Pharmaco-épidémiologie des pratiques de prescription d’antipsychotiques chez les patients schizophrènes (coupes transversales 1995 et 1998)

Pharmacotherapy of Mental Illness in the Mental Health Centers in Kosovo During 2021

Background- Treatment of mental illness with pharmacotherapy is strictly monitored in clinical centers dedicated to this purpose. While in most of developed countries this practice is well established, in Kosovo, in absence of such system, there is the need for further and continues investigation in this context with the aim to better monitor the therapy.   Aim of the study - This work aims to analyze and investigate the treatment of the patients with mental illness in the Mental Health Centers in Kosovo. Methods - The methodology of this research work is based on the specific guidelines published by the WHO. Handbook of the World Health Organization (WHO). All patients’ data were obtained from protocol books of the treated patients. For each city, 30 patients which were selected according to the theory of probability, were analyzed. A total of 209 patients were enrolled in the study. Regarding the pharmacotherapeutic characteristics we have analyzed the way of treatment of mental illnesses according to the groups of drugs and centers. The diseases were categorized according to the International Classification of Diseases - Revision 10.   Results - Drugs were mainly administered through mouth, per os (PO) (82.4%). According to the clinics there was no significant change as per administration route of the drugs (ChiTest = 28, p > 0.11) (Tab.3). Almost, 2/3 of the prescribed drugs were non-essential (66.1%). Considering the class of the therapeutic drugs, over half of them were antipsychotic (53.2%), whereas in a percentage of 17.2% and 13.8% were anticholinergic and anxiolytic/hypnotic drugs, accordingly. These classes of drugs were 84.2% of the overall used drugs.  Taken together, In the Mental Health Centers in Kosovo, drugs are mainly administered orally, with only 17.6% of the cases treated parenterally. The majority of the drugs used are the non-essential drugs, with antipsychotics being the most prescribed ones. Conclusions - Furthermore, the study highlights the use of the third-line therapy as a first choice, and the use of effective drugs with low safety profile such as: Clozapine 84.62% (from SDA group). Moreover, ineffective drugs are used in 1.92% of patients and non-compliance of treatment with drug indications was found in 5.77% of cases. 

The current state of adult mental health care in France

Since the 1960s, French public mental health services are organised in "sectors", each sector catering for a mean population of 54,000 inhabitants. Although this organisation was aimed at insuring equal access to care whatever the place of residence, there are still huge disparities in number of staff and bed resources from one sector to another. The reduction in the number of hospital beds started later in France than in most other European countries, and was really effective in the 1990s. In 2000, there were 9.4 beds for 10,000 inhabitants aged over 20 years. Hospital-based care has still an overwhelming importance, and is associated with a marked under-development of community services and lack of sheltered housing for the most disabled patients. With more than 13,000 registered psychiatrists in France, the density of psychiatrists is one of the highest in the world. However, French psychiatry has currently to face a structural crisis due to the reduction in public health budgets, as well as to the reduction of 30% in the number of French psychiatrists over the next two decades. The numerous national programmes aimed at renovating French mental health services, published over the last decade, have not yet kept their promises.