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NCJRS Abstract

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NCJ Number: 221701 Find in a Library
Title: Costs, Control or Just Good Clinical Practice?: The Use of Antipsychotic Medications and Formulary Decision-Making in Large U.S. Prisons and Jails
Journal: Journal of Offender Rehabilitation  Volume:45  Issue:1/2  Dated:2007  Pages:189-206
Author(s): Bonita M. Veysey; Vanja Stenius; Noel Mazade; Lucille Schacht
Date Published: 2007
Page Count: 18
Type: Issue Overview
Format: Article
Language: English
Country: United States of America
Annotation: This paper explores the provision of antipsychotic medications within large prisons and jails and the factors that go into formulary decisions and the adoption of new medications.
Abstract: Medications are central to the psychiatric armamentarium in United States jails and prisons. Psychiatric medications are used both to stabilize acute symptoms as well as maintain mental health once symptoms are reduced. Both jails and prisons rely heavily on traditional antipsychotics, but both have a full array of atypical medications in their formularies (reference book of pharmaceutical products). In terms of formulary decisionmaking, both jails and prisons are influenced most by personal clinical experience, research-demonstrated effectiveness, FDA approved indications, and exposure through continuing education or professional meetings. Cost is not among the most important factors, but also is not among the least important. It appears that psychiatric staff in jails and prisons must balance good clinical practice with costs. The heavy reliance on cheaper medications, when alternatives are present, suggests that cost remains a factor. The fact that psychiatrists prescribe off the formulary and are more influenced by demonstrated effectiveness, in contrast, supports the notion that they are indeed concerned with good practice. Additional research is warranted to explore the complex pressures facing psychiatric staff in providing the best services in a very difficult environment. Tables, references
Main Term(s): Inmate health care
Index Term(s): Controlled Substances; Correctional facilities; Correctional institutions (adult); Inmate treatment; Jails; Mental health; Mental health services; Mentally ill inmates; Pharmacy services; Prescription drugs; Psychiatric services
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