Choice of antipsychotic treatment by European psychiatry trainees: are decisions based on evidence?

BMC Psychiatry

Research Article

Raphael Psaras¹  Luis Mendonca²  João Gama Marques³  Sameer Jauhar⁴  Greg Lydall⁵  Sinan Guloksuz⁶  Alexander Nawka⁷  Jeroen Van Zanten⁸  Umberto Volpe⁹  Olivier Andlauer^1,10  Iolanda Dumitrescu^1,11  Costin Roventa^1,11  Nele De Vriendt^1,12  Florian Riese^1,13  Rajeev Krishnadas^1,14  Izu Nwachukwu^1,15  Neil Masson^1,16 

[1] 1st Psychiatric Department, Psychiatric Hospital of Attica, 374, Athinon avenue, 12462, Athens, Greece;Centro Hospit alar Psiquiatrico de Lisboa, Lisboa, Portugal;Centro Hospitalar Psiquiátrico de Lisboa, Psychiatry Educator at Faculdade de Medicina de Lisboa, Lisboa, Portugal;Chair, EFPT Research Group, Sackler Institute for Psychobiological Research, Institute of Neurological Sciences, Southern General Hospital, 2nd Floor 1345 Govan Rd, G51 4TF, Glasgow, UK;Department of Molecular Psychiatry, Mental Health Sciences, University College London, W1T 4JF, London, UK;Department of Psychiatry and Psychology, Maastricht University Medical Centre, P.O. Box 616, 6200, Maastricht, MD, The Netherlands;Department of Psychiatry, 1st Faculty of Medicine, Charles University in Prague, Ke Karlovu 11, 128 00, Praha 2, Prague, Czech Republic;Department of Psychiatry, Neuroscience Campus Amsterdam, VU Medical Center, Amsterdam, The Netherlands;Department of Psychiatry, University of Naples - SUN Largo Madonna delle Grazie, 80138, Napoli, Italy;EA 481 Laboratoire de Neurosciences, University of Franche-Comte, and Department of Clinical Psychiatry, University Hospital of Besancon, F-25030, Besancon, France;Hospital Pr Dr Al Obregia, Bucharest, Romania;Openbaar Psychiatrisch Zorgcentrum Rekem, Rekem, Belgium;Psychiatric University Hospital Zurich, Zurich, Switzerland;Sackler Institute for Psychobiological Research,, Institute of Neurological Sciences, Southern General Hospital, 2nd Floor 1345 Govan Rd, G514TF, Glasgow, UK;St Vincent's University Hospital, Dublin 4, Ireland;Wishaw Resource Centre, 48-54 Roberts Street, ML2 7JF, Wishaw, UK;

关键词: Antipsychotics;    Drug therapy;    Psychiatry trainees;    Evidence-based medicine;    Decision-making;    Efficacy;    Psychotherapy;    Psychosis;    Treatment;   

DOI  :  10.1186/1471-244X-12-27

 received in 2011-05-19, accepted in 2012-03-30,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundLittle is known about the factors influencing treatment choice in psychosis, the majority of this work being conducted with specialists (consultant) in psychiatry. We sought to examine trainees' choices of treatment for psychosis if they had to prescribe it for themselves, their patients, and factors influencing decision-making.MethodsCross-sectional, semi-structured questionnaire-based study.ResultsOf the 726 respondents (response rate = 66%), the majority chose second-generation antipsychotics (SGAs) if they had to prescribe it for themselves (n = 530, 93%) or for their patients (n = 546, 94%). The main factor influencing choice was perceived efficacy, 84.8% (n = 475) of trainees stating this was the most important factor for the patient, and 77.8% (n = 404) stating this was the most important factor for their own treatment. Trainees with knowledge of trials questioning use of SGAs (CATIE, CUtLASS, TEOSS) were more likely to choose second-generation antipsychotics than those without knowledge of these trials (χ2 = 3.943; p = 0.047; O.R. = 2.11; 95% C.I. = 1.0-4.48). Regarding psychotherapy, cognitive behavioural therapy (CBT) was the most popular choice for self (33.1%; n = 240) and patient (30.9%; n = 224). Trainees were significantly more likely to prefer some form of psychotherapy for themselves rather than patients (χ2 = 9.98; p < 0,002; O.R. = 1.54; 95% CIs = 1.18-2.0).ConclusionsTrainees are more likely to choose second-generation antipsychotic medication for patients and themselves. Despite being aware of evidence that suggests otherwise, they predominantly base these choices on perceived efficacy.

【 授权许可】

CC BY   
© Jauhar et al; licensee BioMed Central Ltd. 2012