Suzanne Law1, Peter M Haddad2, Imran B Chaudhry3, Nusrat Husain3, Richard J Drake4, Robert J Flanagan1, Anthony S David1, Maxine X Patel5. 1. Institute of Psychiatry, Psychology and Neuroscience, London, UK. 2. Greater Manchester West NHS Foundation Trust, Manchester, UK. 3. University of Manchester, Manchester, UK. 4. Manchester Mental Health and Social Care Trust, Manchester, UK. 5. Institute of Psychiatry, King's College London, Box 68, 16 DeCrespigny Park, London SE5 8AF, UK.
Abstract
BACKGROUND: This study aimed to explore predictive factors for future use of therapeutic drug monitoring (TDM) and to further examine psychiatrists' current prescribing practices and perspectives regarding antipsychotic TDM using plasma concentrations. METHOD: A cross-sectional study for consultant psychiatrists using a postal questionnaire was conducted in north-west England. Data were combined with those of a previous London-based study and principal axis factor analysis was conducted to identify predictors of future use of TDM. RESULTS: Most of the 181 participants (82.9%, 95% confidence interval 76.7-87.7%) agreed that 'if TDM for antipsychotics were readily available, I would use it'. Factor analysis identified five factors from the original 35 items regarding TDM. Four of the factors significantly predicted likely future use of antipsychotic TDM and together explained 40% of the variance in a multivariate linear regression model. Likely future use increased with positive attitudes and expectations, and decreased with potential barriers, negative attitudes and negative expectations. Scientific perspectives of TDM and psychiatrist characteristics were not significant predictors. CONCLUSION: Most senior psychiatrists indicated that they would use antipsychotic TDM if available. However, psychiatrists' attitudes and expectations and the potential barriers need to be addressed, in addition to the scientific evidence, before widespread use of antipsychotic TDM is likely in clinical practice.
BACKGROUND: This study aimed to explore predictive factors for future use of therapeutic drug monitoring (TDM) and to further examine psychiatrists' current prescribing practices and perspectives regarding antipsychotic TDM using plasma concentrations. METHOD: A cross-sectional study for consultant psychiatrists using a postal questionnaire was conducted in north-west England. Data were combined with those of a previous London-based study and principal axis factor analysis was conducted to identify predictors of future use of TDM. RESULTS: Most of the 181 participants (82.9%, 95% confidence interval 76.7-87.7%) agreed that 'if TDM for antipsychotics were readily available, I would use it'. Factor analysis identified five factors from the original 35 items regarding TDM. Four of the factors significantly predicted likely future use of antipsychotic TDM and together explained 40% of the variance in a multivariate linear regression model. Likely future use increased with positive attitudes and expectations, and decreased with potential barriers, negative attitudes and negative expectations. Scientific perspectives of TDM and psychiatrist characteristics were not significant predictors. CONCLUSION: Most senior psychiatrists indicated that they would use antipsychotic TDM if available. However, psychiatrists' attitudes and expectations and the potential barriers need to be addressed, in addition to the scientific evidence, before widespread use of antipsychotic TDM is likely in clinical practice.
Entities:
Keywords:
antipsychotics; attitude; dose; plasma concentration; schizophrenia; therapeutic drug monitoring
Authors: Christoph U Correll; Ladan Shaikh; Juan A Gallego; Jeffrey Nachbar; Vladimir Olshanskiy; Taishiro Kishimoto; John M Kane Journal: Schizophr Res Date: 2011-03-21 Impact factor: 4.939
Authors: Robert W Buchanan; Julie Kreyenbuhl; Deanna L Kelly; Jason M Noel; Douglas L Boggs; Bernard A Fischer; Seth Himelhoch; Beverly Fang; Eunice Peterson; Patrick R Aquino; William Keller Journal: Schizophr Bull Date: 2009-12-02 Impact factor: 9.306
Authors: Sally V J Bowskill; Simon A Handley; Danielle S Fisher; Robert J Flanagan; Maxine X Patel Journal: Ther Drug Monit Date: 2012-06 Impact factor: 3.681
Authors: Maxine X Patel; Sally Bowskill; Lewis Couchman; Victoria Lay; David Taylor; Edgar Pathrose Spencer; Robert James Flanagan Journal: J Clin Psychopharmacol Date: 2011-08 Impact factor: 3.153
Authors: Sue Jordan; Timothy Banner; Marie Gabe-Walters; Jane M Mikhail; Jeff Round; Sherrill Snelgrove; Mel Storey; Douglas Wilson; David Hughes Journal: BMJ Open Date: 2018-09-28 Impact factor: 2.692