Psychotropic prescription practices in east Asia: looking back and peering ahead

Tan, C.H.; Shinfuku, Naotaka; Sim, Kang

doi:10.1097/yco.0b013e32830e6dc4

Cited by 25 publications

(18 citation statements)

References 47 publications

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“…[719] Besides clinical differences which may explain some of the variability in prescription patterns, the lower use of antidepressants found in the present study possibly reflects concerns of a possible switch to mania with antidepressants in bipolar disorder patients.…”

Section: Discussionmentioning

confidence: 82%

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An audit of first prescription of new patients attending a psychiatry walk-in-clinic in north India

2012

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Background:Although almost all psychotropic medications available worldwide are readily available in India, there is meager data in this country on the prescription patterns of psychiatrists.Aim:To study the first prescription handed over to patients attending the psychiatry outpatient clinic of a tertiary care hospital.Materials and Methods:Data of all patients (for the period of January 1, 2009 to November 30, 2010; diagnosed with an ICD-10 diagnosis of F2-F4) were extracted from the computer-based registry and analyzed.Results:Ten thousand two hundred and fourteen (10 214) patients were diagnosed to have a diagnosis of F2-F4 ICD-10 category. In all diagnostic groups, olanzapine was the most commonly prescribed antipsychotic followed by risperidone. Very few patients (8%) received typical antipsychotic medication. In all diagnostic groups, escitalopram was the most commonly prescribed antidepressant; other frequently prescribed antidepressants were sertraline, paroxetine, and venlafaxine. Among the mood stabilizers, valproate was preferred over lithium. In all the groups, more than half of the patients were prescribed benzodiazepines, clonazepam being the most commonly prescribed agent, followed by lorazepam. The mean number of psychotropic medications was highest in the bipolar disorder group. Very few patients received the combination of same group of drugs.Conclusions:Olanzapine, escitalopram, and clonazepam are the most commonly prescribed antipsychotic, antidepressants, and benzodiazepines, respectively. Valproate was preferred over lithium as a mood stabilizer. In general, the prescription trends were in accordance to the recommendations of various treatment guidelines, except for the use of benzodiazepines, which was higher.

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Section: Discussionmentioning

confidence: 82%

“…[6] A few surveys of prescription patterns of various psychotropics from Asian centers too are available. [47]…”

Section: Introductionmentioning

confidence: 99%

An audit of first prescription of new patients attending a psychiatry walk-in-clinic in north India

2012

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“…Thailand, in common with other Southeast Asian countries, has different socioeconomic, cultural, political, linguistic, health care, and reimbursement systems compared with other parts of the world 10. These results thus provide a valuable understanding of the role of paliperidone ER in the Thai context.…”

Section: Discussionmentioning

confidence: 87%

“…The socioeconomic, cultural, political, linguistic, health care, and reimbursement systems in Southeast Asian countries are diverse, as well as being different in comparison with other parts of the world 10. To investigate the efficacy of paliperidone ER in Southeast Asian patients with schizophrenia, the PERFEcT study was conducted from June 2007 to April 2009 11,12.…”

Section: Introductionmentioning

confidence: 99%

Effects of paliperidone extended release on hostility among Thai patients with schizophrenia

Jariyavilas¹,

Thavichachart

Kongsakon

et al. 2017

NDT

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ObjectiveThis open-label prospective study investigated the effects of paliperidone extended release (ER) on hostility in Thai patients with schizophrenia.BackgroundPatients diagnosed with schizophrenia may be hostile or exhibit aggressive behavior, which can occasion their admission to psychiatric hospital. Antipsychotic medications are often used to treat hostility and aggression in such patients. Paliperidone ER is effective and well tolerated in the treatment of schizophrenia. However, there are no data available for paliperidone ER with regard to its efficacy on hostility and aggression among Thai patients. This study was a part of the PERFEcT study, a 6-month, open-label, multicenter, multicountry, prospective trial to explore the safety, efficacy, and functionality of paliperidone ER tablets. The current study included only the data obtained from Thai participants.Materials and methodsFlexible dosing of paliperidone ER in a range of 3–12 mg/day was used, allowing investigators to adjust the dosage of each subject individually. The 199 Thai patients had a stable Clinical Global Impression – severity score before enrollment. Demographic data were collected at enrollment, and assessments took place at 1, 2, 3, and 6 months postbaseline. The Positive and Negative Syndrome Scale (PANSS) and Personal and Social Performance (PSP) scale were used to evaluate efficacy. In this analysis, we report the findings for the specific PANSS factor P7 (hostility) and the PSP subscale disturbing and aggressive behavior. Data were analyzed using paired t-test method to investigate changes in mean PANSS and PSP total and subscale scores. The significance level was set at P<0.05.ResultsFrom a total of 199 Thai patients, 148 patients (74.4%) participated in all visits. There was a significant reduction in mean scores for all total PANSS measures from 1 month onward compared with baseline, as well as ongoing significant reductions in scores from visit to visit. There was a significant reduction in mean hostility score at 2 months (P<0.05), 3 months (P<0.05), and 6 months (P<0.01) (n=148). For the PSP scale, there was a significant across-the-board reduction of mean scores from 3 months onward, including in the disturbing and aggressive behavior subscale (P<0.001) (n=148).ConclusionSwitching from previously unsuccessful antipsychotic treatments to paliperidone ER may be a useful option to reduce hostility and disturbing behavior in patients with schizophrenia. This study in Thai patients is in line with findings in other countries and cultures concerning the management of hostility in patients with schizophrenia.

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“…US business expansion in healthcare services has become a global phenomenon (Health and Medical 1997) and predominates over health concerns. For example,Tan and colleagues (Tan et al 2008;Chong & Tan 2010) found that factors such as insurance arrangements and the healthcare structure in a number of countries have become more significant in the prescription of psychotropic drugs than the drugs' effectiveness.…”

Section: Practice Pointsmentioning

confidence: 99%

Globalisation, economics and professionalism

Tan

Macneill

2015

Medical Teacher

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This paper presents an analysis of the effect of globalisation and attendant economic factors on the global practice of medicine, medical education, medical ethics and medical professionalism. The authors discuss the implications of these trends, citing case scenarios in the healthcare insurance, medical tourism, pharmaceutical industries, and the educational systems as well as in clinical practice, to illustrate the impact of globalisation and economics on professionalism. Globalisation, on the one hand, offers benefits for the global practice of medicine and for medical education. On the other, globalisation can have negative effects, particularly when the main driver is to maximise profitability across national boundaries rather than concern for human well-being. Appraising the effect of globalisation on professionalism involves assessing its effects at the intrapersonal, interpersonal, and institutional levels, and its effect on society at large.

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Psychotropic prescription practices in east Asia: looking back and peering ahead

Cited by 25 publications

References 47 publications

An audit of first prescription of new patients attending a psychiatry walk-in-clinic in north India

An audit of first prescription of new patients attending a psychiatry walk-in-clinic in north India

Effects of paliperidone extended release on hostility among Thai patients with schizophrenia

Globalisation, economics and professionalism

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