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Adherence of psychopharmacological prescriptions to clinical practice guidelines in patients with eating behavior disorders

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to analyze the adherence of psychopharmacological prescriptions to clinical practice guidelines (CPGs) for patients with eating behavior disorders (EDs) and to compare the effectiveness, safety, and cost of treatment according to adherence.

Methods

This retrospective observational study included ED patients admitted to the eating disorders unit (EDU) of Ciudad Real Hospital (Spain) between January 2006 and December 2009 and followed until December 2014. Psychopharmaceuticals prescribed during EDU stay(s) were compared with guidelines published by American Psychiatric Association (APA), National Institute for Clinical Excellence (NICE), and Spanish Ministry of Health and Consumption (SMHC). Adherence was considered as the percentage of patients whose prescription followed all recommendations.

Results

The study included 113 ED patients. Adherence to APA and NICE/SMHC was 30.1% and 45.1%, respectively. Weekly weight gain during hospital stay was higher (p = 0.037) in the APA “adherence” (807.6 g) versus “non-adherence” (544.4 g) group. An association was found between CPG adherence and higher 5-year full recovery rate (p < 0.040). Adherence to NICE/SMHC was associated with lower incidence (p = 0.001) of adverse effects (33.3% in adherence vs. 66.1% in non-adherence group). CPG adherence was associated with lower medication costs (p < 0.020). The age was higher and there was a greater frequency of self-harm behavior and psychiatric comorbidities in the non-adherence than adherence group (p ≤ 0.040).

Conclusions

CPG adherence was low in EDU-admitted patients. Long-term follow-up showed that clinical outcomes were better and medication costs lower in patients with versus without CPG-adherent prescriptions, likely influenced by the apparently greater severity of illness in those with non-CPG-adherent prescriptions.

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Author information

Authors and Affiliations

  1. Pharmacy Department, General University Hospital of Ciudad Real, Ciudad Real, Spain

    María del Mar Alañón Pardo

  2. Pharmacy Department, Provincial Coordination and Inspection Service, Albacete, Spain

    Mónica Ferrit Martín

  3. Pharmacy Department Clinical Management Unit, Virgen Macarena University Hospital, Seville, Spain

    Miguel Ángel Calleja Hernández

  4. School of Pharmacy, University of Granada, Granada, Spain

    Francisco Morillas Márquez

Authors
  1. María del Mar Alañón Pardo
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  2. Mónica Ferrit Martín
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  3. Miguel Ángel Calleja Hernández
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  4. Francisco Morillas Márquez
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Contributions

The authors’ responsibilities were as follows: María del Mar Alañón Pardo collected data, performed the literature search, and drafted the manuscript. Mónica Martín Ferrit contributed to the data analysis and interpretation and critically reviewed the article. Miguel Ángel Calleja Hernández and Francisco Morillas Márquez supervised and approved the final version of the manuscript.

Corresponding author

Correspondence to María del Mar Alañón Pardo.

Ethics declarations

This study was approved by the Clinical Research Ethics Committee of the General University Hospital of Ciudad Real and respected the confidentiality of personal data. For this type of study, formal consent is not required.

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

This article forms part of the doctoral thesis of María del Mar Alañón Pardo, Pharmacy Doctoral Program, University of Granada, Spain.

The authors certify that this study has not been published elsewhere or simultaneously submitted to any journal for publication.

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Alañón Pardo, M.d.M., Ferrit Martín, M., Calleja Hernández, M.Á. et al. Adherence of psychopharmacological prescriptions to clinical practice guidelines in patients with eating behavior disorders. Eur J Clin Pharmacol 73, 1305–1313 (2017). https://doi.org/10.1007/s00228-017-2287-2

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  • DOI: https://doi.org/10.1007/s00228-017-2287-2

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