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A Non-Interventional Naturalistic Study of the Prescription Patterns of Antipsychotics in Patients with Schizophrenia from the Spanish Province of Tarragona.

Gaviria AM, Franco JG, Aguado V, Rico G, Labad J, de Pablo J, Vilella E - PLoS ONE (2015)

Bottom Line: Being prescribed quetiapine (OR 14.24, 95% CI 4.94-40.97), LAI (OR 9.99, 95% CI 6.45-15.45), psychiatric co-medications (OR 4.25, 95% CI 2.72-6.64), and paliperidone (OR 3.13, 95% CI 1.23-7.92) were all associated with an increased likelihood of polypharmacy.Most patients receive psychiatric co-medications such as anxiolytics or antidepressants.Polypharmacy is associated with the use of quetiapine or paliperidone, use of a LAI, younger age, and psychiatric co-medication.

View Article: PubMed Central - PubMed

Affiliation: Hospital Universitari Institut Pere Mata, Universitat Rovira i Virgili, CIBERSAM, IISPV Reus, Spain.

ABSTRACT

Background: The analysis of prescribing patterns in entire catchment areas contributes to global mapping of the use of antipsychotics and may improve treatment outcomes.

Objective: To determine the pattern of long-term antipsychotic prescription in outpatients with schizophrenia in the province of Tarragona (Catalonia-Spain).

Methods: A naturalistic, observational, retrospective, non-interventional study based on the analysis of registries of computerized medical records from an anonymized database of 1,765 patients with schizophrenia treated between 2011 and 2013.

Results: The most used antipsychotic was risperidone, identified in 463 (26.3%) patients, followed by olanzapine in 249 (14.1%), paliperidone in 225 (12.7%), zuclopenthixol in 201 (11.4%), quetiapine in 141 (8%), aripiprazole in 100 (5.7%), and clozapine in 100 (5.7%). Almost 8 out of 10 patients (79.3%) were treated with atypical or second-generation antipsychotics. Long-acting injectable (LAI) formulations were used in 44.8% of patients. Antipsychotics were generally prescribed in their recommended doses, with clozapine, ziprasidone, LAI paliperidone, and LAI risperidone being prescribed at the higher end of their therapeutic ranges. Almost 7 out of 10 patients (69.6%) were on antipsychotic polypharmacy, and 81.4% were on psychiatric medications aside from antipsychotics. Being prescribed quetiapine (OR 14.24, 95% CI 4.94-40.97), LAI (OR 9.99, 95% CI 6.45-15.45), psychiatric co-medications (OR 4.25, 95% CI 2.72-6.64), and paliperidone (OR 3.13, 95% CI 1.23-7.92) were all associated with an increased likelihood of polypharmacy. Being prescribed risperidone (OR 0.54, 95% CI 0.35-0.83) and older age (OR 0.98, 95% CI 0.97-0.99) were related to a low polypharmacy probability.

Conclusions: Polypharmacy is the most common pattern of antipsychotic use in this region of Spain. Use of atypical antipsychotics is extensive. Most patients receive psychiatric co-medications such as anxiolytics or antidepressants. Polypharmacy is associated with the use of quetiapine or paliperidone, use of a LAI, younger age, and psychiatric co-medication.

No MeSH data available.


Related in: MedlinePlus

Comparison of the frequencies of psychiatric co-medications (other than antipsychotics) between the principal antipsychotic prescription patterns.An asterisk (*) indicates an observed frequency higher than expected in all χ2 comparisons, p<0.01.
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pone.0139403.g001: Comparison of the frequencies of psychiatric co-medications (other than antipsychotics) between the principal antipsychotic prescription patterns.An asterisk (*) indicates an observed frequency higher than expected in all χ2 comparisons, p<0.01.

Mentions: More than half of the patients (61.5%) were treated with at least two antipsychotics and at least one psychiatric co-medication. The mean number of non-antipsychotic co-medications was 1.84±1.36. A total of 25.7% patients were taking one other psychiatric co-medication, 25.1% two, and 20% three medications. The frequency of psychiatric co-medication was significantly higher when this formed part of a pattern of antipsychotic polypharmacy (Fig 1).


A Non-Interventional Naturalistic Study of the Prescription Patterns of Antipsychotics in Patients with Schizophrenia from the Spanish Province of Tarragona.

Gaviria AM, Franco JG, Aguado V, Rico G, Labad J, de Pablo J, Vilella E - PLoS ONE (2015)

Comparison of the frequencies of psychiatric co-medications (other than antipsychotics) between the principal antipsychotic prescription patterns.An asterisk (*) indicates an observed frequency higher than expected in all χ2 comparisons, p<0.01.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4591292&req=5

pone.0139403.g001: Comparison of the frequencies of psychiatric co-medications (other than antipsychotics) between the principal antipsychotic prescription patterns.An asterisk (*) indicates an observed frequency higher than expected in all χ2 comparisons, p<0.01.
Mentions: More than half of the patients (61.5%) were treated with at least two antipsychotics and at least one psychiatric co-medication. The mean number of non-antipsychotic co-medications was 1.84±1.36. A total of 25.7% patients were taking one other psychiatric co-medication, 25.1% two, and 20% three medications. The frequency of psychiatric co-medication was significantly higher when this formed part of a pattern of antipsychotic polypharmacy (Fig 1).

Bottom Line: Being prescribed quetiapine (OR 14.24, 95% CI 4.94-40.97), LAI (OR 9.99, 95% CI 6.45-15.45), psychiatric co-medications (OR 4.25, 95% CI 2.72-6.64), and paliperidone (OR 3.13, 95% CI 1.23-7.92) were all associated with an increased likelihood of polypharmacy.Most patients receive psychiatric co-medications such as anxiolytics or antidepressants.Polypharmacy is associated with the use of quetiapine or paliperidone, use of a LAI, younger age, and psychiatric co-medication.

View Article: PubMed Central - PubMed

Affiliation: Hospital Universitari Institut Pere Mata, Universitat Rovira i Virgili, CIBERSAM, IISPV Reus, Spain.

ABSTRACT

Background: The analysis of prescribing patterns in entire catchment areas contributes to global mapping of the use of antipsychotics and may improve treatment outcomes.

Objective: To determine the pattern of long-term antipsychotic prescription in outpatients with schizophrenia in the province of Tarragona (Catalonia-Spain).

Methods: A naturalistic, observational, retrospective, non-interventional study based on the analysis of registries of computerized medical records from an anonymized database of 1,765 patients with schizophrenia treated between 2011 and 2013.

Results: The most used antipsychotic was risperidone, identified in 463 (26.3%) patients, followed by olanzapine in 249 (14.1%), paliperidone in 225 (12.7%), zuclopenthixol in 201 (11.4%), quetiapine in 141 (8%), aripiprazole in 100 (5.7%), and clozapine in 100 (5.7%). Almost 8 out of 10 patients (79.3%) were treated with atypical or second-generation antipsychotics. Long-acting injectable (LAI) formulations were used in 44.8% of patients. Antipsychotics were generally prescribed in their recommended doses, with clozapine, ziprasidone, LAI paliperidone, and LAI risperidone being prescribed at the higher end of their therapeutic ranges. Almost 7 out of 10 patients (69.6%) were on antipsychotic polypharmacy, and 81.4% were on psychiatric medications aside from antipsychotics. Being prescribed quetiapine (OR 14.24, 95% CI 4.94-40.97), LAI (OR 9.99, 95% CI 6.45-15.45), psychiatric co-medications (OR 4.25, 95% CI 2.72-6.64), and paliperidone (OR 3.13, 95% CI 1.23-7.92) were all associated with an increased likelihood of polypharmacy. Being prescribed risperidone (OR 0.54, 95% CI 0.35-0.83) and older age (OR 0.98, 95% CI 0.97-0.99) were related to a low polypharmacy probability.

Conclusions: Polypharmacy is the most common pattern of antipsychotic use in this region of Spain. Use of atypical antipsychotics is extensive. Most patients receive psychiatric co-medications such as anxiolytics or antidepressants. Polypharmacy is associated with the use of quetiapine or paliperidone, use of a LAI, younger age, and psychiatric co-medication.

No MeSH data available.


Related in: MedlinePlus