People with schizophrenia are sometimes prescribed multiple antipsychotic drugs, even though clinical guidelines rarely recommend this course of action.
This cross-sectional observational study from Denmark explored the reasons behind this prescribing practice in two treatment centres; one that had high rates of antipsychotic polypharmacy and the other that had low rates.
The researchers sent a questionnaire to doctors and nurses in the two treatment centres and got a decent response rate (doctors: 93%; nurses: 87%).
The treatment centre with low use of antipsychotic polypharmacy were characterised by:
- raised knowledge/awareness of local antipsychotic treatment guidelines (P = .02 for doctors; P = .01 for nurses)
- elevated confidence in these guidelines by doctors (P = .01)
- frequent local educational activities by doctors (P < .0001)
- increased recent involvement in research by doctors (P = .01).
The treatment centre with high use of antipsychotic polypharmacy were characterised by:
- a perception amongst nurses of an overwhelming work load (P = .01)
- time pressure for nurses (P = .003)
- the belief in the benefit of antipsychotic polypharmacy augmentation (P = .001).
The authors concluded:
Albeit no causal relationships can be inferred from this cross-sectional observational study, we recommend the furtherance of a treatment environment characterized by easily accessible clinical guidelines, frequent academic activities, and an unruffled atmosphere.