Pub Date : 2023-12-15DOI: 10.1108/ijoph-07-2023-0040
Stanimir Čekerinac, Ana Starčević, Miloš Basailović, Dušan Sekulić, N. Divac
Purpose Prison settings have limited resources, and it is of particular interest to analyze which antipsychotics are commonly prescribed in these conditions and to determine the prevalence of the adverse effects. Design/methodology/approach A cross-sectional, epidemiological survey was used to measure the prevalence of antipsychotic prescribing among adult prisoners in Sremska Mitrovica Prison in 2020. Findings The prevalence of antipsychotic use was 7.58%. The most commonly prescribed antipsychotic was clozapine (45.36%), but also olanzapine, haloperidol and risperidone were prescribed. The incidence of extrapyramidal adverse effects was nonexistent and the metabolic parameters did not differ between participants using metabolic syndrome–inducing antipsychotics and those who were prescribed metabolically inert medications. The prescribed doses were lower compared with the recommended. Research limitations/implications This research includes certain points that should be cautiously considered. First, the data were cross-sectional and the findings did not provide causal interpretations. Second, the data are from a single penitentiary institution, albeit the largest in the country; however, that may affect the generalizability of the findings. Third, because the included subjects were not hospitalized, some laboratory analyses were not available, according to the local regulations, and thus the prevalence of metabolic syndrome could not be precisely determined. Practical implications The prevalence of the antipsychotic use in prison environment is significantly higher than in general population. The most frequently prescribed antipsychotics are clozapine and olanzapine. The prevalence of adverse effects is rare, however, that is possibly due to low doses of the prescribed antipsychotics. The list of therapeutic options available to the incarcerated persons in this facility is also limited. The list of available antipsychotics does not include some atypical antipsychotics with more favorable safety and tolerability profile, such as aripiprazole or cariprazine. Long-acting antipsychotic injectables were also not available to these patients. Laboratory analyses are not regularly conducted and do not include some essential parameters such as lipid status or differential blood count. Low-dose antipsychotics for behavioral symptoms appears to be well tolerated under prison conditions where adherence is assured. It is effective during the prison stay but long-term effects, especially after release from prison, had not been studied. Social implications This paper advocates for better quality of health care in this correctional facility: more therapeutic options and better laboratory monitoring. The authors justify the use of clozapine in this settings due its benefits in reducing violence and aggression; however, further research would be necessary to clarify does the use of clozapine in incarcerated persons cause behavioral improvements that cou
{"title":"Analysis of antipsychotic drugs prescribing in incarcerated persons in a Serbian correctional facility","authors":"Stanimir Čekerinac, Ana Starčević, Miloš Basailović, Dušan Sekulić, N. Divac","doi":"10.1108/ijoph-07-2023-0040","DOIUrl":"https://doi.org/10.1108/ijoph-07-2023-0040","url":null,"abstract":"Purpose Prison settings have limited resources, and it is of particular interest to analyze which antipsychotics are commonly prescribed in these conditions and to determine the prevalence of the adverse effects. Design/methodology/approach A cross-sectional, epidemiological survey was used to measure the prevalence of antipsychotic prescribing among adult prisoners in Sremska Mitrovica Prison in 2020. Findings The prevalence of antipsychotic use was 7.58%. The most commonly prescribed antipsychotic was clozapine (45.36%), but also olanzapine, haloperidol and risperidone were prescribed. The incidence of extrapyramidal adverse effects was nonexistent and the metabolic parameters did not differ between participants using metabolic syndrome–inducing antipsychotics and those who were prescribed metabolically inert medications. The prescribed doses were lower compared with the recommended. Research limitations/implications This research includes certain points that should be cautiously considered. First, the data were cross-sectional and the findings did not provide causal interpretations. Second, the data are from a single penitentiary institution, albeit the largest in the country; however, that may affect the generalizability of the findings. Third, because the included subjects were not hospitalized, some laboratory analyses were not available, according to the local regulations, and thus the prevalence of metabolic syndrome could not be precisely determined. Practical implications The prevalence of the antipsychotic use in prison environment is significantly higher than in general population. The most frequently prescribed antipsychotics are clozapine and olanzapine. The prevalence of adverse effects is rare, however, that is possibly due to low doses of the prescribed antipsychotics. The list of therapeutic options available to the incarcerated persons in this facility is also limited. The list of available antipsychotics does not include some atypical antipsychotics with more favorable safety and tolerability profile, such as aripiprazole or cariprazine. Long-acting antipsychotic injectables were also not available to these patients. Laboratory analyses are not regularly conducted and do not include some essential parameters such as lipid status or differential blood count. Low-dose antipsychotics for behavioral symptoms appears to be well tolerated under prison conditions where adherence is assured. It is effective during the prison stay but long-term effects, especially after release from prison, had not been studied. Social implications This paper advocates for better quality of health care in this correctional facility: more therapeutic options and better laboratory monitoring. The authors justify the use of clozapine in this settings due its benefits in reducing violence and aggression; however, further research would be necessary to clarify does the use of clozapine in incarcerated persons cause behavioral improvements that cou","PeriodicalId":510181,"journal":{"name":"International Journal of Prison Health","volume":"257 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139178482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-15DOI: 10.1108/ijoph-02-2023-0013
Tenzin Butsang, Shahroze Zafar, Parisa Dastoori, Arthur McLuhan, E. Rice, Carolyn Ziegler, Angela Mashford-Pringle, Flora I. Matheson
Purpose Public health experts and advocates have long raised concerns about the pandemic preparedness of prison systems worldwide – an issue that became increasingly salient at the start of the COVID-19 pandemic. People in prison experience poorer health outcomes compared to the general population, making timely access to adequate health services in prison critical for their health and wellbeing. This study aims to identify the extent of the literature on initial changes in mental health and substance use services for people in prison during the COVID-19 pandemic, summarize and synthesize the findings and identify areas in need of further study. Design/methodology/approach The authors conducted a review of the academic literature published internationally in English between 2019 and December 1, 2020 to describe the disruptions and adaptations to mental health and substance use services in prisons during the onset of the COVID-19 pandemic. Findings The authors found that mental health and substance use services in prisons around the world were widely disrupted due to the COVID-19 pandemic – predominantly consisting of the complete suspension of services, discontinuation of transfers to off-site treatment sites and limitations on service capacity. Adaptations ranged from virtual service delivery and changes to treatment dispensation processes to information sessions on overdose prevention. Originality/value To the best of the authors’ knowledge, this is the first review to examine the nature and extent of the literature on delivery of mental health and substance use services in prisons during the COVID-19 pandemic.
{"title":"COVID-related disruptions and adaptations to prison-based mental health and substance use services: a narrative review","authors":"Tenzin Butsang, Shahroze Zafar, Parisa Dastoori, Arthur McLuhan, E. Rice, Carolyn Ziegler, Angela Mashford-Pringle, Flora I. Matheson","doi":"10.1108/ijoph-02-2023-0013","DOIUrl":"https://doi.org/10.1108/ijoph-02-2023-0013","url":null,"abstract":"Purpose Public health experts and advocates have long raised concerns about the pandemic preparedness of prison systems worldwide – an issue that became increasingly salient at the start of the COVID-19 pandemic. People in prison experience poorer health outcomes compared to the general population, making timely access to adequate health services in prison critical for their health and wellbeing. This study aims to identify the extent of the literature on initial changes in mental health and substance use services for people in prison during the COVID-19 pandemic, summarize and synthesize the findings and identify areas in need of further study. Design/methodology/approach The authors conducted a review of the academic literature published internationally in English between 2019 and December 1, 2020 to describe the disruptions and adaptations to mental health and substance use services in prisons during the onset of the COVID-19 pandemic. Findings The authors found that mental health and substance use services in prisons around the world were widely disrupted due to the COVID-19 pandemic – predominantly consisting of the complete suspension of services, discontinuation of transfers to off-site treatment sites and limitations on service capacity. Adaptations ranged from virtual service delivery and changes to treatment dispensation processes to information sessions on overdose prevention. Originality/value To the best of the authors’ knowledge, this is the first review to examine the nature and extent of the literature on delivery of mental health and substance use services in prisons during the COVID-19 pandemic.","PeriodicalId":510181,"journal":{"name":"International Journal of Prison Health","volume":"37 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139178733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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