Introduction: Patients’ and relatives’ associations, psychiatrists, and pharmaceutical companies
are complaining about a deficiency in the care of psychiatric patients with innovative
medications in Germany. They estimate that only about 10- 30 % of all patients with
schizophrenia receive second-generation antipsychotics, a figure that lies significantly
below the international average.
Methods: In order to determine the frequency of use of second-generation antipsychotics in
the actual care of schizophrenic patients, we conducted the following investigations:
- Discharge papers of schizophrenic inpatients from a university hospital and from
a district hospital were studied with regard to the antipsychotic discharge medication.
- Practicing psychiatrists were contacted and asked whether during the first 3 months
after discharge they had continued the antipsychotic discharge medication that was
proposed by the hospital.
Results: The investigation of a total of 200 discharge papers and the subsequent questioning
of the psychiatrists who carried out the follow-up treatment showed that 166 patients
(83 %) received a second-generation antipsychotic upon discharge. Only 5 % of these
patients were switched to conventional antipsychotics in the outpatient treatment.
Thus, contrary to our expectations, there was no noteworthy change from second-generation
to classical antipsychotics. Discussion: Therefore, in the sample analyzed the second-generation antipsychotics were far more
frequently prescribed than would have been expected according to general estimates,
and it was not possible to verify the often-heard complaints of an under-treatment
with second generations in this study. Our findings suggest, however, that only 60
% of the patients still receive their discharge medication 3 months after discharge
from the hospital. This raises the important question as to how continuity of the
antipsychotic treatment could be better ensured.
References
Innovationen in der Therapie der Schizophrenie . Stuttgart New York; Schattauer 2001: 77-79 Arzneiverordnungs-Report 2001 . Berlin; Springer 2001: 597-629
j.hamann@lrz.tum.de
