Irrational use of antipsychotic drugs as one of the problems of emotional burnout syndrome

One of the most important aspects of the optimal use of financial resources aimed to improve the functioning of the health system is the rational use of medicines. The problem of the adequate use of medicaments is of particular interest at this time for psychiatric service of the Kyrgyz Republic (KR), where the budget financing is inadequate, however, the inefficient and outdated medicines are still in the use. This problem results in an increase in the number of patients resistant to therapy and, consequently, in an increase in readmissions, invalidation, and deterioration in the quality of patient’s life. An important factor that inşuences the effectiveness of the treatment of patients having mental disorders is a professional deformation of doctors, in particular, emotional burnout syndrome (EBS). The purpose of our study was to identify the correlation between the irrational use of antipsychotic drugs in patients suffering from schizophrenia-related disorders and emotional burnout syndrome among the psychiatrists of KR. The following tasks were determined:
1. To reveal the emotional burnout syndrome and dependence of intensity of its phases on the age and length of service in psychiatrists of the specialized hospitals in KR.
2. To determine the efficiency of using the antipsychotic drugs procured under budgetary financing in patients suffering from schizophrenia-related disorders at the specialized medical institutions of KR.
3. To identify the correlation of the emotional burnout syndrome and its phases with the irrational use of antipsychotic drugs. A study of the emotional burnout syndrome was carried out using the technique developed by V.V.Boyko, which allowed assessing the formation of the EBS in accordance with the stages of general adaptation syndrome (stress, resistance, exhaustion). A correlation analysis has revealed the dependence of the emotional burnout syndrome phases on the age and length of service in psychiatrists of the specialized hospitals in KR. An analysis of the annual receipts and expenditures of the antipsychotic drugs, as well as budgetary funds spent to procure those drugs, has allowed revealing an inadequate supply of these drugs to the patients and their irrational use. At the final stage a correlation was identified between the applied antipsychotic drugs and their doses, on the one hand, and the intensity of the EBS phases, on the other hand.

Conclusions:
1. The symptoms of the emotional burnout syndrome in KR occur in 50.7% of psychiatrists working in hospitals, and 24% of psychiatrists have the formed EBS.
2. There is a dependence of the intensity of the EBS phases on the age and length of service of psychiatrists in all of the specialized hospitals of KR.
3. Inadequate budgetary provision of psychiatric hospitals in KR with antipsychotic drugs, combined use of psychotropic drugs, and predominant use of typical antipsychotic drugs lead to the irrational use of antipsychotic drugs.
4. The emotional burnout syndrome is one of the factors of irrational use of antipsychotic drugs by psychiatrists of KR – the more intensive the manifestations of EBS are, the less adequate the choice and doses of antipsychotic drugs become.