MRC General Practice Research Framework, London, UK.
Pharmacoepidemiol Drug Saf. 2012 Feb;21(2):161-9. doi: 10.1002/pds.2213. Epub 2011 Aug 19.
There is little information regarding antipsychotic prescription in primary care, despite general practitioners issuing most ongoing prescriptions. We sought to investigate changes in oral antipsychotic prescriptions in primary care from January 1998 to December 2007.
We conducted a cohort analysis of patients diagnosed with schizophrenia in primary care in the United Kingdom, using The Health Improvement Network database, to determine the proportions of prescribed antipsychotics. We investigated the yearly estimates of the overall time patients spent in treatment with any antipsychotic as well as the class of antipsychotic and individual antipsychotic agent.
We found that in any one calendar year, approximately 24% of patients previously prescribed antipsychotics do not receive treatment in primary care. Over the last decade, people with schizophrenia have been prescribed antipsychotic treatment for greater proportions of time. The greatest increase was observed in older women. The overall increase in treatment time can be attributed to the increased prescription of second-generation antipsychotics (SGAs). The annual proportion of time in SGA treatment increased from 16.6% to 51.2% within the study period, whereas time in first-generation antipsychotic treatment reduced from 37.1% to 15.0%. Overall, olanzapine, risperidone and sulpiride were prescribed for the longest periods of time.
Over the last decade, the general practice of prescribing SGAs has increased whereas first-generation antipsychotic prescriptions have declined. By 2007, patients with schizophrenia were prescribed antipsychotics for greater proportions of time, perhaps reflecting the greater acceptability of SGAs or a shift from secondary to primary care prescription.
尽管全科医生开具了大多数持续性处方，但有关初级保健中抗精神病药物处方的信息却很少。我们试图调查从 1998 年 1 月至 2007 年 12 月期间，初级保健中口服抗精神病药物处方的变化情况。
我们使用英国的健康改善网络数据库（The Health Improvement Network database），对初级保健中被诊断为精神分裂症的患者进行了队列分析，以确定处方抗精神病药物的比例。我们调查了患者接受任何抗精神病药物治疗的总时间以及抗精神病药物的类别和个别抗精神病药物的年度估计值。
我们发现，在任何一个日历年中，大约有 24%的曾接受过抗精神病药物治疗的患者未在初级保健中接受治疗。在过去的十年中，精神分裂症患者接受抗精神病药物治疗的时间比例有所增加。在年龄较大的女性中观察到的增幅最大。治疗时间的总体增加归因于第二代抗精神病药物（SGAs）的处方增加。在研究期间，SGAs 治疗的年比例从 16.6%增加到 51.2%，而第一代抗精神病药物治疗的时间从 37.1%减少到 15.0%。总体而言，奥氮平、利培酮和舒必利的处方时间最长。
在过去的十年中，初级保健中开具 SGAs 的处方有所增加，而第一代抗精神病药物的处方有所减少。到 2007 年，精神分裂症患者接受抗精神病药物治疗的时间比例有所增加，这也许反映了 SGAs 的可接受性增加，或者从二级保健转向初级保健处方的转变。
