1
|
Yasui-Furukori N, Kawamata Y, Sasaki T, Yokoyama S, Okayasu H, Shinozaki M, Takeuchi Y, Sato A, Ishikawa T, Komahashi-Sasaki H, Miyazaki K, Fukasawa T, Furukori H, Sugawara N, Shimoda K. Prescribing Trends for the Same Patients with Schizophrenia Over 20 Years. Neuropsychiatr Dis Treat 2023; 19:921-928. [PMID: 37089914 PMCID: PMC10120815 DOI: 10.2147/ndt.s390482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 04/07/2023] [Indexed: 04/25/2023] Open
Abstract
Background Recent pharmacoepidemiology data show an increase in the proportion of patients receiving second-generation antipsychotic (SGA) monotherapy, but no studies have analyzed the same patients over a long period of time. Therefore, in this study, we retrospectively evaluated schizophrenia patients with available data for 20 years to determine whether the drug treatments in the same patients have changed in the past 20 years. Methods The study began in April 2021 and was conducted in 15 psychiatric hospitals in Japan. Schizophrenia patients treated in the same hospital for 20 years were retrospectively examined for all prescriptions in 2016, 2011, 2006, and 2001 (ie, every 5 years). Results The mean age of the 716 patients surveyed in 2021 was 61.7 years, with 49.0% being female. The rate of antipsychotic monotherapy use showed a slight increasing trend over the past 20 years; the rate of SGA use showed a marked increasing trend from 28.9% to 70.3% over the past 20 years, while the rate of SGA monotherapy use showed a gradual increasing trend over the past 20 years. The rates of concomitant use of anticholinergics, antidepressants, anxiolytics/sleep medications, and mood stabilizers showed decreasing, flat, flat, and flat trends over the past 20 years, respectively. Conclusion The results of this study showed a slow but steady substitution of SGAs for first-generation antipsychotics (FGAs) over time, even in the same patients.
Collapse
Affiliation(s)
- Norio Yasui-Furukori
- Department of Psychiatry, Dokkyo Medical University, School of Medicine, Tochigi, Japan
- Department of Psychiatry, TMC Shimotsuga, Tochigi, Japan
- Correspondence: Norio Yasui-Furukori, Department of Psychiatry, Dokkyo Medical University, School of Medicine, Mibu, Shimotsuga, Tochigi, 321-0293, Japan, Tel +81-282-86-1111, Fax +81-282-86-5187, Email
| | - Yasushi Kawamata
- Department of Psychiatry, Dokkyo Medical University, School of Medicine, Tochigi, Japan
- Department of Psychiatry, Kikuchi Hospital, Tochigi, Japan
| | - Taro Sasaki
- Department of Psychiatry, Dokkyo Medical University, School of Medicine, Tochigi, Japan
- Department of Psychiatry, Asahi Hospital, Tochigi, Japan
| | - Saaya Yokoyama
- Department of Psychiatry, Dokkyo Medical University, School of Medicine, Tochigi, Japan
- Department of Psychiatry, Aoki Hospital, Tochigi, Japan
| | - Hiroaki Okayasu
- Department of Psychiatry, Dokkyo Medical University, School of Medicine, Tochigi, Japan
- Department of Psychiatry, Fudogaoka Hospital, Saitama, Japan
| | - Masataka Shinozaki
- Department of Psychiatry, Dokkyo Medical University, School of Medicine, Tochigi, Japan
- Department of Psychiatry, Takizawa Hospital, Tochigi, Japan
| | - Yoshitaka Takeuchi
- Department of Psychiatry, Dokkyo Medical University, School of Medicine, Tochigi, Japan
- Department of Psychiatry, Okamotodai Hospital, Tochigi, Japan
| | - Aoi Sato
- Department of Psychiatry, Dokkyo Medical University, School of Medicine, Tochigi, Japan
- Department of Psychiatry, Muroi Hospital, Tochigi, Japan
| | - Takaaki Ishikawa
- Department of Psychiatry, Dokkyo Medical University, School of Medicine, Tochigi, Japan
- Department of Psychiatry, Saitama-Konan Hospital, Saitama, Japan
| | - Hazuki Komahashi-Sasaki
- Department of Psychiatry, Dokkyo Medical University, School of Medicine, Tochigi, Japan
- Department of Psychiatry, Kanuma Hospital, Tochigi, Japan
| | - Kensuke Miyazaki
- Department of Neuropsychiatry, Hirosaki-Aiseikai Hospital, Aomori, Japan
| | | | - Hanako Furukori
- Department of Neuropsychiatry, Kuroichi-Akebono Hospital, Aomori, Japan
| | - Norio Sugawara
- Department of Psychiatry, Dokkyo Medical University, School of Medicine, Tochigi, Japan
- Department of Psychiatry, TMC Shimotsuga, Tochigi, Japan
| | - Kazutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University, School of Medicine, Tochigi, Japan
| |
Collapse
|
2
|
Cheng SW, Lu CW, Chan HY, Chen JJ, Hsu CC. Antipsychotic prescription patterns and associated factors among the elderly with psychiatric illnesses. Int Clin Psychopharmacol 2022; 37:151-158. [PMID: 35357333 DOI: 10.1097/yic.0000000000000406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Prescribing rate of antipsychotics in elderly patients with psychiatric illnesses has been increasing all over the world. However, there is a lack of research examining the use of antipsychotics at psychiatric hospitals. We aim to find out long-term trends in antipsychotic prescriptions and factors associated with the use of antipsychotics in the elderly population. All outpatient visits with patients aged over 65 years between 2006 and 2015 in a psychiatric hospital were included in the analysis. Demographic and clinical data, including patient age, sex, National Health Insurance status, psychiatric diagnosis and antipsychotic prescription, were retrieved through the electronic medical information system. In this study, we found that prescribing rate of antipsychotics has increased around 5.07% through the study period (from 57.25% in 2006 to 60.15% in 2015, P < 0.001). Among all antipsychotics, there was an increase in the use of second-generation antipsychotics with a simultaneous decline in the use of first-generation antipsychotics. Logistic regression analysis showed advanced age, female gender and certification for catastrophic illnesses were positively associated with the use of antipsychotics. Furthermore, patients most likely to be prescribed an antipsychotic were those with psychotic disorders, followed by dementia, and then affective or neurotic disorders. The results of this study were consistent with the worldwide trend of increasing prescriptions of second-generation antipsychotics among elderly patients with psychiatric illnesses. Despite the potential benefits of these medications on certain psychiatric symptoms, clinicians need to exercise due caution as they may also cause potentially serious side effects among the elderly population.
Collapse
Affiliation(s)
| | - Chao-Wei Lu
- Department of General Psychiatry, Taoyuan Psychiatric Center, Taoyuan
| | - Hung-Yu Chan
- Department of General Psychiatry, Taoyuan Psychiatric Center, Taoyuan
- Department of Psychiatry, National Taiwan University Hospital and School of Medicine, National Taiwan University, Taipei, Taiwan
| | - Jiahn-Jyh Chen
- Department of General Psychiatry, Taoyuan Psychiatric Center, Taoyuan
| | - Chun-Chi Hsu
- Department of General Psychiatry, Taoyuan Psychiatric Center, Taoyuan
| |
Collapse
|
3
|
Kuo CL, Chien IC, Lin CH. Trends, correlates, and disease patterns of sedative-hypnotic use among elderly persons in Taiwan. BMC Psychiatry 2022; 22:316. [PMID: 35508990 PMCID: PMC9066755 DOI: 10.1186/s12888-022-03964-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 04/27/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The population-based National Health Insurance database was adopted to investigate the prevalence, correlates, and disease patterns of sedative-hypnotic use in elderly persons in Taiwan. METHODS The National Health Research Institutes provided a database of 1,000,000 random subjects in the National Health Insurance program. We adopted this sample of subjects who were older than 65 years from 1997 to 2005 and examined the proportions of psychiatric and nonpsychiatric disorders with regard to sedative-hypnotic use. RESULTS The 1-year prevalence of sedative-hypnotic use in elderly individuals increased from 1.7% in 1997 to 5.5% in 2005. The 1-year prevalence rates of benzodiazepine (BZD) and non-BZD hypnotics were 3.2 and 3.1%, respectively, in 2005. The overall hypnotic use was highest in ≥85-year-olds, males, those with lower amounts of insurance or higher Charlson Comorbidity Index scores and those living in eastern Taiwan. Both BZD and non-BZD hypnotic use were most commonly used in nonpsychiatric disorders instead of psychiatric disorders. Among the psychiatric disorders, the disorders that accounted for higher BZD and non-BZD hypnotic use were senile and presenile organic psychotic conditions (3.4 and 3.4%, respectively). Higher BZD and non-BZD use was for diseases of the respiratory system (30.4 and 17.8%, respectively), the circulatory system (20.4 and 22.4%, respectively), and neoplasms (12.6 and 13.8%, respectively). CONCLUSION The prevalence rates of both BZD and non-BZD sedative-hypnotic use increased from 1997 to 2005 in the elderly. The risk factors for sedative-hypnotic use were aging, male sex, lower insurance amount, and higher Charlson Comorbidity Index scores. Most BZD and non-BZD sedative-hypnotic users were persons with nonpsychiatric disorders.
Collapse
Affiliation(s)
- Chia-Lun Kuo
- grid.454740.6Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan ,grid.64523.360000 0004 0532 3255Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - I-Chia Chien
- Bali Psychiatric Center, Ministry of Health and Welfare, No. 33, HuaFuShan Rd, Bali District, New Taipei City, 249, Taiwan. .,National Yang-Ming University, Taipei, Taiwan.
| | - Ching-Heng Lin
- grid.410764.00000 0004 0573 0731Taichung Veterans General Hospital, Taichung, Taiwan ,grid.412146.40000 0004 0573 0416National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| |
Collapse
|
4
|
[Antipsychotic prescription prevalence and metabolic monitoring of patients under chronic treatment]. REVISTA DE LA FACULTAD DE CIENCIAS MÉDICAS 2021. [PMID: 34596370 DOI: 10.31053/1853.0605.v78.n3.32653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction Antipsychotics agents increase morbidity and mortality due to their metabolic impact. Information on its prescription and follow-up is scarce. The objective of this study was to estimate the chronic antipsychotic prescription prevalence and to evaluate the metabolic monitoring of patients treated with these medications. Methods We examined a retrospective cohort of patients older than 18 years treated in the outpatient setting of a hospital in Argentina. The crude and adjusted prevalence of chronic antipsychotic prescription was estimated by indirect standardization of the World Health Organization population, with its confidence interval (95%). It was evaluated whether the patients had biochemical determinations, systolic blood pressure (SBP), and body mass index (BMI) at the beginning and at 12 months of their treatment. Results The crude antipsychotic prescription prevalence was 23.8 ‰ (95% CI 23.0 - 24.6) and the adjusted prevalence was 10.1 ‰ (95% CI 9.5-10.7). 3702 patients were evaluated. The male:female ratio was 0.6. Median age 77.5 years (IQR 25-75: 59.5-86.1). Quetiapine was the most frequently prescribed. Initial determinations: Lipid profile 1804 (48.7%), blood glucose 2034 (54.9%), SBP 2546 (68.8%) and BMI 1584 (42.8%). At 12 months: Lipid profile 680 (18.4%), blood glucose 898 (24.3%), SAT 1609 (43.5%), and BMI 1584 (21.7%). Conclusions We observed a higher prevalence of atypical antipsychotic prescription in the elderly and female population and scarce registry of biochemical determinations for adverse effects follow-up.
Collapse
|
5
|
Noelia Vivacqua M, Abudarham T, Pagotto V, Luis Faccioli J. [Antipsychotic prescription prevalence and metabolic monitoring of patients under chronic treatment]. REVISTA DE LA FACULTAD DE CIENCIAS MÉDICAS 2021; 78. [PMID: 34596370 PMCID: PMC8760904 DOI: 10.3105310.31053/1853.0605.v78.n3.32653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Antipsychotics agents increase morbidity and mortality due to their metabolic impact. Information on its prescription and follow-up is scarce. The objective of this study was to estimate the chronic antipsychotic prescription prevalence and to evaluate the metabolic monitoring of patients treated with these medications. METHODS We examined a retrospective cohort of patients older than 18 years treated in the outpatient setting of a hospital in Argentina. The crude and adjusted prevalence of chronic antipsychotic prescription was estimated by indirect standardization of the World Health Organization population, with its confidence interval (95%). It was evaluated whether the patients had biochemical determinations, systolic blood pressure (SBP), and body mass index (BMI) at the beginning and at 12 months of their treatment. RESULTS The crude antipsychotic prescription prevalence was 23.8 ‰ (95% CI 23.0 - 24.6) and the adjusted prevalence was 10.1 ‰ (95% CI 9.5-10.7). 3702 patients were evaluated. The male:female ratio was 0.6. Median age 77.5 years (IQR 25-75: 59.5-86.1). Quetiapine was the most frequently prescribed. Initial determinations: Lipid profile 1804 (48.7%), blood glucose 2034 (54.9%), SBP 2546 (68.8%) and BMI 1584 (42.8%). At 12 months: Lipid profile 680 (18.4%), blood glucose 898 (24.3%), SAT 1609 (43.5%), and BMI 1584 (21.7%). CONCLUSIONS We observed a higher prevalence of atypical antipsychotic prescription in the elderly and female population and scarce registry of biochemical determinations for adverse effects follow-up.
Collapse
Affiliation(s)
| | - Tomás Abudarham
- Hospital Italiano de Buenos AiresCiudad Autónoma de Buenos AiresArgentina
| | - Vanina Pagotto
- Hospital Italiano de Buenos AiresCiudad Autónoma de Buenos AiresArgentina
| | - José Luis Faccioli
- Hospital Italiano de Buenos AiresCiudad Autónoma de Buenos AiresArgentina
| |
Collapse
|
6
|
International trends in antipsychotic use: A study in 16 countries, 2005-2014. Eur Neuropsychopharmacol 2017; 27:1064-1076. [PMID: 28755801 DOI: 10.1016/j.euroneuro.2017.07.001] [Citation(s) in RCA: 168] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 07/05/2017] [Indexed: 11/23/2022]
Abstract
The objective of this study was to assess international trends in antipsychotic use, using a standardised methodology. A repeated cross-sectional design was applied to data extracts from the years 2005 to 2014 from 16 countries worldwide. During the study period, the overall prevalence of antipsychotic use increased in 10 of the 16 studied countries. In 2014, the overall prevalence of antipsychotic use was highest in Taiwan (78.2/1000 persons), and lowest in Colombia (3.2/1000). In children and adolescents (0-19 years), antipsychotic use ranged from 0.5/1000 (Lithuania) to 30.8/1000 (Taiwan). In adults (20-64 years), the range was 2.8/1000 (Colombia) to 78.9/1000 (publicly insured US population), and in older adults (65+ years), antipsychotic use ranged from 19.0/1000 (Colombia) to 149.0/1000 (Taiwan). Atypical antipsychotic use increased in all populations (range of atypical/typical ratio: 0.7 (Taiwan) to 6.1 (New Zealand, Australia)). Quetiapine, risperidone, and olanzapine were most frequently prescribed. Prevalence and patterns of antipsychotic use varied markedly between countries. In the majority of populations, antipsychotic utilisation and especially the use of atypical antipsychotics increased over time. The high rates of antipsychotic prescriptions in older adults and in youths in some countries merit further investigation and systematic pharmacoepidemiologic monitoring.
Collapse
|
7
|
Trends and factors associated with antipsychotic use among elderly patients with dementia in Taiwan from 2005 to 2013: a population-based study. Int Clin Psychopharmacol 2017; 32:262-270. [PMID: 28542035 DOI: 10.1097/yic.0000000000000181] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
This study aimed to examine the trends and factors associated with antipsychotic prescriptions for elderly outpatients with dementia in Taiwan from 2005 to 2013. We assessed the annual prescription patterns of antipsychotic medications among elderly patients attending outpatient visits for dementia between 2005 and 2013 using the National Health Insurance Research Database in Taiwan. We also carried out logistic regression analyses to test the trends and associated factors. We found that any antipsychotic prescriptions for elderly patients making visits for dementia increased slightly, from 25.5 to 26.5%, over the 9-year period. From 2005 to 2013, prescriptions for first-generation antipsychotics only decreased from 7.8 to 3.3%, whereas second-generation antipsychotic prescriptions only increased from 17.0 to 22.2%. Elderly dementia patients who were female, older, concomitantly using other psychotropic drugs (antidepressants, benzodiazepines, and Z-drugs), and treated by psychiatrists and at regional/local hospitals were prescribed significantly more antipsychotics, whereas patients with comorbid hypertension, hyperlipidemia, diabetes, and stroke used antipsychotics significantly less. Although physicians seemed to avoid prescribing antipsychotics for elderly outpatients with dementia and certain comorbid physical disorders, second-generation antipsychotic use increased during the study period. Physicians should balance the benefits and risks of antipsychotic use to ensure the safety of dementia patients.
Collapse
|