Prescribing Antipsychotics in Montenegro: a Focus Group Analysis

2014 
Background . Although prescribing of antipsychotics to patients with schizophrenia is advised by national and/or international evidence-based practice guidelines, the implementation of the guidelines in clinical practice is still matter of concern. Objective. The aim of our study was to estimate the schizophrenia guidance adherence and identify eventual barriers to its implementation in Montenegro. Method . This study used focus group methodology. The focus group was composed of two psychiatrists, one psychologist, one pharmacist from a community pharmacy, one pharmacist from the State reimbursement fund, one pharmacist from a drug wholesaler and the chief investigator, clinical pharmacologist. The focus group took place in Podgorica, Montenegro, during year 2013. The analysis of recordings was performed using iterative qualitative technique and constant comparison method. Results. The most important barriers to implementation of evidence-based guidelines for treatment of schizophrenia in Montenegro are non-adherence to medication, low level of psychiatrist-patient concordance, restrictive procedure of prescribing atypical antipsychotics, un-availability of newer antipsychotics and some dosage forms, and mixing primary, secondary and tertiary care services within a tertiary care psychiatric institution. Conclusion . Addressing the barriers identified by focus group and avoiding consequences of poor adherence would be the first step for better mental health planning in the community.
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