School of Medicine, University of Wollongong (UOW), Wollongong, Australia.
Illawarra Shoalhaven Local Health District (ISLHD), Wollongong, Australia.
BMC Psychiatry. 2022 Feb 12;22(1):110. doi: 10.1186/s12888-022-03755-z.
To examine real-world patterns of antipsychotic use in patients with schizophrenia Australia.
This retrospective cohort analysis was conducted using the Australian Commonwealth Department of Human Services Pharmaceutical Benefits Scheme (PBS) 10% sample data. Included data were for patients aged 16-years or older who initiated treatment for the first time with a PBS-reimbursed antipsychotic medication for schizophrenia between July 2013 and September 2017. Patterns of treatment usage were summarised descriptively. Differences in prescribing patterns by age and prescribing year were reported. Treatment persistence was estimated using Kaplan-Meier methods, with differences explored using log-rank tests. Values of p < 0.05 were considered statistically significant.
6,740 patients, representing 8,249 non-unique patients, received prescriptions for antipsychotic medications. Patients were aged 16 years to over 85 years (54.5% were < 55 years) and two-thirds of patients were male (61%). The majority of treatment episodes (62%, n = 5,139/8,249) were prescribed an atypical oral antipsychotic. Typical long-acting antipsychotic therapies (LATs) were prescribed 19% of the treatment episodes (n = 1,608/8,249. There was a small increase in prescribing of atypical LAT and typical LAT and a small decrease in atypical oral and clozapine prescribing over the study period. Treatment persistence was greatest in patients treated with clozapine, than in those treated with atypical LATs.
While the majority of patients receive atypical antipsychotic medications, one in five continue to use older typical LAT therapies. Patient age and time on therapy may be associated with choice of therapy. Persistence to atypical LAT therapy is better than for other treatment modalities in this real-world cohort.
在澳大利亚，检查精神分裂症患者抗精神病药物的实际使用模式。
这是一项回顾性队列分析，使用澳大利亚联邦人类服务部药品福利计划（PBS）10%样本数据进行。纳入的数据为 2013 年 7 月至 2017 年 9 月期间首次使用 PBS 报销的抗精神病药物治疗精神分裂症的 16 岁或以上患者。描述性总结治疗使用模式。按年龄和开处方年份报告处方模式的差异。使用 Kaplan-Meier 方法估计治疗的持久性，并使用对数秩检验探索差异。p 值<0.05 被认为具有统计学意义。
6740 名患者，代表 8249 名非唯一患者，接受了抗精神病药物处方。患者年龄为 16 岁至 85 岁以上（54.5%为<55 岁），三分之二的患者为男性（61%）。大多数治疗发作（62%，n=5139/8249）使用非典型口服抗精神病药物。典型长效抗精神病药物治疗（LAT）占治疗发作的 19%（n=1608/8249）。在研究期间，非典型 LAT 和典型 LAT 的处方略有增加，而非典型口服和氯氮平的处方略有减少。在接受氯氮平治疗的患者中，治疗的持久性最大，其次是接受非典型 LAT 治疗的患者。
尽管大多数患者使用非典型抗精神病药物，但仍有五分之一的患者继续使用较老的典型 LAT 治疗。患者年龄和治疗时间可能与治疗选择有关。在这个真实世界的队列中，与其他治疗方式相比，非典型 LAT 治疗的持久性更好。
