María Del Mar Alañón Pardo1, Mónica Ferrit Martín2, Miguel Ángel Calleja Hernández3, Francisco Morillas Márquez4. 1. Pharmacy Department, General University Hospital of Ciudad Real, Ciudad Real, Spain. mar89_ap@hotmail.com. 2. Pharmacy Department, Provincial Coordination and Inspection Service, Albacete, Spain. 3. Pharmacy Department Clinical Management Unit, Virgen Macarena University Hospital, Seville, Spain. 4. School of Pharmacy, University of Granada, Granada, Spain.
Abstract
PURPOSE: The purpose of this study was to analyze the adherence of psychopharmacological prescriptions to clinical practice guidelines (CPGs) for patients with eating behavior disorders (EDs) and to compare the effectiveness, safety, and cost of treatment according to adherence. METHODS: This retrospective observational study included ED patients admitted to the eating disorders unit (EDU) of Ciudad Real Hospital (Spain) between January 2006 and December 2009 and followed until December 2014. Psychopharmaceuticals prescribed during EDU stay(s) were compared with guidelines published by American Psychiatric Association (APA), National Institute for Clinical Excellence (NICE), and Spanish Ministry of Health and Consumption (SMHC). Adherence was considered as the percentage of patients whose prescription followed all recommendations. RESULTS: The study included 113 ED patients. Adherence to APA and NICE/SMHC was 30.1% and 45.1%, respectively. Weekly weight gain during hospital stay was higher (p = 0.037) in the APA "adherence" (807.6 g) versus "non-adherence" (544.4 g) group. An association was found between CPG adherence and higher 5-year full recovery rate (p < 0.040). Adherence to NICE/SMHC was associated with lower incidence (p = 0.001) of adverse effects (33.3% in adherence vs. 66.1% in non-adherence group). CPG adherence was associated with lower medication costs (p < 0.020). The age was higher and there was a greater frequency of self-harm behavior and psychiatric comorbidities in the non-adherence than adherence group (p ≤ 0.040). CONCLUSIONS: CPG adherence was low in EDU-admitted patients. Long-term follow-up showed that clinical outcomes were better and medication costs lower in patients with versus without CPG-adherent prescriptions, likely influenced by the apparently greater severity of illness in those with non-CPG-adherent prescriptions.
PURPOSE: The purpose of this study was to analyze the adherence of psychopharmacological prescriptions to clinical practice guidelines (CPGs) for patients with eating behavior disorders (EDs) and to compare the effectiveness, safety, and cost of treatment according to adherence. METHODS: This retrospective observational study included ED patients admitted to the eating disorders unit (EDU) of Ciudad Real Hospital (Spain) between January 2006 and December 2009 and followed until December 2014. Psychopharmaceuticals prescribed during EDU stay(s) were compared with guidelines published by American Psychiatric Association (APA), National Institute for Clinical Excellence (NICE), and Spanish Ministry of Health and Consumption (SMHC). Adherence was considered as the percentage of patients whose prescription followed all recommendations. RESULTS: The study included 113 ED patients. Adherence to APA and NICE/SMHC was 30.1% and 45.1%, respectively. Weekly weight gain during hospital stay was higher (p = 0.037) in the APA "adherence" (807.6 g) versus "non-adherence" (544.4 g) group. An association was found between CPG adherence and higher 5-year full recovery rate (p < 0.040). Adherence to NICE/SMHC was associated with lower incidence (p = 0.001) of adverse effects (33.3% in adherence vs. 66.1% in non-adherence group). CPG adherence was associated with lower medication costs (p < 0.020). The age was higher and there was a greater frequency of self-harm behavior and psychiatric comorbidities in the non-adherence than adherence group (p ≤ 0.040). CONCLUSIONS: CPG adherence was low in EDU-admitted patients. Long-term follow-up showed that clinical outcomes were better and medication costs lower in patients with versus without CPG-adherent prescriptions, likely influenced by the apparently greater severity of illness in those with non-CPG-adherent prescriptions.
Authors: Susan L Ettner; Francisca Azocar; Robert B Branstrom; Lisa S Meredith; Lily Zhang; Michael K Ong Journal: Psychiatr Serv Date: 2010-12 Impact factor: 3.084
Authors: Ellen B Dennehy; Trisha Suppes; A John Rush; Alexander L Miller; Madhukar H Trivedi; M Lynn Crismon; Thomas J Carmody; T Michael Kashner Journal: Psychol Med Date: 2005-09-29 Impact factor: 7.723
Authors: Cerstin Nickel; Karin Tritt; Moritz Muehlbacher; Francisco Pedrosa Gil; Ferdinand O Mitterlehner; Patrick Kaplan; Claas Lahmann; Peter K Leiberich; Jakub Krawczyk; Christian Kettler; Wolfhardt K Rother; Thomas H Loew; Marius K Nickel Journal: Int J Eat Disord Date: 2005-12 Impact factor: 4.861