Cardiovascular and cerebrovascular risk factors and events associated with second-generation antipsychotic compared to antidepressant use in a non-elderly adult sample: results from a claims-based inception cohort study

Correll, Christoph U.; Joffe, Benjamin I.; Rosen, Lisa; Sullivan, Timothy B.; Joffe, Russell T.

doi:10.1002/wps.20187

Cited by 84 publications

(69 citation statements)

References 48 publications

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“…In conclusion, this study identified that the reduction in racial/ethnic differences in antidepressant use after the box warning (caused by the decline among White youth and steady rates among Blacks and Latinos) was in large part explained by the fact that racial/ethnic minority youth largely seek care from a different subset of providers than White youth and that minority‐serving providers reacted differently to the box warning. As rates of psychotropic medication use in youth continue to climb in the United States, information about the long‐term risks of these medications has emerged eg, and will continue to challenge decision making for providers, youth living with mental illness, and their caregivers. Going forward, policy makers and prescribers should pay close attention to how these risk warnings are disseminated and the differential practice patterns of providers of youth of color, and target resources and provider education to lower the risk of adverse health outcomes faced by these vulnerable patient populations.…”

Section: Discussionmentioning

confidence: 99%

Assessing provider and racial/ethnic variation in response to the FDA antidepressant box warning

Cook

Wang

Sonik

et al. 2019

Health Services Research

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Introduction After the 2004 FDA box warning raised concerns about increased suicidal ideation among youth taking antidepressants, antidepressant use decreased for White youth but slightly increased for Black and Latino youth. Better understanding of patient and provider factors contributing to these differences is needed to improve future risk warning dissemination. Methods We analyzed antidepressant prescriptions for youth aged 5‐17 in 2002‐2006 Medicaid claims data from four states (CA, FL, NC, and NY). In multilevel models, we assessed provider‐ and patient‐level contributions to changes in antidepressant use by race/ethnicity and compared responses to the box warning between providers with large (>2/3) and small (<1/3) proportions of minority patients. Results A significant amount of variance in overall prescribing patterns (calculated by the ICC) was explained at the provider level. Significant provider‐level variation was also identified in the differential effect of the box warning by racial/ethnic group. In a test of the influence of provider panel mix, we found that providers with large proportions of minority patients reduced antidepressant prescribing more slowly after the box warning than other providers. Discussion This study is the first to assess provider‐ and patient‐level variation in the impact of a health care policy change on treatment disparities. Black and Latino youth Medicaid beneficiaries were seen by largely different providers than their White counterparts, and these distinct providers were influential in driving antidepressant prescription patterns following the box warning. Concerted outreach to providers of minority beneficiaries is needed to ensure that risk warnings and clinical innovations diffuse swiftly across racial/ethnic minority groups.

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Section: Discussionmentioning

confidence: 99%

Assessing provider and racial/ethnic variation in response to the FDA antidepressant box warning

Cook

Wang

Sonik

et al. 2019

Health Services Research

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“…We used the literature (e.g., (13–16) and expertise within our research team (XX [anonymized for review]) to classify drugs. Since there is insufficient evidence on the impact of antipsychotic combinations on metabolic risk (e.g., are risks additive?…”

Section: Methodsmentioning

confidence: 99%

“…The strength of the evidence on the association between second-generation antipsychotics, the most widely used class of antipsychotics, and metabolic risk varies substantially by drug (e.g., (5–12)). However, the high metabolic risk associated with several of these drugs is incontrovertible (e.g., (13–16). …”

Section: Introductionmentioning

confidence: 99%

Simulated Effects of Policies to Reduce Diabetes Risk Among Adults With Schizophrenia Receiving Antipsychotics

Mulcahy

Normand

Newcomer

et al. 2017

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Objective Second-generation antipsychotics increase the risk for diabetes and other metabolic conditions among people with schizophrenia. While metabolic testing is recommended to reduce this risk, low testing rates prompt concerns of negative health consequences and downstream medical costs. This study simulated the effect of increasing metabolic testing rates on 10-year prevalence rates of pre-diabetes and diabetes (diabetes conditions) and their associated healthcare costs. Methods A microsimulation model with a 10-year time horizon was used to quantify the impacts of policies that increase annual testing rates in a Medicaid population with schizophrenia. Data sources included California Medicaid data, National Health and Nutrition Examination Survey data, and the literature. In the model, metabolic testing increases diagnosis of diabetes conditions and diagnosis prompts prescribers to switch patients to lower-risk antipsychotics. Key inputs include observed diagnoses, prescribing rates, annual testing rates, imputed rates of undiagnosed diabetes conditions, and literature-based estimates of policy effectiveness. Results Relative to 2009 annual testing rates, 10-year outcomes for policies that achieve universal testing reduced exposure to higher-risk antipsychotics by 14%, time to diabetes diagnosis by 57%, and diabetes prevalence by .6%. These policies were associated with higher spending due to testing and earlier treatment. Conclusions Policies that promote metabolic testing provide an effective approach to improve the safety of second-generation antipsychotic prescribing in a Medicaid population with schizophrenia yet lead to additional costs at 10 years. Simulation studies are a useful source of information on the potential impacts of these policies.

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“…, Haddad & Sharma , Correll et al . ). A large meta‐analysis comparing the efficacy and tolerability of 15 different antipsychotic drugs (Leucht et al .…”

Section: Physical Health Problems – the Risks Of Taking Antipsychoticsmentioning

confidence: 97%

Recovery from psychosis: physical health, antipsychotic medication and the daily dilemmas for mental health nurses

Bressington

White

2015

Psychiatric Ment Health Nurs

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Cardiovascular and cerebrovascular risk factors and events associated with second-generation antipsychotic compared to antidepressant use in a non-elderly adult sample: results from a claims-based inception cohort study

Cited by 84 publications

References 48 publications

Assessing provider and racial/ethnic variation in response to the FDA antidepressant box warning

Assessing provider and racial/ethnic variation in response to the FDA antidepressant box warning

Simulated Effects of Policies to Reduce Diabetes Risk Among Adults With Schizophrenia Receiving Antipsychotics

Recovery from psychosis: physical health, antipsychotic medication and the daily dilemmas for mental health nurses

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