Health-related quality of life in patients treated with atypical antipsychotics

Almeida, Juliana Lopes; Zuppo, Isabella de Figueiredo; Castel, Saulo; Reis, Edna Afonso; Oliveira, Helian Nunes de; Ruas, Cristina Mariano

doi:10.1590/1516-4446-2019-0739

Cited by 4 publications

(6 citation statements)

References 32 publications

(46 reference statements)

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“…In South America, one study from Brazil (de Almeida et al, 2020 ), whose information was considered low-quality, found no significant differences in the rates of Afro-Brazilian or mixed heritage service-users in receiving clozapine treatment compared to Caucasian and Asian people ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…This disparity was present in studies that controlled for various demographic and clinical covariates including treatment-resistance. In the only study included in the review from Brazil, no significant differences were reported in the rates of receiving clozapine for service-users of mixed race or Afro-Brazilian descent compared to those of Asian or Caucasian backgrounds (de Almeida et al, 2020 ). Mixed findings were observed regarding clozapine treatment within Asian communities in the UK (Cho et al, 2019 ; Das-Munshi et al, 2018 ; Govind et al, 2020 ; Kesserwani et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

“…Importantly, the use of broad classifications may cover up potential disparities affecting some ethnic communities and impair our understanding of ethnic differences in treatments and disease prevalence (Bhopal, 2004 ). Some of the included studies merge different groups under one category (Beck et al, 2019 ; de Almeida et al, 2020 ; Dey et al, 2016 ; Mark, Palmer, Russo, & Vasey, 2003 ). Caution should be taken when interpreting these findings.…”

Section: Discussionmentioning

confidence: 99%

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Ethnic disparities in clozapine prescription for service-users with schizophrenia-spectrum disorders: a systematic review

2022

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Clozapine is the only licenced medication for treating treatment-resistant schizophrenia. Previous studies have suggested unequal rates of clozapine treatment by ethnicity among individuals with schizophrenia-spectrum disorders. One previous review has investigated this topic but was restricted to studies from the USA. This current review aims to synthesise the international literature regarding ethnic disparities in clozapine prescription amongst individuals with schizophrenia-spectrum disorders. We searched CINAHL, PubMed, Medline, Embase, APA PsycINFO and Open Grey and reviewed studies reporting on the proportion of service-users prescribed clozapine separately for different ethnic groups, in individuals with a primary diagnosis of schizophrenia or any schizophrenia-spectrum disorders. A narrative synthesis was conducted to integrate information from included studies. The review was registered in PROSPERO (Number: CRD42020221731). From 24 studies, there is strong, consistent evidence that Black and Hispanic service-users in the UK and the USA are significantly less likely to receive clozapine than White/Caucasian service-users after controlling for multiple demographic and clinical potential confounders. In New Zealand, Māori service-users were reported to be more likely to receive clozapine than those of White/European ethnicity. There is mixed evidence regarding Asian service-users in the UK. The mentioned disparities were observed in studies with TRS and non-TRS cohorts. The results imply that access to clozapine treatment varies among ethnic groups. These findings raise an ethical concern as they suggest a compromise of the standards of care in schizophrenia treatment practices. Interventions are needed to reduce clozapine prescribing disparities among ethnic communities.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Ethnic disparities in clozapine prescription for service-users with schizophrenia-spectrum disorders: a systematic review

2022

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“…The VAS scale was used in this paper in order to evaluate the self-reported health status of the individuals rather than the utility score provided by the EQ-5D. This decision was supported by a paper recently published by Almeida et al [27], which evaluated the influence of atypical antipsychotic usage on QOL and revealed that the VAS scale could be useful to address further factors influencing the self-perceived health status of the patients.…”

Section: Variablesmentioning

confidence: 99%

Health equity and the usage of atypical antipsychotics within the Brazilian national health system: findings and implications

Zuppo

Ruas

Oliveira

et al. 2020

Expert Review of Pharmacoeconomics & Outcomes Research

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Background: There is a need to evaluate the health equity of atypical antipsychotics users who obtain their medicines from the Brazilian National Health System (SUS) through the identification of key factors that influence their health status due to concerns with equity of care. Research design and methods:Cross-sectional study among patients attending state pharmacies in Brazil. Individuals were included if they used atypical antipsychotics, aged ≥18 years, and answered the EQ-5D-3L questionnaire. Sociodemographic, behavioral, and clinical data were collected. The dependent variable was health status. Associations between the independent variables and the dependent variable were analyzed by adjusting a linear regression model. Results: Overall, 388 individuals met the eligibility criteria and were included in the analysis. The final multiple linear regression model demonstrated a statistically significant association between VAS and suicide attempts, private care, current antipsychotics, comorbidities, and perceived family support. Conclusions: The study identified several factors both individual and collective that correlate with the health status of atypical antipsychotic users, and confirmed the importance of providing medicines for treating psychotic disorders. However, other factors are involved including social support. Our results suggest additional activities and policies are necessary including strategies to address the differences in private and public health care.

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“…A broad understanding of antipsychotics and their effects on movement disorders associated with dose and treatment length is relevant. Since these adverse effects directly impact the quality of life of individuals undergoing these medications, such as problems with mobility, self-care, daily activities, anxiety, and depression 15 . Knowing that there are still disagreements in the literature about the dosage and duration of treatment associated with the use of antipsychotics and their adverse effects on movement, the objective of the present study was to identify movement disorders induced by the use of antipsychotics.…”

Section: Introductionmentioning

confidence: 99%

Antipsychotic-induced movement disorders: integrative review

et al. 2022

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Objective: To identify movement disorders induced by antipsychotics. Methods: We selected clinical trials from MEDLINE and LILACS databases without publication date restriction. Studies of antipsychotics as a pharmacological intervention, compared or not to other interventions were included (combined treatments were not included). The primary outcome was movement disorders. Two independent reviewers analyzed the studies and summarized them in an electronic spreadsheet. We assessed the quality of the selected studies using the PEDro scale. Results: Five studies were included in this review. In these studies, it was possible to identify the main psychiatric symptoms and their severity, as well as dyskinetic movements. When a reduction in dyskinetic movements was observed in treatments with both atypical and typical antipsychotics, there were adverse effects. Those included excessive sedation, loss of body mass, vomiting, and leukocytopenia. Conclusion: This study verified the findings in literature on the effects of antipsychotics, including the type of medication, dosage, and form of administration, as well as instruments used to assess the outcome related to movement disorders. It was not possible to determine the best therapeutic dose for managing the disorders due to the significant distinction in dosages and medications. All five studies had some effect related to the drug use or its withdrawal.

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Health-related quality of life in patients treated with atypical antipsychotics

Cited by 4 publications

References 32 publications

Ethnic disparities in clozapine prescription for service-users with schizophrenia-spectrum disorders: a systematic review

Ethnic disparities in clozapine prescription for service-users with schizophrenia-spectrum disorders: a systematic review

Health equity and the usage of atypical antipsychotics within the Brazilian national health system: findings and implications

Antipsychotic-induced movement disorders: integrative review

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