Abstract
Background and aimSeveral studies have raised concerns over consequences of brand-to-generic and generic-to-generic pharmacy-generated medication substitutions in psychiatric and non-psychiatric patients. The purpose of this retrospective study was to assess behavioral and emotional responses of patients with schizophrenia to antipsychotic medication substitution performed by pharmacies.MethodsA group of Polish ambulatory patients with schizophrenia (n = 196) chronically treated with antipsychotic medications were asked whether antipsychotic medication substitution had been proposed by a pharmacist in the last 12 months. Ninety-nine patients answering positively were administered more questions addressing the patient’s emotional and behavioral response to the pharmacy proposal.ResultsThe most important findings of the present study can be summarized as follows: (1) approximately half of the patients were confronted with a pharmacy proposal to switch their antipsychotic medications in the last 12 months, (2) one quarter of these patients did not accept the pharmacy switch, (3) a substantial proportion of patients (>40 %) did not receive any explanation from a pharmacist offering medication substitution, (4) pharmacy-generated substitution proposals were mainly associated with negative patient attitudes and negative emotional responses, (5) substitution proposals provoked an unscheduled psychiatric visit in approx. 10 % of patients, (6) despite the negative attitudes reported by patients, the pharmacy switch rarely led to treatment discontinuation, but did provoke a change in drug dosing in 7 % of patients accepting the switch.ConclusionsA pharmacy proposal to switch their antipsychotic medications is a relatively common experience of Polish ambulatory patients with schizophrenia. Pharmacy-generated substitution proposals are mainly associated with negative patient attitudes, but rarely lead to antipsychotic treatment discontinuation in this group of patients.
Highlights
The questions refer to your visits in pharmacy over the last 12 months with a prescription for antipsychotic medications received from your doc‐ tor Questions and explanations to patientsResponses and its analyses1
Ambulatory patients with schizophrenia chronically treated with oral antipsychotic medications were asked whether they had been offered by a pharmacist a substitution of their antipsychotic medication in the last 12 months
Selection of final study group Ninety-nine (50.5 %) of 196 patients recruited to the study answered positively when asked the question whether they had been offered by a pharmacist, in the last year, an antipsychotic medication named differently from that prescribed by their doctor
Summary
The questions refer to your visits in pharmacy over the last 12 months with a prescription for antipsychotic medications received from your doc‐ tor Questions and explanations to patientsResponses and its analyses1. Several studies have raised concerns over consequences of brand-to-generic and generic-togeneric pharmacy-generated medication substitutions in psychiatric and non-psychiatric patients. Non-compliance may pose a significant burden to the Several studies have raised concerns over therapeutic and clinical consequences of brand-to-generic and generic-to-generic pharmacy-generated medication substitutions in psychiatric and non-psychiatric patients [5,6,7,8]. Murawiec et al Ann Gen Psychiatry (2015) 14:31 perspective, surprisingly little is known about attitudes of psychiatric patients towards brand-to-generic and generic-to-generic switches and about consequences of the pharmacy substitution to patient compliance. In a single study on this topic, Roman [13] asked 106 Dutch patients with chronic psychotic disorders about their possible reactions to the proposal of exchange of their original antipsychotic medication with a generic counterpart in an artificial situation mimicking a pharmacy visit. The overall attitude to the medication switch remained negative [13]
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