Selective prescribing of atypical antipsychotics

Breekveldt-Postma, Nancy S; Schillevoort, Igor; Nolen, Willem A.; Veraart, C; Herings, Ron M. C.

doi:10.1002/pds.1037

Cited by 8 publications

(8 citation statements)

References 12 publications

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“…Instead, we used the co‐prescribing of APDs as an indicator of probable EPS when antipsychotics were also prescribed. The use of ADPs as an indicator has been supported by the literature 11 , 55 , 56 , 57 , 58 , 59 …”

Section: Methodsmentioning

confidence: 91%

“…The use of ADPs as an indicator has been supported by the literature. 11,[55][56][57][58][59] Because the switching within and between FGAs and SGAs is common in patients with schizophrenia, some hospitalizations involved the use of both types of medications. To clearly attribute EPS to a specific drug, a subset of hospitalizations using only one oral antipsychotic was extracted to estimate the prevalence of EPS for individual antipsychotics.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Risk of Extrapyramidal Syndrome in Schizophrenic Patients Treated with Antipsychotics: A Population-based Study

Yang

Chong

et al. 2007

Clin Pharmacol Ther

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To compare the prevalence of extrapyramidal syndrome (EPS) between the first-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs), the co-prescribing rate of anti-Parkinson drugs (APDs) of each antipsychotic drug was analyzed using population database. Fourteen antipsychotics had been prescribed during the 5-year study period. Among the SGAs, quetiapine had the lowest crude co-prescribing rate of APDs (27.09%), whereas risperidone had the highest rate (66.50%). Among the FGAs, thioridazine and loxapine had the lowest (60.99%) and highest rates (96.35%), respectively. The rankings of the co-prescribing rate of APDs among antipsychotics, in increasing order, were quetiapine, clozapine, olanzapine, thioridazine, zotepine, chlorpromazine, risperidone, sulpiride, clotiapine, flupentixol, haloperidol, zuclopentixol, trifluoperazine, and loxapine. The results indicate that the risk of EPS appears to be lower in SGAs than in FGAs; however, the considerably high rate of EPS in some of the newer generation of antipsychotics warrants clinical attention.

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Section: Methodsmentioning

confidence: 91%

Section: Methodsmentioning

confidence: 99%

Risk of Extrapyramidal Syndrome in Schizophrenic Patients Treated with Antipsychotics: A Population-based Study

Yang

Chong

et al. 2007

Clin Pharmacol Ther

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“…Over time, as reimbursement factors change and clinicians gain greater training in administration of LAR microspheres, patient selection for LAR may change. Similar channeling biases have been demonstrated in selection of antipsychotic medications 49. Fourth, in order to help ensure complete prescription data retrieval, patients with extensive inpatient treatment before starting depot were excluded.…”

Section: Discussionmentioning

confidence: 97%

Treatment of Schizophrenia With Long-Acting Fluphenazine, Haloperidol, or Risperidone

Olfson

Marcus

Ascher-Svanum

2006

Schizophrenia Bulletin

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Objective: This study compares 3 cohorts of patients with schizophrenia before, during, and after initiating treatment with fluphenazine decanoate (FD), haloperidol decanoate (HD), or long-acting injectable risperidone (LAR). Methods: Administrative data are analyzed from California Medicaid (Medi-Cal) beneficiaries with schizophrenia who initiated FD, HD, or LAR treatment. Patients were required to have been continuously enrolled in Medi-Cal for 180 days before and 180 days after the start of the new episode of long-acting antipsychotic therapy. Results: There were few demographic and clinical differences among patients initiating FD, HD, and LAR. During the 180 days before starting long-acting injections, most patients initiating FD (53.5%), HD (58.5%), and LAR (61.2%) received oral antipsychotic medications for <80% of the days in this period (medication possession ratio: <0.80). The mean duration of depot treatment episodes was 58.3 days (SD = 53.6) for FD, 71.7 days (SD = 56.4) for HD, and 60.6 days (SD = 48.8) for LAR (F = 18.3, df = 2, 2694, P < .0001, HD > FD). Few patients who started on FD (5.4%), HD (9.7%), or LAR (2.6%) continued for at least 180 days. Most patients in each group (FD [77.4%], HD [78.9%], and LAR [75.5%]) received oral antipsychotic medications during the 45 days after discontinuing long-acting injections. Coprescription with antidepressants, mood stabilizers, and benzodiazepines was common. Conclusions: Patients treated with long-acting antipsychotic injections tend to have complex pharmacological regimens and recent medication nonadherence. A great majority of patients initiating long-acting antipsychotic medications discontinue use within the first few months of treatment.

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“…We reviewed over 10,000 abstracts and employed a comprehensive search strategy to identify relevant articles [50], 14 were identified through back references, Scopus citations or Google Scholar searches, indicating the challenges of targeted searching and the diversity of keywords and subject headings used across studies and databases. We excluded articles that were not published in English; as nearly half of included studies originated from Europe we may have missed studies published in other languages [51,52]. Our estimates of prescription drug misuse are solely from the perspective of the health care payer; we are unable to address access issues outside the dispensing episodes observed in our data set including medication obtained illegally.…”

Section: Discussionmentioning

confidence: 99%

“…A) 3.7% (n=940) C) 2.5% (n=274) B) 4.2% (n=1,129) D) 4.5% (n=1,212) 5) Receipt of ≥4 different BZDs (120 days) A) 1.7% (n=432) C) 0.6% (n=66) B) 1.9% (n=511) D) 1.9% (n=512) 6) Pharmacy hopping: dispensed same BZD from ≥2 pharmacies (7 days) A) 7.7% (n=1,956) C) 3.7% (n=405) B) 3.8% (n=1,090) D) 3.9% (n=1,050) 7) Receipt of a long half-life BZD for person aged >65 years (Various) A) 56.1% (n unclear) C) 51.3% (n unclear) B) 52.6% (n unclear) D) 48.6% (n unclear) A) 42.8% (n=10,871) C) 45.1% (n=4,929) B) 40 Period of observation covers the entire year, unless otherwise stated. c Reported aim(s) and cohort(s) may differ from original article as we only report aspects of paper related to prescription drug misuse.…”

Section: A) Abusersmentioning

confidence: 99%

Harmonizing Post-Market Surveillance of Prescription Drug Misuse: A Systematic Review of Observational Studies Using Routinely Collected Data (2000–2013)

et al. 2015

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Background Prescription drug misuse is a growing public health concern globally. Routinely collected data provides a valuable tool for quantifying prescription drug misuse.Objective To synthesize the global literature investigating prescription drug misuse utilizing routinely collected, person-level prescription/dispensing data to examine reported measures, documented extent of misuse and associated factors.Methods We searched MEDLINE, Embase, CINAHL, MEDLINE In Process, Scopus citations and Google Scholar for relevant articles published between January 1 2000-July 31 2013. We screened 10,803 abstracts and retrieved 281 full-text manuscripts. Fifty-two peer-reviewed, English-language manuscripts met our inclusion criteria: an aim/method investigating prescription drug misuse and a measure of misuse derived exclusively from prescription/dispensing data.Results Four proxies of prescription drug misuse were used commonly across studies: number of prescribers, dispensing pharmacies, early refills and volume of drugs dispensed. We identified 89 unique measures of misuse across the 52 studies, reflecting the heterogeneity in how measures are constructed; single or composite; different thresholds, cohort definitions and time period of assessment. Consequently, it was not possible to make definitive comparisons about the extent (range reported: 0.01-93.5%), variations and factors associated with prescription drug misuse.Conclusion Routine data collections are relatively consistent across jurisdictions. Despite the heterogeneity of the current literature, our review identifies the capacity to develop universally accepted metrics of misuse applied to a core set of variables in prescription/dispensing claims. Our timely recommendations have the potential to unify the global research field and increase the capacity for routine surveillance of prescription drug misuse. 3 Key points Prescription drug misuse is increasing globally. This can be monitored readily using routinely collected data; quantifying drug access patterns at the population-level. Our review identified only four common proxies for prescription drug misuse (number of prescribers; number of dispensing pharmacies; volume of drug(s) dispensed; and/or overlapping prescriptions/early refills) yet they were used to derive 89 unique definitions of misuse due to variations in thresholds, or use alone or in combination. We recommend the development of consistent and replicable metrics to facilitate monitoring and comparisons of the extent of prescription drug misuse across health care settings and over time.

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Selective prescribing of atypical antipsychotics

Cited by 8 publications

References 12 publications

Risk of Extrapyramidal Syndrome in Schizophrenic Patients Treated with Antipsychotics: A Population-based Study

Risk of Extrapyramidal Syndrome in Schizophrenic Patients Treated with Antipsychotics: A Population-based Study

Treatment of Schizophrenia With Long-Acting Fluphenazine, Haloperidol, or Risperidone

Harmonizing Post-Market Surveillance of Prescription Drug Misuse: A Systematic Review of Observational Studies Using Routinely Collected Data (2000–2013)

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