Factors in choosing atypical antipsychotics: toward understanding the bases of physicians' prescribing decisions. Academic Article uri icon

Overview

abstract

  • OBJECTIVE: Off-label prescribing of medications, polypharmacy, and other questionable prescribing practices have led investigators to examine a large VA pharmacy database to determine if physician prescribing decisions appear reasonable. METHOD: The current study addresses the question of physician prescribing of atypical antipsychotics in 34,925 veterans with schizophrenia, using a series of signal detection analyses. RESULTS: These results suggest that only three factors (hospital size, age, and secondary diagnosis) allow classification of patients prescribed atypicals into three groups with frequencies of use of atypicals ranging from 43% to 79%, and that these results are consistent with reasonable clinical practice. CONCLUSIONS: Results of two-stage signal detection analyses are readily interpretable by clinicians and administrators who are faced with the task of evaluating how physicians prescribe medications in clinical practice. Physicians' decisions to prescribe atypical antipsychotics are based on both patient and fiscal considerations. This likely reflects a combination of clinical judgment and institutional guidelines.

publication date

  • September 8, 2005

Research

keywords

  • Antipsychotic Agents
  • Decision Making
  • Drug Prescriptions
  • Drug Therapy
  • Health Knowledge, Attitudes, Practice
  • Physicians
  • Schizophrenia

Identity

Scopus Document Identifier

  • 31644435075

Digital Object Identifier (DOI)

  • 10.1016/j.jpsychires.2005.06.004

PubMed ID

  • 16150458

Additional Document Info

volume

  • 40

issue

  • 2