Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong.
Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK.
Pharmacoepidemiol Drug Saf. 2021 Nov;30(11):1588-1600. doi: 10.1002/pds.5318. Epub 2021 Jul 8.
Bipolar disorder (BPD) is often an under-addressed mental disorder. Limited studies have investigated its epidemiology and drug utilisation in Hong Kong (HK) and the United Kingdom (UK) and thus local prescribing practices remain unclear. This study aimed to determine the prevalence of BPD and the prescribing of psychotropic medications as maintenance treatment from 2001-2018 in HK and the UK.
A retrospective study using the data from Clinical Data Analysis and Reporting System in HK and IQVIA Medical Research Data in the UK.
The prevalence of BPD diagnosis in HK and the UK more than doubled during the study period. Some distinct changes in prescribing patterns over time were observed. Lithium use declined by 2.46% and 14.58% in HK and the UK, respectively. By 2018, patients were 4.6 times more likely to receive antidepressant monotherapy in the UK versus HK (15.62% vs. 3.42%). In HK, 38.41% of women of childbearing age were prescribed valproate in 2018 compared with 8.46% in the UK.
The prevalence of BPD diagnosis has been increasing in HK and the UK. The disparity in prescribing patterns of BPD maintenance treatment in two regions reflected three major issues in clinical practice: (1) under-prescribing of lithium in both regions, (2) antidepressant monotherapy in the UK and (3) overprescribing of valproate to women of childbearing age in HK. A review of current clinical treatment guidelines and regulations of prescribing practice by local clinicians should be immediately implemented to ensure the safe use of medications in patients with BPD.
双相情感障碍（BPD）常被忽视。目前关于香港（HK）和英国（UK）的 BPD 流行病学和药物使用情况的研究有限，因此当地的处方实践仍不清楚。本研究旨在确定 2001 年至 2018 年期间在 HK 和 UK 中 BPD 的患病率和作为维持治疗的精神药物的处方情况。
这是一项使用 HK 的临床数据分析和报告系统和 UK 的 IQVIA 医学研究数据的回顾性研究。
在研究期间，HK 和 UK 中 BPD 的诊断患病率增加了一倍以上。随着时间的推移，观察到一些处方模式的明显变化。锂的使用在 HK 和 UK 中分别下降了 2.46%和 14.58%。到 2018 年，与 HK 相比（15.62%比 3.42%），英国的患者更有可能接受抗抑郁药单药治疗，可能性高 4.6 倍。在 HK，2018 年有 38.41%的育龄妇女被开了丙戊酸盐处方，而 UK 只有 8.46%。
在 HK 和 UK，BPD 的诊断患病率一直在增加。两个地区在 BPD 维持治疗的处方模式上存在差异，反映了临床实践中的三个主要问题：（1）两个地区锂的处方不足；（2）英国的抗抑郁药单药治疗；（3）HK 中育龄妇女丙戊酸盐的过度处方。当地临床医生应立即审查当前的临床治疗指南和处方实践规定，以确保 BPD 患者安全用药。
