Kochi Kenji, Sato Izumi, Nishiyama Chika, Tanaka-Mizuno Sachiko, Doi Yuko, Arai Masaru, Fujii Yosuke, Matsunaga Toshiyuki, Ogawa Yusuke, Furukawa Toshi A, Kawakami Koji
Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
Medical Affairs, Drug Development Division, Sumitomo Dainippon Pharma Co. Ltd, Tokyo, Japan.
Pharmacoepidemiol Drug Saf. 2017 Jun;26(6):642-656. doi: 10.1002/pds.4187. Epub 2017 Mar 7.
This study aimed to assess the trends in antipsychotic prescriptions for outpatients in Japan, where a community-based approach to mental healthcare is emphasized.
This descriptive epidemiological study used claims data from 1038 community pharmacies across Japan. Outpatients who were ≥18 years old and receiving their initial antipsychotic prescription during 2006-2012 were evaluated. The annual trends were reported for monotherapies, polypharmacy, antipsychotic doses, and the concurrent prescription of psychotropic medications.
The 152 592 outpatients included 101 133 (66%) adults (18-64 years old) and 51 459 (34%) older adults (≥65 years old). Among the adults, second-generation antipsychotic monotherapy prescriptions increased from 49% in 2006 to 71% in 2012, first-generation antipsychotic monotherapy prescriptions decreased from 29 to 14%, and antipsychotic polypharmacy decreased from 23 to 15%, respectively. Among the older adults, second-generation antipsychotic monotherapy prescriptions increased from 64 to 82%, first-generation antipsychotic monotherapy prescriptions decreased from 29 to 12%, and antipsychotic polypharmacy decreased from 7 to 6%, respectively. During the study period, >80% of the adults and >90% of the older adults received antipsychotics at risperidone-equivalent doses of <6 mg/day. Anxiolytics/hypnotics, antidepressants, antiparkinson agents, mood stabilizers, and anti-dementia agents were concurrently prescribed with antipsychotics for 70, 33, 20, 20, and 0.3% of the adults and for 43, 16, 19, 8, and 16% of the older adults, respectively.
The present study evaluated large-scale claims-based datasets and found that high-dose prescriptions and antipsychotic polypharmacy among Japanese outpatients were not as prevalent as has been previously thought. Copyright © 2017 John Wiley & Sons, Ltd.
本研究旨在评估日本门诊患者抗精神病药物处方的趋势，日本强调以社区为基础的精神卫生保健方法。
这项描述性流行病学研究使用了来自日本1038家社区药房的索赔数据。对年龄≥18岁且在2006 - 2012年期间首次接受抗精神病药物处方的门诊患者进行评估。报告了单一疗法、联合用药、抗精神病药物剂量以及精神药物联合处方的年度趋势。
152592名门诊患者中包括101133名（66%）成年人（18 - 64岁）和51459名（34%）老年人（≥65岁）。在成年人中，第二代抗精神病药物单一疗法处方从2006年的49%增加到2012年的71%，第一代抗精神病药物单一疗法处方从29%降至14%，抗精神病药物联合用药从23%降至15%。在老年人中，第二代抗精神病药物单一疗法处方从64%增加到82%，第一代抗精神病药物单一疗法处方从29%降至12%；抗精神病药物联合用药从7%降至6%。在研究期间，超过80%的成年人和超过90%的老年人接受的抗精神病药物剂量相当于利培酮每日剂量<6毫克。成年人中，分别有70%、33%、20%、20%和0.3%的患者同时使用抗精神病药物和抗焦虑/催眠药、抗抑郁药、抗帕金森病药、心境稳定剂和抗痴呆药；老年人中这一比例分别为43%、16%、19%、8%和16%。
本研究评估了基于索赔的大规模数据集，发现日本门诊患者中的高剂量处方和抗精神病药物联合用药并不像之前认为的那么普遍。版权所有© 2017约翰威立父子有限公司。
