Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland.
University of Eastern Finland, School of Pharmacy, Kuopio, Finland.
Nord J Psychiatry. 2021 Jul;75(5):315-322. doi: 10.1080/08039488.2020.1854853. Epub 2020 Dec 17.
To compare the differences in prevalence of antipsychotic and adjunctive pharmacotherapy use among individuals with schizophrenia between Sweden and Finland during 2006-2016.
Nationwide register-based data were utilized for constructing two separate cohorts: all persons in Finland with a diagnosis of schizophrenia treated in inpatient care during 1972-2014, and persons in Sweden aged 16-64 with recorded diagnoses of schizophrenia in inpatient or specialized outpatient care, sickness absence or disability pension during 2005-2013. The prevalence of use was assessed as a point prevalence on 31 October each year 2006-2016, based on drug use periods modelled with the PRE2DUP method. In 2016, the Finnish cohort included 37,780 persons and Swedish cohort 25,433 persons.
The most commonly used antipsychotic in 2016 was oral olanzapine in both countries (22.7% [95% CI 21.6-22.4] in Finland, 20.9% [20.4-21.4] in Sweden), followed by clozapine which was more frequently used in Finland (22.0%, 21.6-22.4) than in Sweden (14.8%, 14.4-15.3). Long-acting injectable (LAI) use was almost two times more likely in Sweden (21.6%, 95% CI 21.1-22.1) than in Finland (12.8%, 12.5-13.1), a difference which was due to more common use of FG-LAIs in Sweden. A four-fold difference was observed in Z-drugs use (19.9% in Sweden versus 5.0% in Finland).
Potential explanations for the observed discrepancies include differences in national treatment guidelines, methods of data collection, patient characteristics and/or attitudes towards treatment among both patients and physicians.
比较 2006-2016 年间瑞典和芬兰精神分裂症患者抗精神病药物和辅助药物治疗使用的差异。
利用全国范围内基于登记的资料构建了两个独立队列：芬兰队列包括在 1972-2014 年期间接受住院治疗的所有精神分裂症患者；瑞典队列包括在 2005-2013 年期间在住院或专科门诊治疗、休病假或领取残疾抚恤金的年龄在 16-64 岁的记录诊断为精神分裂症的患者。2006-2016 年，每年 10 月 31 日，根据 PRE2DUP 方法建立的药物使用期间，评估使用的患病率，为时点患病率。2016 年，芬兰队列包括 37780 人，瑞典队列包括 25433 人。
2016 年，两国最常用的抗精神病药物均为奥氮平口服制剂（芬兰为 22.7%[95%CI21.6-22.4]，瑞典为 20.9%[20.4-21.4]），其次是氯氮平，芬兰（22.0%[21.6-22.4]）的使用频率高于瑞典（14.8%[14.4-15.3]）。长效注射剂（LAI）在瑞典（21.6%[95%CI21.1-22.1]）的使用率几乎是芬兰（12.8%[12.5-13.1]）的两倍，这主要是由于瑞典更常使用 FG-LAI。唑吡坦类药物（Z 药）的使用也存在四倍差异（瑞典为 19.9%，芬兰为 5.0%）。
观察到的差异可能与国家治疗指南、数据收集方法、患者特征以及患者和医生对治疗的态度等因素有关。
