PS-103 Prescription of quetiapine from the perspective of patient safety

Abstract

Background Atypical antipsychotics need a prescription check (visa), that is, a prior official authorisation of prescriptions, so as monitor patient safety. Purpose To describe the prescription of quetiapine in a health area and compare the indications for prescribing with the indications approved on the visa summaries from the perspective of patient safety. Material and methods We conducted a descriptive observational study of the prescription of quetiapine between 15th September and 15th October 2014 in a visa unit of a health area, formed by a hospital and a primary care district. We recorded the following variables: gender, age, medical service, indication and acceptance or rejection. Quetiapine indications allowed by the visa are: (1) schizophrenia, (2) depressive episodes associated with bipolar disorder, (3) moderate to severe manic episodes in bipolar disorder, (4) prevention of recurrence of manic or depressive episodes in patients with bipolar disorder who previously responded to quetiapine treatment, (5) add-on ongoing treatment in patients with major depressive disorder who have had sub-optimal response to treatment with other antidepressants, (6) persistent aggressiveness among elderly people with moderate to severe dementia, who have contraindication or have not responded to other treatment (benzodiazepines, haloperidol, risperidone). Results We assessed 31 prescriptions for quetiapine (58.1% male, mean age 65 ± 19.4 years). The medical services were primary care (41.9%), mental health (32.3%) and neurology (6.5%). The main indication for quetiapine was “persistent aggressiveness with moderate to severe dementia” (32.3%), “followed by depressive episodes associated with bipolar disorder” (22.6%), “schizophrenia” (19.4%) and “moderate to severe manic episodes in bipolar disorder” (19.4%). Four prescriptions (12.9%) were not correct according to the visa, so they were rejected. Conclusion Discrepancies between the drug’s visa recommendations and real use of quetiapine commonly occur, which means added risk for the patients. The visa unit is essential to promote the safer use of atypical antipsychotics. Reference Rev Espanol Econ Salud 2006;5:276–85 No conflict of interest.