Pharmacological treatment of ambulatory schizophrenic patients in Belgium
1 Service de santé publique, d'épidemiologie et d'économie de la santé, Université de Liège, Sart Tilman, 4000 Liège, Belgium
2 University Psychiatric Center Katholieke Universiteit Leuven, Leuvensesteenweg 517, 3070 Kortenberg, Belgium
Clinical Practice and Epidemiology in Mental Health 2006, 2:11 doi:10.1186/1745-0179-2-11Published: 30 May 2006
the objective of this study was twofold:
1) Describe the use of antipsychotic treatments in ambulatory patients suffering from schizophrenia in Belgium.
2) Evaluate to which extend antipsychotic treatment prescribing patterns are in accordance with published treatment guidelines.
A cross-sectional survey was carried out in 16 Belgian hospitals selected from a sample of 67 hospitals. The hospitals were equally distributed between the north and south part of the country and were representative of Belgian practice. During 2 months, participating psychiatrists were asked to record the medication use as well as demographic parameters of all consecutive ambulatory patients seen at their consultation or attending a day-hospital. Data concerning 1000 ambulatory patients with schizophrenia or schizoaffective disorder were collected.
In Belgium, the use of atypical antipsychotics is frequent (69%) in ambulatory patients with schizophrenia. In the overall sample, 73% receive only one antipsychotic drug. The majority of patients are treated with drugs of only one antipsychotic drug group, either first- typical (29.8%) or second-generation, atypical antipsychotics (53.2%). 15.8% of patients combine different types of antipsychotics. Antipsychotic dosing is adequate for the majority of patients but about one fifth receives a higher than recommended dose as per package inserts. Polypharmacy remains within reasonable limits. The use of concomitant medication varies according the antipsychotic treatment: patients who take second-generation antipsychotics only, receive the least additional drugs.
Atypical antipsychotics appear to be the first line treatment for schizophrenic psychosis. Psychiatrists working with ambulatory patients are well aware of treatment guidelines and follow them quite adequately.