A Call for a Rational Polypharmacy Policy: International Insights From Psychiatrists

• 발행기관: 대한신경정신의학회
• 저자명: Yukako Nakagami Kohei Hayakawa Toru Horinouchi Victor Pereira-Sanchez Marcus P.J. Tan Seon-Cheol Par
• 간행물 정보: 『Psychiatry Investigation』제18권 제11호, 1058~1067쪽, 전체 10쪽
• 주제분류: 의약학 > 정신과학
• 파일형태: PDF
• 발행일자: 2021.11.30

영문 초록

Objective Recently, rational polypharmacy approaches have been proposed, regardless of the lower risk and cost of monotherapy. Considering monotherapy as first-line treatment and polypharmacy as rational treatment, a balanced attitude toward polypharmacy is recommended. However, the high prevalence of polypharmacy led the Japanese government to establish a polypharmacy reduction policy. Based on this, the association between the policy and psychiatrists’ attitude toward polypharmacy has been under debate. Methods We developed an original questionnaire about Psychiatrists’ attitudes toward polypharmacy (PAP). We compared the PAP scores with the treatment decision-making in clinical case vignettes. Multiple regression analyses were performed to quantify associations of explanatory variables including policy factors and PAP scores. The anonymous questionnaires were administered to psychiatrists worldwide. Results The study included 347 psychiatrists from 34 countries. Decision-making toward polypharmacy was associated with high PAP scores. Multiple regression analysis revealed that low PAP scores were associated with the policy factor (β=-0.20, p=0.004). The culture in Korea was associated with high PAP scores (β=0.34, p<0.001), whereas the culture in India and Nepal were associated with low scores (β=-0.15, p=0.01, and β=-0.17, p=0.006, respectively). Conclusion Policy on polypharmacy may influence psychiatrists’ decision-making. Thus, policies considering rational polypharmacy should be established.

목차

INTRODUCTION

METHODS

RESULTS

DISCUSSION

키워드

Polypharmacy Psychiatry policy