Department of Psychiatry, Yong-In Mental Hospital, Yongin, Korea. ; Institute of Mental Health, Hanyang University, Seoul, Korea.
Seoul Mental Health Center & Seoul Suicide Prevention Center, Seoul, Korea.
J Korean Med Sci. 2014 May;29(5):719-28. doi: 10.3346/jkms.2014.29.5.719. Epub 2014 Apr 25.
This study aimed to analyze the patterns of antipsychotic prescription to patients with schizophrenia in Korea. Using the Health Insurance Review & Assessment Service-National Patients Sample (HIRA-NPS), which was a stratified sampling from the entire population under the Korean national health security system (2009), descriptive statistics for the patterns of the monopharmacy and polypharmacy, neuropsychiatric co-medications, and prescribed individual antipsychotic for patients with schizophrenia were performed. Comparisons of socioeconomic and clinical factors were performed among patients prescribed only with first- and second-generation antipsychotics. Of 126,961 patients with schizophrenia (age 18-80 yr), 13,369 were prescribed with antipsychotic monopharmacy and the rest 113,592 with polypharmacy. Two or more antipsychotics were prescribed to 31.34% of the patients. Antiparkinson medications (66.60%), anxiolytics (65.42%), mood stabilizers (36.74%), and antidepressants (25.90%) were co-medicated. Patients who were prescribed only with first-generation antipsychotics (n=26,254) were characterized by significantly older age, greater proportion of male, higher proportion of medicaid, higher total medical cost, lower self-payment cost, and higher co-medication rates of antiparkinson agents and anxiolytics than those who were prescribed only with second-generation antipsychotics (n=67,361). In this study, it has been reported substantial prescription rates of first-generation antipsychotics and antipsychotic polypharmacy and relatively small prescription rate of clozapine to patients with schizophrenia. Since this study has firstly presented the patterns of antipsychotic prescription to schizophrenic patients in Korean national population, the findings of this study can be compared with those of later investigations about this theme.
本研究旨在分析韩国精神分裂症患者抗精神病药物的处方模式。使用韩国国家健康保障体系(2009 年)下全民健康保险审查和评估服务-国家患者样本(HIRA-NPS),对精神分裂症患者的单药和多药治疗、神经精神共用药以及个体抗精神病药物处方模式进行描述性统计。对仅使用第一代和第二代抗精神病药物处方的患者进行了社会经济和临床因素的比较。在 126961 例精神分裂症患者(年龄 18-80 岁)中,有 13369 例患者接受了单药治疗,其余 113592 例患者接受了多药治疗。有 31.34%的患者使用了两种或两种以上的抗精神病药物。共使用了抗帕金森药物(66.60%)、抗焦虑药物(65.42%)、心境稳定剂(36.74%)和抗抑郁药(25.90%)。仅使用第一代抗精神病药物(n=26254)的患者年龄较大,男性比例较高,医疗补助比例较高,总医疗费用较高,自付费用较低,抗帕金森药物和抗焦虑药物的共用药率也较高,而仅使用第二代抗精神病药物(n=67361)的患者则相反。在本研究中,报告了第一代抗精神病药物和抗精神病药物联合用药的处方率较高,而氯氮平的处方率相对较低,用于治疗精神分裂症患者。由于本研究首次报告了韩国全国人口中精神分裂症患者抗精神病药物的处方模式,因此本研究的结果可与以后关于这一主题的调查结果进行比较。