Polypharmacy and high-dose treatment of antipsychotics have been major problems in Japanese mental health. Although importance of simplifying prescription has been recognized, polypharmacy and high-dose medication especially for Schizophrenia remains prevalent. It’s considered that psycho-social approach ; for example,improvement of coping skills and social support such as care management can make reform of treatment efficiently and also improve patient’s QOL.
In ACT service,Medication,rehabilitation and social support work closely together and it could make prescription change even for SMI patients. Low-dose medication leads improvement of cognitive function and furthermore social activity. Considering the higher dose of antipsychotics prescribed concurrency in Japan,it’s important to evaluate the change in medication for patients of ACT in Japan.
We did one year follow up study about prescription change for 52 patients who have used ACT program at ACT-J team for more than one year at the end of December 2009. It was found that the dosage antipsychotics significantly decreased from 1131.3mg converted to the relative potency equivalent of 100mg of Chlorpromazine(CPZ eq),to 731.3mg(CPZ eq)over the course of the 12 months. But there was no significant change about polyphamacy.
Also it could be possible to reduce rehospitalization under the ACT program. Because recovery model could make improve not only drop out from psychiatric service, but user’s dependency for hospitalization.
Antipsychotic Medication Change and Reduction of Rehospitalization in Clients of ACT-J
Kohnodai Hospital, National Center for Global Health
Psychiatria et Neurologia Japonica
113: 612-618, 2011
<Keywords:ACT, medication, care management, polypharmacy, Rehospitalization>