Psychiatr. praxi. 2024;25(3):140-147 | DOI: 10.36290/psy.2024.023

Risks of psychopharmacy polypharmacy in patients in long-term institutional care

PharmDr. Kristina Pechandová, Ph.D.¹, PharmDr. Ivana Tašková, PGDip.^{2, 3}

¹ Pracoviště klinického farmaceuta, Nemocnice Strakonice, a. s., Strakonice

² Oddělení klinické farmacie, Psychiatrická nemocnice Bohnice, Praha

³ Bezpečnost a kvalita léčiv, Farmaceutická fakulta, Masarykova univerzita, Brno

The article focuses on the issues of psychopharmacotherapy in patients in long-term institutional care, where emphasis should be placed particularly on rational and safe pharmacotherapy. The authors discuss the specific challenges associated with meeting the needs of this population, managing problematic behaviours, and simultaneously minimizing the risk of over-prescription. They emphasize that inappropriate combinations of psychotropic drugs can lead to serious health complications. They critically evaluate current practices and aim to highlight the need for monitoring the risks of psychiatric polypharmacy. Drug-related problems and specific risks of medication are illustrated by providing examples from practice in the form of three case studies, which are accompanied by commentary from clinical pharmacists. The aim of the article is not to criticize the current state, but to provide a comprehensive view of the problematic prescriptions in this population and propose strategies on how to focus on and subsequently mitigate their risks. The issue of irrational prescription in the population of long-term institutionalized patients still does not receive the attention it deserves. It is necessary to address this topic more thoroughly, which means not only rationalizing pharmacotherapy but also finding solutions in the areas of funding, staffing, and overall availability of facilities for this target population.

Keywords: clinical pharmacy, long-term care, drug-related problems, polypharmacy.

Accepted: October 2, 2024; Published: November 15, 2024  Show citation