[Concordance between hospital prescriptions and recommendations in the treatment of mania]

Abstract

Purpose: There are differences between recommendations and practice in the pharmacological treatment of acute mania.

Objective: The objective was to assess conformity of the anti-manic prescription between national recommendations (Haute Autorité de santé [French health authority, HAS] and "résumé des caractéristiques du produit" [product characteristics, RCP]) and clinical practice.

Methods: We observed the drug prescriptions of in-patients for a manic episode. The main outcome measure was the concordance rate with the recommendations of the drugs prescriptions at the 48th hour. The secondary outcome repeated the same process with the hospital discharge statement of switches, associations, the presence of symptomatic and antidepressant treatments.

Results: Sixty-six episodes were included, 40 patients (60%) had a prescription complies with RCP recommendations H48 and 46 patients (70%) to HAS. These rates fall at hospital discharge.

Conclusions: Off-label prescriptions, drug combinations and choices of not listed molecules are the most common reasons for non-conformity.

Keywords: Bipolar disorder; Drug treatment; Good practice guide; Guide de bonnes pratiques; Pharmacoepidemiology; Pharmacoépidémiologie; Psychotropes; Psychotropic; Traitements médicamenteux; Trouble bipolaire.