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Use of second-generation antipsychotics in the acute inpatient management of schizophrenia in the Middle East.

Alkhadhari S, Al Zain N, Darwish T, Khan S, Okasha T, Ramy H, Tadros TM - Neuropsychiatr Dis Treat (2015)

Bottom Line: Of the 1,057 patients, 180 (17.0%) and 692 (65.5%) received SGAs as monotherapy and in combination therapy, respectively.Upon discharge, 93.9% of patients were prescribed SGAs as maintenance therapy, and 84.8% were prescribed the same medication(s) as during hospitalization.Current clinical practice in the Middle East differs from guideline recommendations.

View Article: PubMed Central - PubMed

Affiliation: Kuwait Center for Mental Health, Safat, Kuwait, Saudi Arabia.

ABSTRACT

Background: Management of acute psychotic episodes in schizophrenic patients remains a significant challenge for clinicians. Despite treatment guidelines recommending that second-generation antipsychotics (SGAs) should be used as monotherapy, first-generation antipsychotics, polypharmacy, and lower than recommended doses are frequently administered in clinical practice. Minimal data exist regarding the use of SGAs in the Middle East. The objective of this study was to examine the discrepancies between current clinical practice and guideline recommendations in the region.

Methods: RECONNECT-S Beta was a multicenter, noninterventional study conducted in Egypt, Kuwait, Saudi Arabia, and the United Arab Emirates to observe the management of schizophrenic patients who were hospitalized due to an acute psychotic episode. Patients underwent one visit on the day of discharge. Demographic and medical history, together with data on antipsychotic treatment and concomitant medication during the hospitalization period and medication recommendations at discharge were recorded.

Results: Of the 1,057 patients, 180 (17.0%) and 692 (65.5%) received SGAs as monotherapy and in combination therapy, respectively. Overall, the most frequently administered medications were given orally, and included risperidone (40.3%), olanzapine (32.5%), and quetiapine (24.6%); the doses administered varied between countries and deviated from the recommended guidelines. Upon discharge, 93.9% of patients were prescribed SGAs as maintenance therapy, and 84.8% were prescribed the same medication(s) as during hospitalization.

Conclusion: Current clinical practice in the Middle East differs from guideline recommendations. Patients frequently received antipsychotics in combination therapy, by various methods of administration, and at doses above and below the recommended guidelines for the management of their acute psychotic episodes.

No MeSH data available.


Related in: MedlinePlus

Study design.Notes: Patients made one visit on the day of their discharge after hospitalization due to an acute psychotic episode; during this visit, data on demographics, diagnosis, and medical history were recorded. In addition, data on antipsychotic treatment and concomitant medication were collected for the hospitalization period, together with the recommendation at discharge. Any patients who met the enrolment criteria (≥18 years and met the diagnostic criteria for schizophrenia stated in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) and had signed a written informed consent form were included in the study.
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f1-ndt-11-915: Study design.Notes: Patients made one visit on the day of their discharge after hospitalization due to an acute psychotic episode; during this visit, data on demographics, diagnosis, and medical history were recorded. In addition, data on antipsychotic treatment and concomitant medication were collected for the hospitalization period, together with the recommendation at discharge. Any patients who met the enrolment criteria (≥18 years and met the diagnostic criteria for schizophrenia stated in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) and had signed a written informed consent form were included in the study.

Mentions: This was a noninterventional, multicenter study, registered as NCT01544608, to observe the management of patients with schizophrenia hospitalized due to an acute psychotic episode in Egypt, Kuwait, Saudi Arabia, and the United Arab Emirates. All psychiatrists recruited into the study (full details included in Table S1) had at least 10–15 years’ experience, represented different geographical locations, and were responsible for the inpatient wards that subjects participating in the study had stayed on. Public, private, general, and mental health hospitals were included in the study. Subjects participated in one visit on their day of discharge after hospitalization due to an acute psychotic episode (Figure 1). At the study visit, data on demographics, diagnosis, and medical history were recorded. Data on antipsychotic treatments and concomitant medications were collected for the hospitalization period, along with the recommended treatment regimen at discharge. The first subject’s first visit was on April 7, 2012, and the last subject’s last visit was on December 31, 2012.


Use of second-generation antipsychotics in the acute inpatient management of schizophrenia in the Middle East.

Alkhadhari S, Al Zain N, Darwish T, Khan S, Okasha T, Ramy H, Tadros TM - Neuropsychiatr Dis Treat (2015)

Study design.Notes: Patients made one visit on the day of their discharge after hospitalization due to an acute psychotic episode; during this visit, data on demographics, diagnosis, and medical history were recorded. In addition, data on antipsychotic treatment and concomitant medication were collected for the hospitalization period, together with the recommendation at discharge. Any patients who met the enrolment criteria (≥18 years and met the diagnostic criteria for schizophrenia stated in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) and had signed a written informed consent form were included in the study.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4389914&req=5

f1-ndt-11-915: Study design.Notes: Patients made one visit on the day of their discharge after hospitalization due to an acute psychotic episode; during this visit, data on demographics, diagnosis, and medical history were recorded. In addition, data on antipsychotic treatment and concomitant medication were collected for the hospitalization period, together with the recommendation at discharge. Any patients who met the enrolment criteria (≥18 years and met the diagnostic criteria for schizophrenia stated in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) and had signed a written informed consent form were included in the study.
Mentions: This was a noninterventional, multicenter study, registered as NCT01544608, to observe the management of patients with schizophrenia hospitalized due to an acute psychotic episode in Egypt, Kuwait, Saudi Arabia, and the United Arab Emirates. All psychiatrists recruited into the study (full details included in Table S1) had at least 10–15 years’ experience, represented different geographical locations, and were responsible for the inpatient wards that subjects participating in the study had stayed on. Public, private, general, and mental health hospitals were included in the study. Subjects participated in one visit on their day of discharge after hospitalization due to an acute psychotic episode (Figure 1). At the study visit, data on demographics, diagnosis, and medical history were recorded. Data on antipsychotic treatments and concomitant medications were collected for the hospitalization period, along with the recommended treatment regimen at discharge. The first subject’s first visit was on April 7, 2012, and the last subject’s last visit was on December 31, 2012.

Bottom Line: Of the 1,057 patients, 180 (17.0%) and 692 (65.5%) received SGAs as monotherapy and in combination therapy, respectively.Upon discharge, 93.9% of patients were prescribed SGAs as maintenance therapy, and 84.8% were prescribed the same medication(s) as during hospitalization.Current clinical practice in the Middle East differs from guideline recommendations.

View Article: PubMed Central - PubMed

Affiliation: Kuwait Center for Mental Health, Safat, Kuwait, Saudi Arabia.

ABSTRACT

Background: Management of acute psychotic episodes in schizophrenic patients remains a significant challenge for clinicians. Despite treatment guidelines recommending that second-generation antipsychotics (SGAs) should be used as monotherapy, first-generation antipsychotics, polypharmacy, and lower than recommended doses are frequently administered in clinical practice. Minimal data exist regarding the use of SGAs in the Middle East. The objective of this study was to examine the discrepancies between current clinical practice and guideline recommendations in the region.

Methods: RECONNECT-S Beta was a multicenter, noninterventional study conducted in Egypt, Kuwait, Saudi Arabia, and the United Arab Emirates to observe the management of schizophrenic patients who were hospitalized due to an acute psychotic episode. Patients underwent one visit on the day of discharge. Demographic and medical history, together with data on antipsychotic treatment and concomitant medication during the hospitalization period and medication recommendations at discharge were recorded.

Results: Of the 1,057 patients, 180 (17.0%) and 692 (65.5%) received SGAs as monotherapy and in combination therapy, respectively. Overall, the most frequently administered medications were given orally, and included risperidone (40.3%), olanzapine (32.5%), and quetiapine (24.6%); the doses administered varied between countries and deviated from the recommended guidelines. Upon discharge, 93.9% of patients were prescribed SGAs as maintenance therapy, and 84.8% were prescribed the same medication(s) as during hospitalization.

Conclusion: Current clinical practice in the Middle East differs from guideline recommendations. Patients frequently received antipsychotics in combination therapy, by various methods of administration, and at doses above and below the recommended guidelines for the management of their acute psychotic episodes.

No MeSH data available.


Related in: MedlinePlus