Antipsychotic polypharmacy in a regional health service: a population-based study
<p>Abstract</p> <p>Background</p> <p>To analyse the extent and profile of outpatient regular dispensation of antipsychotics, both in combination and monotherapy, in the Barcelona Health Region (Spain), focusing on the use of clozapine and long-acting injections (LAI).&l...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2012-05-01
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| Series: | BMC Psychiatry |
| Subjects: | |
| Online Access: | http://www.biomedcentral.com/1471-244X/12/42 |
| _version_ | 1818919564936740864 |
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| author | Bernardo Miguel Coma Anna Ibáñez Cristina Zara Corinne Bari Josep Serrano-Blanco Antoni |
| author_facet | Bernardo Miguel Coma Anna Ibáñez Cristina Zara Corinne Bari Josep Serrano-Blanco Antoni |
| author_sort | Bernardo Miguel |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>To analyse the extent and profile of outpatient regular dispensation of antipsychotics, both in combination and monotherapy, in the Barcelona Health Region (Spain), focusing on the use of clozapine and long-acting injections (LAI).</p> <p>Methods</p> <p>Antipsychotic drugs dispensed for people older than 18 and processed by the Catalan Health Service during 2007 were retrospectively reviewed. First and second generation antipsychotic drugs (FGA and SGA) from the Anatomical Therapeutic Chemical classification (ATC) code N05A (except lithium) were included. A patient selection algorithm was designed to identify prescriptions regularly dispensed. Variables included were age, gender, antipsychotic type, route of administration and number of packages dispensed.</p> <p>Results</p> <p>A total of 117,811 patients were given any antipsychotic, of whom 71,004 regularly received such drugs. Among the latter, 9,855 (13.9%) corresponded to an antipsychotic combination, 47,386 (66.7%) to monotherapy and 13,763 (19.4%) to unspecified combinations. Of the patients given antipsychotics in association, 58% were men. Olanzapine (37.1%) and oral risperidone (36.4%) were the most common dispensations. Analysis of the patients dispensed two antipsychotics (57.8%) revealed 198 different combinations, the most frequent being the association of FGA and SGA (62.0%). Clozapine was dispensed to 2.3% of patients. Of those who were receiving antipsychotics in combination, 6.6% were given clozapine, being clozapine plus amisulpride the most frequent association (22.8%). A total of 3.800 patients (5.4%) were given LAI antipsychotics, and 2.662 of these (70.1%) were in combination. Risperidone was the most widely used LAI.</p> <p>Conclusions</p> <p>The scant evidence available regarding the efficacy of combining different antipsychotics contrasts with the high number and variety of combinations prescribed to outpatients, as well as with the limited use of clozapine.</p> |
| first_indexed | 2024-12-20T01:07:52Z |
| format | Article |
| id | doaj.art-dd13155f81e941689f921da5f3833a32 |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-12-20T01:07:52Z |
| publishDate | 2012-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-dd13155f81e941689f921da5f3833a322022-12-21T19:58:47ZengBMCBMC Psychiatry1471-244X2012-05-011214210.1186/1471-244X-12-42Antipsychotic polypharmacy in a regional health service: a population-based studyBernardo MiguelComa AnnaIbáñez CristinaZara CorinneBari JosepSerrano-Blanco Antoni<p>Abstract</p> <p>Background</p> <p>To analyse the extent and profile of outpatient regular dispensation of antipsychotics, both in combination and monotherapy, in the Barcelona Health Region (Spain), focusing on the use of clozapine and long-acting injections (LAI).</p> <p>Methods</p> <p>Antipsychotic drugs dispensed for people older than 18 and processed by the Catalan Health Service during 2007 were retrospectively reviewed. First and second generation antipsychotic drugs (FGA and SGA) from the Anatomical Therapeutic Chemical classification (ATC) code N05A (except lithium) were included. A patient selection algorithm was designed to identify prescriptions regularly dispensed. Variables included were age, gender, antipsychotic type, route of administration and number of packages dispensed.</p> <p>Results</p> <p>A total of 117,811 patients were given any antipsychotic, of whom 71,004 regularly received such drugs. Among the latter, 9,855 (13.9%) corresponded to an antipsychotic combination, 47,386 (66.7%) to monotherapy and 13,763 (19.4%) to unspecified combinations. Of the patients given antipsychotics in association, 58% were men. Olanzapine (37.1%) and oral risperidone (36.4%) were the most common dispensations. Analysis of the patients dispensed two antipsychotics (57.8%) revealed 198 different combinations, the most frequent being the association of FGA and SGA (62.0%). Clozapine was dispensed to 2.3% of patients. Of those who were receiving antipsychotics in combination, 6.6% were given clozapine, being clozapine plus amisulpride the most frequent association (22.8%). A total of 3.800 patients (5.4%) were given LAI antipsychotics, and 2.662 of these (70.1%) were in combination. Risperidone was the most widely used LAI.</p> <p>Conclusions</p> <p>The scant evidence available regarding the efficacy of combining different antipsychotics contrasts with the high number and variety of combinations prescribed to outpatients, as well as with the limited use of clozapine.</p>http://www.biomedcentral.com/1471-244X/12/42AntipsychoticsClozapineAntipsychotic combinationOutpatient setting |
| spellingShingle | Bernardo Miguel Coma Anna Ibáñez Cristina Zara Corinne Bari Josep Serrano-Blanco Antoni Antipsychotic polypharmacy in a regional health service: a population-based study BMC Psychiatry Antipsychotics Clozapine Antipsychotic combination Outpatient setting |
| title | Antipsychotic polypharmacy in a regional health service: a population-based study |
| title_full | Antipsychotic polypharmacy in a regional health service: a population-based study |
| title_fullStr | Antipsychotic polypharmacy in a regional health service: a population-based study |
| title_full_unstemmed | Antipsychotic polypharmacy in a regional health service: a population-based study |
| title_short | Antipsychotic polypharmacy in a regional health service: a population-based study |
| title_sort | antipsychotic polypharmacy in a regional health service a population based study |
| topic | Antipsychotics Clozapine Antipsychotic combination Outpatient setting |
| url | http://www.biomedcentral.com/1471-244X/12/42 |
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