Retrospective study of psychotropic drugs used in neurological rehabilitation (2010–2016): Impact of a collaboration between prescribers and pharmacists

Abstract

The prescription of psychotropic drugs is common in neuro-rehabilitation. In our establishment it represents 16% of prescriptions. Since 2010, a collaboration between pharmacists, psychiatrists and medical specialists has led to a policy of reducing and supervising their prescriptions. The retrospective study of the psychotropic drugs’ consumption compared to the evolution of the type of patients treated with makes possible to evaluate the undertaken measures. From 2010 to 2016, in addition to its routine analysis, audits and awareness compaign of the psychotropic drug's prescriptions were regularly carried out by pharmacists to doctors and interns. Over the same period, the data of stays by psychological diagnostic code — psychotic disorders, anxiety, depressive disorders, other — were collected from the DIM (Medical informations department in France). Consumptions of psychotropic drugs (hypnotics, anxiolytics, antidepressants, antipsychotics) were extracted from pharmaceutical management software. For each drug the daily intake was calculated according to the SPC. The overall number of patients with psychological diagnosis code hospital stays increased by 321% in 6 years. +150% for depressive disorders, +287% for psychotic disorders, +443% for anxiety disorders and +488% for sleep disorders. The daily consumption of psychotropic drugs decreased by 19.9%; a decrease of 45.3% and 39.4% for hypnotics and anxiolytics respectively, antipsychotics remained stable (0.9%) and antidepressants increased by 21.1%. The Pearson correlation test shows a negative correlation with a phi coefficient −0.7 ( P = 0.06) between the number of targeted stays and the psychotropic drugs’consumption. The collaboration between prescribers and pharmacists is successful: the use of psychotropic drugs is decreasing despite a number of ever-increasing stays of patients. The involvement of pharmacists must be continued. As a reinforcement of these results, drug-free therapeutic alternatives are currently being examined such as relaxation techniques, RESC, psychiatric or psychological care.