Evidence map›Paper›PMID 39304310›Full record

ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2025

Antipsychotic management in general practice: serial cross-sectional study (2011-2020).

Alan Woodall, Alex Gampel, Lauren E Walker, Frances S Mair, Sally Sheard, Pyers Symon, Iain Buchan

Abstract read
In one paragraph

Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. 'Flattened, fattened, and forgotten': the 'dis-integrated' care of patients prescribed antipsychotics in the UK.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Alan WoodallDepartment of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool; clinical lead for integrated care, Powys Teaching Health Board, Bronllys, Powys.ORCID 0000-0003-2933-0508
Alex GampelPowys Teaching Health Board, Bronllys, Powys.ORCID 0000-0001-6923-5818
Lauren E WalkerCentre for Experimental Therapeutics, University of Liverpool, Liverpool.ORCID 0000-0002-3827-4387
Frances S MairGeneral Practice and Primary Care, School of Health and Wellbeing, University of Glasgow, Glasgow.ORCID 0000-0001-9780-1135
Sally SheardDepartment of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool.ORCID 0000-0001-8116-9120
Pyers SymonNational Institute for Health and Care Research (NIHR) Mental Health Research for Innovation Centre, University of Liverpool, Liverpool.ORCID 0009-0001-6499-8442
Iain BuchanNIHR Mental Health Research for Innovation Centre, University of Liverpool, Liverpool; director, Civic Health Innovation Labs, University of Liverpool, Liverpool.ORCID 0000-0003-3392-1650

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLong-term use of antipsychotics confers increased risk of cardiometabolic disease. Ongoing need should be reviewed regularly by psychiatrists.

aimTo explore trends in antipsychotic management in general practice, and the proportions of patients prescribed antipsychotics receiving psychiatrist review. DESIGN AND

settingSerial cross-sectional study using linked general practice and hospital data in Wales (2011-2020).

methodParticipants 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.

resultsPrevalence 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.

conclusionPrevalence 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.

Indexed as

Antipsychotic AgentsGeneral PracticePractice Patterns, Physicians'AdultAgedCross-Sectional StudiesFemaleHumansMaleMental DisordersMiddle AgedWalesAntipsychotic Agentsantipsychoticscardiometabolic risk factorscross-sectional studiesgeneral practicemedication reviewpsychiatry

Identifiers

PMID39304310
PMCPMC11614393

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.