giving a prevalence rate of 18.2% (95% CI, 14.4–22.0), and the related categories of potential adverse events were: torsades de pointes (TdP, n=43), several kinds of additive or potentiated toxicities (n=22), and antagonism‐induced therapeutic inefficacy (n=8). Antipsychotics were involved in 52 of the 73 H/C DDCs and in all of those carrying the risk of TdP, a pattern consistent with the high prevalence of antipsychotic polypharmacy, that was 37.5% in the 307 patients receiving antipsychotic therapy. CONCLUSION Given the relatively high prevalence of H/C DDCs, online reminders need to be combined with other types of intervention if appropriate drug prescribing is to be promoted in our hospital. Clinical Pharmacology & Therapeutics (2005) 79 , P71–P71; doi: 10.1016/j.clpt.2005.12.255