JLE

Journal de Pharmacie Clinique

MENU

Correction of neurological disorders related with antipsychotics: prescription’s analysis Volume 28, issue 2, avril-mai-juin 2009

Figures

See all figures

Authors
Service pharmacie-stérilisation, Centre hospitalier Sainte-Anne, 1 rue Cabanis, 75014 Paris, Secteur 17, pôle XVI e arrondissement, Centre hospitalier Sainte-Anne, 1 rue Cabanis, 75014 Paris, Direction de la qualité et de la gestion des risques, Centre hospitalier Sainte-Anne, 1 rue Cabanis, 75014 Paris

Schizophrenia is a frequent pathology. Its treatment is mainly medicinal. Antipsychotics are the reference treatment. They block the dopamine D2 receptors and this action mechanism is responsible for numerous side effects. Among these, neurological disorders are relatively frequent, disabling and are likely to lead to the stopping of the treatment. Within the professional practicing evaluation’s scope and the health establishment certification’s, it has been decided to evaluate the relevance of prescriptions for the neurologic disorder corrector drug (antiparkinsonian) - due to antipsychotics for schizophrenic adult patients. The purpose of our study is to draw up the assessment of practices from an international and national recommendations point of view and if necessary, to establish corrective measures. The chosen method is made up of two phases: first, a day given volumetric study of the antipsychotics and antiparkinsonian prescriptions, followed by two clinical files audits, one on the antiparkinsonian prescriptions associated with antipsychotic of second generation prescriptions, and the other on the antiparkinsonian conditional prescriptions. The antipsychotic monotherapy part (15.4%) is very weak compared to the recommendations. 39.4% of the patients (127/322) with antipsychotic have also antiparkinsonian which is very superior to what the recommendations had estimated (10 to 20%). On 9 schizophrenic patients having an antipsychotic of second generation and an antiparkinsonian, the prescription of antiparkinsonian is only justified for two patients. 30 patients have a conditional prescription but no administration trace of these drugs has been found in the medical file. Further to this study, the improvement measures of the practices of neurological disorders corrector prescriptions are proposed: leaflets for psychiatrists and nurses, training on psychotropic drugs and optimization of the prescription software.