Woodall, A 
ORCID: 0000-0003-2933-0508, Gampel, A ORCID: 0000-0001-6923-5818, Walker, LE ORCID: 0000-0002-3827-4387, Mair, FS ORCID: 0000-0001-9780-1135, Sheard, S ORCID: 0000-0001-8116-9120, Symon, P ORCID: 0009-0001-6499-8442 and Buchan, I ORCID: 0000-0003-3392-1650
(2025)
Antipsychotic management in general practice: serial cross-sectional study (2011–2020)
British Journal of General Practice, 75 (750).
e68-e79.
ISSN 0960-1643, 1478-5242
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Abstract
Background Long-term use of antipsychotics confers increased risk of cardiometabolic disease. Ongoing need should be reviewed regularly by psychiatrists. Aim To explore trends in antipsychotic management in general practice, and the proportions of patients prescribed antipsychotics receiving psychiatrist review. Design and setting Serial cross-sectional study using linked general practice and hospital data in Wales (2011–2020). Method Participants were adults (aged ≥18 years) registered with general practices in Wales. Outcome measures were prevalence of patients receiving ≥6 antipsychotic prescriptions annually, the proportion of patients prescribed antipsychotics receiving annual psychiatrist review, and the proportion of patients prescribed antipsychotics who were registered on the UK serious mental illness, depression, and/or dementia registers, or not on any of these registers. Results Prevalence of adults prescribed long-term antipsychotics increased from 1.055% (95% confidence interval [CI] = 1.041 to 1.069) in 2011 to 1.448% (95% CI = 1.432 to 1.464) in 2020. The proportion receiving annual psychiatrist review decreased from 59.6% (95% CI = 58.9 to 60.4) in 2011 to 52.0% (95% CI = 51.4 to 52.7) in 2020. The proportion of overall antipsychotic use prescribed to patients on the serious mental illness register decreased from 50.0% (95% CI = 49.4 to 50.7) in 2011 to 43.6% (95% CI = 43.0 to 44.1) by 2020. Conclusion Prevalence of long-term antipsychotic use is increasing. More patients are managed by GPs without psychiatrist review and are not on monitored disease registers; they thus may be less likely to undergo cardiometabolic monitoring and miss opportunities to optimise or deprescribe antipsychotics. These trends pose risks for patients and need to be addressed urgently.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Humans, Antipsychotic Agents, Cross-Sectional Studies, Mental Disorders, Adult, Aged, Middle Aged, Wales, Female, Male, General Practice, Practice Patterns, Physicians' |
| Divisions: | Faculty of Health & Life Sciences Faculty of Humanities & Social Sciences Faculty of Humanities & Social Sciences > School of Histories, Languages and Cultures Faculty of Health & Life Sciences > Inst. Population Health Faculty of Health & Life Sciences > Inst. Systems, Molec & Integrative Biology > Inst. Systems, Molec & Integrative Biology |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 18 Dec 2024 15:27 |
| Last Modified: | 24 Jan 2026 05:01 |
| DOI: | 10.3399/BJGP.2024.0367 |
| Related Websites: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3189288 |
| Disclaimer: | The University of Liverpool is not responsible for content contained on other websites from links within repository metadata. Please contact us if you notice anything that appears incorrect or inappropriate. |
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