Lao Kim S J, Tam Anthony W Y, Wong Ian C K, Besag Frank M C, Man Kenneth K C, Chui Celine S L, Chan Esther W
Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong, China.
Research Department of Practice and Policy, UCL School of Pharmacy, London, UK.
Pharmacoepidemiol Drug Saf. 2017 Nov;26(11):1387-1394. doi: 10.1002/pds.4244. Epub 2017 Jun 30.
Antipsychotic-prescribing patterns remain unclear in Asia. The aims of our study were to investigate prescribing trends of antipsychotic medication in the general population, children, and older patients by drug generation (first or second), the prescribing trend in pregnant women, the probable indication for antipsychotic prescription, and the prescribing trend by dosage form.
This descriptive study identified and included all patients prescribed with antipsychotic in Hong Kong from 2004 to 2014 using the Clinical Data Analysis and Report System. This study calculated and reported the prevalence of antipsychotic prescribing in patient groups of interest, the percentage with diagnoses of mental disorders were derived, and the prevalence of antipsychotic by dosage forms.
The study included 10 109 206 prescriptions of any antipsychotics to 256 903 patients. Over the study period, the prevalence of antipsychotic prescribing increased from 1.06% to 1.54% in the general population, from 0.10% to 0.23% in children (3-17 years old), and from 2.61% to 3.26% in older patients (≥65 years old). The prevalence of second-generation antipsychotics increased, but the prevalence of first-generation antipsychotics did not. Prevalence of antipsychotic prescribing in prepregnancy, pregnancy, and postpartum timeframes varied from 0.18% to 0.38%. The percentage of incident prescriptions with a diagnosis of psychosis decreased from 54.1% to 47.5%.
Antipsychotics have been increasingly prescribed in the general population, children, and older patients. There is an increase in second-generation antipsychotic prescribing. Over half of incident users had a recent diagnosis of a nonpsychotic mental disorder in 2014, suggesting that off-label prescribing of antipsychotics might be common.
亚洲地区抗精神病药物的处方模式仍不明确。我们研究的目的是按药物代数（第一代或第二代）调查普通人群、儿童及老年患者中抗精神病药物的处方趋势、孕妇的处方趋势、抗精神病药物处方的可能适应症以及剂型的处方趋势。
这项描述性研究使用临床数据分析与报告系统，识别并纳入了2004年至2014年在香港开具抗精神病药物处方的所有患者。本研究计算并报告了目标患者群体中抗精神病药物处方的患病率、确诊精神障碍患者的百分比以及不同剂型抗精神病药物的患病率。
该研究纳入了向256903名患者开具的10109206份抗精神病药物处方。在研究期间，普通人群中抗精神病药物处方的患病率从1.06%增至1.54%，儿童（3至17岁）从0.10%增至0.23%，老年患者（≥65岁）从2.61%增至3.26%。第二代抗精神病药物的患病率上升，而第一代抗精神病药物的患病率未上升。孕前、孕期及产后时间段抗精神病药物处方的患病率在0.18%至0.38%之间。诊断为精神病的新处方百分比从54.1%降至47.5%。
普通人群、儿童及老年患者中抗精神病药物的处方量越来越大。第二代抗精神病药物的处方量有所增加。2014年，超过一半的新使用者近期被诊断为非精神病性精神障碍，这表明抗精神病药物的超说明书用药可能很常见。
