{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:18:37Z","timestamp":1790691517938,"version":"4.1.0"},"reference-count":31,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002661","name":"Fonds De La Recherche Scientifique - FNRS","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002661","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Psychopharmacology"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Antipsychotic polypharmacy (APP) prescribing and clozapine underuse are considered inappropriate prescribing in schizophrenia. Psychiatric hospitalisations may be suitable occasions to re-evaluate patient pharmacotherapy and to switch to monotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To explore the evolution of APP and other psychotropic prescribing patterns during psychiatric hospitalisations, to detect characteristics associated with APP on admission and at discharge, and to examine clozapine prescribing patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>We performed a retrospective observational study based on electronic health records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Data on adult inpatients diagnosed with schizophrenia spectrum disorders were collected retrospectively from 6 Belgian hospitals in 2020-2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of the 516 patients included, APP prescribing increased significantly from 47.9% on hospital admission to 59.1% at discharge. On admission and at discharge, APP was associated with prior clozapine use (OR\n                      <jats:sub>admission<\/jats:sub>\n                      \u2004=\u20042.53, CI\u2004=\u20041.1\u20135.84, OR\n                      <jats:sub>discharge<\/jats:sub>\n                      \u2004=\u200411.01, CI\u2004=\u20044.45\u201327.28), treatment with a first-generation antipsychotic (OR\n                      <jats:sub>admission<\/jats:sub>\n                      \u2004=\u200426.79, CI\u2004=\u200413.08\u201354.86, OR\n                      <jats:sub>discharge<\/jats:sub>\n                      \u2004=\u200425.2, CI\u2004=\u200412.2\u201352.04), increased antipsychotic exposure (OR\n                      <jats:sub>admission<\/jats:sub>\n                      \u2004=\u20048.93, CI\u2004=\u20045.13\u201315.56, OR\n                      <jats:sub>discharge<\/jats:sub>\n                      \u2004=\u200419.89, CI\u2004=\u200410\u201339.54), and a greater number of hypno-sedatives (OR\n                      <jats:sub>admission<\/jats:sub>\n                      \u2004=\u20041.88, CI\u2004=\u20041.23\u20132.88, OR\n                      <jats:sub>discharge<\/jats:sub>\n                      \u2004=\u20044.18, CI\u2004=\u20042.53\u20136.91). APP was negatively associated with involuntary admission (OR\n                      <jats:sub>admission<\/jats:sub>\n                      \u2004=\u20040.31, CI\u2004=\u20040.14\u20130.7, OR\n                      <jats:sub>discharge<\/jats:sub>\n                      \u2004=\u20040.3, CI\u2004=\u20040.13\u20130.68). When using an alternative definition of monotherapy (i.e. including patients with an add-on low-dose antipsychotic for sleep disorders), alcohol use disorder (OR\n                      <jats:sub>admission<\/jats:sub>\n                      \u2004=\u20040.26, CI\u2004=\u20040.13\u20130.54) and higher age (OR\n                      <jats:sub>discharge<\/jats:sub>\n                      \u2004=\u20040.53, CI\u2004=\u20040.29\u20130.95) were negatively associated with APP, and living in a residential facility (OR\n                      <jats:sub>discharge<\/jats:sub>\n                      \u2004=\u20042.39 CI\u2004=\u20041.21\u20134.71) and a higher daily dosage of benzodiazepines during the stay (OR\n                      <jats:sub>discharge<\/jats:sub>\n                      \u2004=\u20041.32 CI\u2004=\u20041.03\u20131.69) increased the odds of being discharged on APP. On admission, 9.3% of patients were being treated with clozapine. Although 28.1% of patients were eligible for clozapine treatment, only 11% of patients were discharged with a clozapine prescription. For 7 of the 10 patients with a new clozapine prescription, it was directly prescribed in combination with another antipsychotic, without a prior trial of clozapine monotherapy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Suboptimal prescriptions of antipsychotics in patients with schizophrenia persist after psychiatric hospitalisations and are associated with identifiable characteristics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20451253221112587","type":"journal-article","created":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T07:22:20Z","timestamp":1661239340000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Antipsychotic polypharmacy and clozapine prescribing patterns: evolution and correlates before and after a psychiatric hospitalisation"],"prefix":"10.1177","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7646-6224","authenticated-orcid":false,"given":"Juliette","family":"Lagreula","sequence":"first","affiliation":[{"name":"Clinical Pharmacy Research Group (CLIP), Louvain Drug Research Institute (LDRI), Universit\u00e9 Catholique de Louvain, Avenue Mounier 72, 1200 Brussels, Belgium"},{"name":"Fonds de la Recherche Scientifique (FNRS), Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"de Timary","sequence":"additional","affiliation":[{"name":"Institute of Neuroscience, UCLouvain, Brussels, Belgium"},{"name":"Psychiatry Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laure","family":"Elens","sequence":"additional","affiliation":[{"name":"Integrated PharmacoMetrics, PharmacoGenomics and PharmacoKinetics (PMGK), Louvain Drug Research Institute (LDRI), UCLouvain, Brussels, Belgium"},{"name":"Louvain Centre for Toxicology and Applied Pharmacology (LTAP), Institut de Recherche Exp\u00e9rimentale et Clinique (IREC), UCLouvain, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Dalleur","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy Research Group (CLIP), Louvain Drug Research Institute (LDRI), UCLouvain, Brussels, Belgium"},{"name":"Pharmacy Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,8,23]]},"reference":[{"key":"bibr1-20451253221112587","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2012.03.018"},{"key":"bibr2-20451253221112587","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2013.03.014"},{"key":"bibr3-20451253221112587","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2016.12.032"},{"key":"bibr4-20451253221112587","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20387"},{"key":"bibr5-20451253221112587","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2018.4320"},{"key":"bibr6-20451253221112587","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201800504"},{"key":"bibr7-20451253221112587","doi-asserted-by":"publisher","DOI":"10.1517\/14740338.2012.683523"},{"key":"bibr8-20451253221112587","doi-asserted-by":"publisher","DOI":"10.1177\/0269881113477709"},{"key":"bibr9-20451253221112587","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.2005.00589.x"},{"key":"bibr10-20451253221112587","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-018-1848-y"},{"key":"bibr11-20451253221112587","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-017-4767-6"},{"key":"bibr12-20451253221112587","doi-asserted-by":"publisher","DOI":"10.1177\/0269881119889296"},{"key":"bibr13-20451253221112587","doi-asserted-by":"publisher","DOI":"10.1177\/0004867416641195"},{"key":"bibr14-20451253221112587","doi-asserted-by":"publisher","DOI":"10.1177\/0706743717720196"},{"key":"bibr15-20451253221112587","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.002022012"},{"key":"bibr16-20451253221112587","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201600041"},{"key":"bibr17-20451253221112587","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2011.10060908"},{"key":"bibr18-20451253221112587","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2017.09.050"},{"key":"bibr19-20451253221112587","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2013.08.024"},{"key":"bibr20-20451253221112587","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2015.04.027"},{"key":"bibr21-20451253221112587","doi-asserted-by":"publisher","DOI":"10.1177\/2045125314540298"},{"key":"bibr22-20451253221112587","doi-asserted-by":"publisher","DOI":"10.1177\/0706743717720448"},{"key":"bibr23-20451253221112587","doi-asserted-by":"publisher","DOI":"10.1080\/13651500600811206"},{"key":"bibr24-20451253221112587","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsmc.2014.11.001"},{"key":"bibr25-20451253221112587","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.13945"},{"key":"bibr26-20451253221112587","volume":"13","author":"Lee 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