Objective: Our aim was to assess the impact of six recommendations
regarding drug prescription on the clinical practices of French psychiatrists.
The recommendations were part of the conclusions of a consensus conference
entitled “Long-term therapy of schizophrenia” (Paris, January
Methods: The impact of the conference was assessed on the basis of
awareness of the existence of the conference, knowledge of its conclusions,
and actual changes in clinical practice. We performed: a) a survey of a
representative sample of 396 psychiatrists 2 years after the conference; and
b) an analysis of changes in drug prescriptions in a cohort of 2,407 patients
with schizophrenia under treatment at the time of the conference.
Results: Overall, 78% of interviewed psychiatrists were aware of
the existence of the conference and 70% of its conclusions. Declared
prescription practices conformed with conference conclusions about 60%
(10%–95%) of the time. No difference in practices was noted between
psychiatrists who were aware of the recommendations and those who were not.
Single neuroleptic prescriptions increased in the cohort study in line with
the main conference recommendation. The increase was small, but significant
from 51.1% to 56.4%, and mainly concerned patients recently put on treatment.
Contrary to recommendations, prescriptions of anticholinergics plus
neuroleptics inexplicably rose from 48.2% to 54.3%.
Conclusion: Small changes in prescription habits occurred in the
wake of the consensus conference, but we cannot really ascribe them to a
direct impact of the conference. Despite the great pains we took in
disseminating the conclusions of the conference as widely as possible, it is
clear that a more forceful action plan (e.g., including continuous medical
education) is required.