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Adverse effects of antipsychotic drugs: survey of doctors’ versus patients’ perspective

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Aims

Almost no data are available on whether patients and doctors have similar or dissimilar opinions on the presence and level of distress due to antipsychotic adverse effects. The aim of this survey is to compare doctors’ versus patients’ perspective on the presence and level of distress due to antipsychotic adverse effects in a sample of patients under the care of the South-Verona mental health services.

Methods

All patients exposed to antipsychotic drugs during a census period of 6 months were identified. For each included subject, socio-demographic, clinical and treatment data were extracted. Patients’ perspective on antipsychotic adverse effects was measured by means of the Liverpool University Neuroleptic Side Effect Rating Scale (LUNSERS). The LUNSERS was similarly employed to measure doctors’ perspective on antipsychotic adverse effects.

Results

During the recruitment period, 243 patients taking antipsychotic drugs were enrolled. The correlation between the total LUNSERS score reported by patients and doctors was very low (correlation coefficient 0.22, 95% confidence interval 0.15–0.30). On average, patients perceived more adverse effects and with a significant higher distress than doctors. Multivariate analyses found no factors simultaneously associated with both patient and doctor ratings of adverse effects.

Conclusion

Our study suggests that doctors, researchers and health care providers should increasingly consider patient and doctor perspectives as two complementary dimensions that may provide different insights in the evaluation of antipsychotic drugs. Integrating different points of view may represent a way to develop a better therapeutic alliance that might decrease the likelihood of nonadherence.

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References

  1. Amaddeo F, Tansella M (2009) Information systems for mental health. Epidemiol Psichiatr Soc 18(1):1–4

    PubMed  Google Scholar 

  2. Barbui C, Nosè M, Rambaldelli G, Bonetto C, Levi D, Patten S et al (2005) Development of a registry for monitoring psychotropic drug prescriptions: aims, methods and implications for ordinary practice and research. Int J Methods Psych Res 14:151–157

    Article  Google Scholar 

  3. Barbui C, Nose M, Bindman J, Schene A, Becker T, Mazzi MA et al (2005) Sex differences in the subjective tolerability of antipsychotic drugs. J Clin Psychopharmacol 25(6):521–526

    Article  PubMed  Google Scholar 

  4. Berkanovic E, Hurwicz ML, Lachenbruch PA (1995) Concordant and discrepant views of patients’ physical functioning. Arthritis Care Res 8(2):94–101

    Article  PubMed  CAS  Google Scholar 

  5. Bonetto C, Nose M, Barbui C (2006) Generating drug exposure data from computer-based medical records. Comput Methods Programs Biomed 83:120–124

    Article  PubMed  Google Scholar 

  6. Davidson L, Miller R, Flanagan E (2008) What’s in it for me? The utility of psychiatric treatments from the perspective of the person in recovery. Epidemiol Psichiatr Soc 17(3):177–181

    PubMed  Google Scholar 

  7. Day JC, Wood G, Dewey M, Bentall RP (1995) A self-rating scale for measuring neuroleptic side-effects. Validation in a group of schizophrenic patients. Br J Psychiatry 166(5):650–653

    Article  PubMed  CAS  Google Scholar 

  8. Day JC, Kinderman P, Bentall R (1998) A comparison of patients’ and prescribers’ beliefs about neuroleptic side-effects: prevalence, distress and causation. Acta Psychiatr Scand 97(1):93–97

    Article  PubMed  CAS  Google Scholar 

  9. Day JC, Bentall RP, Roberts C, Randall F, Rogers A, Cattell D et al (2005) Attitudes toward antipsychotic medication: the impact of clinical variables and relationships with health professionals. Arch Gen Psychiatry 62(7):717–724

    Article  PubMed  Google Scholar 

  10. Evangelou E, Tsianos G, Ioannidis JP (2008) Doctors’ versus patients’ global assessments of treatment effectiveness: empirical survey of diverse treatments in clinical trials. BMJ 336(7656):1287–1290

    Article  PubMed  Google Scholar 

  11. Finn SE, Bailey JM, Schultz RT, Faber R (1990) Subjectiveutility ratings of neuroleptics in treating schizophrenia. Psychol Med 20(4):843–848

    Article  PubMed  CAS  Google Scholar 

  12. Fleiss JL (1981) Statistical methods for rates and proportions. New York, John Wiley & Sons

  13. Fonda SJ, Herzog AR (2001) Patterns and risk factors of change in somatic and mood symptoms among older adults. Ann Epidemiol 11(6):361–368

    Article  PubMed  CAS  Google Scholar 

  14. Gray R, Leese M, Bindman J, Becker T, Burti L, David A et al (2006) Adherence therapy for people with schizophrenia. European multicentre randomised controlled trial. Br J Psychiatry 189:508–514

    Article  PubMed  Google Scholar 

  15. Hamer S, Haddad PM (2007) Adverse effects of antipsychotics as outcome measures. Br J Psychiatry Suppl 50:s64–s70

    Article  PubMed  Google Scholar 

  16. Huffman JC, Blais MA, Pirl WF (2004) A comparison of clinician and patient concerns about antipsychotic side effects: a pilot study. J Nerv Ment Dis 192(4):328–330

    Article  PubMed  Google Scholar 

  17. Kwoh CK, Ibrahim SA (2001) Rheumatology patient and physician concordance with respect to important health and symptom status outcomes. Arthritis Rheum 45(4):372–377

    Article  PubMed  CAS  Google Scholar 

  18. Lambert M, Conus P, Eide P, Mass R, Karow A, Moritz S, Golks D, Naber D (2004) Impact of present and past antipsychotic side effects on attitude toward typical antipsychotic treatment and adherence. Eur Psychiatry 19(7):415–422

    Article  PubMed  CAS  Google Scholar 

  19. Landis JR, Koch GG (1977) An application of hierarchical kappa-type statistics in the assessment of majority agreement among multiple observers. Biometrics 33(2):363–374

    Article  PubMed  CAS  Google Scholar 

  20. Lieberman JA, Stroup TS, McEvoy JP, Swartz MS, Rosenheck RA, Perkins DO et al (2005) Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med 353(12):1209–1223

    Article  PubMed  CAS  Google Scholar 

  21. Morrison P, Gaskill D, Meehan T, Lunney P, Lawrence G, Collings P (2000) The use of the Liverpool University Neuroleptic Side-Effect Rating Scale (LUNSERS) in clinical practice. Aust N Z J Ment Health Nurs 9(4):166–176

    Article  PubMed  CAS  Google Scholar 

  22. Naber D (2008) Subjective effects of antipsychotic drugs and their relevance for compliance and remission. Epidemiol Psichiatr Soc 17(3):174–176

    PubMed  Google Scholar 

  23. Nose M (2008) Tolerability of antipsychotic drugs: does patient perspective deserve consideration? Epidemiol Psichiatr Soc 17(3):182–185

    PubMed  Google Scholar 

  24. Nose M, Barbui C (2008) A simple approach to manage dosages in drug-epidemiology research. Epidemiol Psichiatr Soc 17(3):186–187

    Google Scholar 

  25. Nose M, Accordini S, Artioli P, Barale F, Barbui C, Beneduce R et al (2009) Rationale and design of an independent randomised controlled trial evaluating the effectiveness of aripiprazole or haloperidol in combination with clozapine for treatment-resistant schizophrenia. Trials 10:31

    Article  PubMed  Google Scholar 

  26. Rosenheck RA, Davis S, Covell N, Essock S, Swartz M, Stroup S, McEvoy J, Lieberman J (2009) Does switching to a new antipsychotic improve outcomes? Data from the CATIE Trial. Schizophr Res 107(1):22–29

    Article  PubMed  Google Scholar 

  27. Swift JK, Callahan JL (2009) The impact of client treatment preferences on outcome: a meta-analysis. J Clin Psychol 65(4):368–381

    Article  PubMed  Google Scholar 

  28. Tansella M, Burti L (2003) Integrating evaluative research and community-based mental health care in Verona, Italy. Br J Psychiatry 183:167–169

    Article  PubMed  Google Scholar 

  29. Tansella M, Amaddeo F, Burti L, Lasalvia A, Ruggeri M (2006) Evaluating a community-based mental health service focusing on severe mental illness. The Verona experience. Acta Psychiatr Scand Suppl 429:90–94

    Article  PubMed  Google Scholar 

  30. Zellner A (1962) An efficient method of estimating seemingly unrelated regressions and tests for aggregation bias. J Am Stat Assoc 57:348–368

    Article  Google Scholar 

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The authors declare that they have no conflicts of interest.

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Correspondence to Michela Nosè.

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Nosè, M., Mazzi, M.A., Esposito, E. et al. Adverse effects of antipsychotic drugs: survey of doctors’ versus patients’ perspective. Soc Psychiatry Psychiatr Epidemiol 47, 157–164 (2012). https://doi.org/10.1007/s00127-010-0320-1

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  • DOI: https://doi.org/10.1007/s00127-010-0320-1

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