International Research Collaborative - Oral Health and Equity, School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia; School of Medicine, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.
International Research Collaborative - Oral Health and Equity, School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia.
Res Social Adm Pharm. 2021 Jun;17(6):1159-1165. doi: 10.1016/j.sapharm.2020.09.001. Epub 2020 Sep 2.
Antipsychotic medications can be prescribed in Australia by medical and nurse practitioners under the Pharmaceutical Benefits Scheme (PBS). The current pharmacoepidemiology study aims to determine the dispensing rates of antipsychotic medicines in Australia, and to produce and examine a time-trend of the dispensing patterns of these medicines.
Dispensing counts of antipsychotic medication from 2006 to 2018 were accessed from the PBS dataset. All of the antipsychotic medicines dispensed were included for time trend analysis. Cumulative dispensing counts and defined daily dose (DDD) per 1000 concessional population days (DPD) were analysed for the purpose of time trend analysis.
Sixteen antipsychotic medications were assessed and had a total cumulative dispensing count of 33, 732, 404. Olanzapine had the highest cumulative prescription count and Quetiapine experienced the highest average dispensing count and rate as determined by DPD. Twelve out of the sixteen medications were second-generation antipsychotics (SGAs). Overall, eleven out of the sixteen medications (aripiprazole, asenapine, brexpiprazole, clozapine, flupentixol, lurasidone, olanzapine, paliperidone, quetiapine, ziprasidone, zuclopenthixol) had an increase in both dispensing count and rate, as expressed per DPD.
The current study highlights the increasing prescription rates of SGAs and the stagnation of FGA prescription among Australian health practitioners. This is observed through particularly large increase in the dispensing rates of Olanzapine and Quetiapine. Further interdisciplinary investigation is required to ensure that these medications are being prescribed under the appropriate medical rationale, particularly to groups that are vulnerable to the adverse effects of the medications.
在药品福利计划（PBS）下，澳大利亚的医疗和护士从业者可以开处抗精神病药物。本项当前的药物流行病学研究旨在确定澳大利亚抗精神病药物的配药率，并生成和检查这些药物的配药模式的时间趋势。
从 PBS 数据集获取了 2006 年至 2018 年抗精神病药物的配药计数。所有配出的抗精神病药物均纳入时间趋势分析。为了进行时间趋势分析，分析了每 1000 个优惠人群日（DPD）的累积配药计数和规定日剂量（DDD）。
评估了 16 种抗精神病药物，总累积配药计数为 33732404 。奥氮平的处方计数最高，而喹硫平的平均配药计数和 DPD 确定的配药率最高。16 种药物中有 12 种是第二代抗精神病药物（SGAs）。总体而言，16 种药物中有 11 种（阿立哌唑、阿塞那平、布瑞哌唑、氯氮平、氟奋乃静、鲁拉西酮、奥氮平、帕利哌酮、喹硫平、齐拉西酮、佐匹克隆）的 DPD 表示的配药计数和配药率均有所增加。
当前的研究强调了澳大利亚卫生保健从业者中 SGA 的处方率不断增加和 FGA 处方停滞不前的情况。这一点从奥氮平和喹硫平的配药率显著增加中可以看出。需要进一步进行跨学科研究，以确保这些药物是在适当的医学原理下开具的，特别是对于那些容易受到药物不良反应影响的群体。
