Evaluating antipsychotic prescribing trends and patient outcomes in schizophrenia and schizoaffective disorder: Insights from a year-long observational study across two tertiary mental health treatment centres in South Australia

Abstract

Background

Schizophrenia and schizoaffective disorder are complex, lifelong disorders. This study evaluates antipsychotic medication use and the management of inpatients diagnosed with these conditions to better inform health service providers about patient characteristics and prescribing patterns.

Methods

Retrospective chart review of electronic medical records (EMRs) of a randomly chosen subset of inpatients diagnosed with schizophrenia or schizoaffective disorder at Lyell McEwin Hospital (LMH) and Modbury Hospital in Adelaide, South Australia, from 01 January–31 December 2022, inclusive.

Results

The study included 101 patients with eligible inpatient admissions. Of 123 admissions during the 12-month observation period, 22 were readmissions. Worsening of positive symptoms (91.1%) was the most frequently reported primary reason for admission. During the first inpatient stay, 97.0% were prescribed maintenance antipsychotics and 92.1% at least one oral antipsychotic (OA). Polypharmacy occurred in 29.7% and antipsychotic switching in 22.8%. Oral second-generation antipsychotics (SGAs) had the highest discontinuation rate (49.5%).

Conclusion

Several hospital patient management practices at LMH and Modbury Hospital aligned with Australian guidelines and published evidence. However, it is important to highlight any notable deviations, such as a lack of metabolic screening prior to and during treatment, as it may help other providers improve their standard of care for patients with schizophrenia or schizoaffective disorder.