Liu Yifei, Patterson Mark E, Sahil Suman, Stoner Steven C
Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, MO, United States.
Department of Biomedical and Health Informatics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States.
Front Pharmacol. 2023 May 22;14:1140969. doi: 10.3389/fphar.2023.1140969. eCollection 2023.
Long-acting injectable (LAI) antipsychotics (APs) each have an oral equivalent formulation, while aripiprazole, olanzapine, and ziprasidone each also have a short-acting injectable (SAI) equivalent formulation. Inpatient prescribing patterns of LAIs and their oral/SAI equivalents are less characterized in populations other than Medicaid, Medicare, and Veterans Affairs populations. Mapping out inpatient prescribing patterns remains an important first step to ensure appropriate use of antipsychotics during this critical juncture of patient care prior to discharge. This study determined inpatient prescribing patterns of first- (FGA) and second-generation antipsychotic (SGA) LAIs and their oral/SAI formulations. This was a large retrospective study using the Cerner Health Facts® database. Hospital admissions due to schizophrenia, schizoaffective disorder, or bipolar disorder from 2010 to 2016 were identified. AP utilization was defined as the proportion of inpatient stays during which at least 1 AP was administered to the total number of inpatient visits over the observed period. Descriptive analyses were used to determine prescribing patterns for APs. Chi-square tests were used to determine utilization differences across years. 94,989 encounters were identified. Encounters during which oral/SAI of SGA LAIs were administered were most common (n = 38,621, 41%). Encounters during which FGA LAIs or SGA LAIs were administered were the least common (n = 1,047, 1.1%). Prescribing patterns differed across years ( < 0.05) within the SGA LAI subgroup analysis (N = 6,014). Paliperidone palmitate (63%, N = 3,799) and risperidone (31%, N = 1,859) were the most frequently administered. Paliperidone palmitate utilization increased from 30% to 72% ( < 0.001), while risperidone utilization decreased from 70% to 18% ( < 0.001). Compared with their oral or SAI formulations, LAIs were underutilized from 2010 to 2016. Among SGA LAIs, the prescribing patterns of paliperidone palmitate and risperidone changed significantly.
长效注射用（LAI）抗精神病药物（APs）均有口服等效制剂，而阿立哌唑、奥氮平和齐拉西酮也均有短效注射用（SAI）等效制剂。除医疗补助、医疗保险和退伍军人事务人群外，其他人群中LAIs及其口服/SAI等效制剂的住院处方模式鲜为人知。梳理住院处方模式仍然是确保在出院前这个关键的患者护理阶段合理使用抗精神病药物的重要第一步。本研究确定了第一代（FGA）和第二代抗精神病药物（SGA）LAIs及其口服/SAI制剂的住院处方模式。这是一项使用Cerner Health Facts®数据库的大型回顾性研究。确定了2010年至2016年因精神分裂症、分裂情感性障碍或双相情感障碍而住院的患者。AP的使用定义为在观察期内至少使用1种AP的住院天数占总住院就诊次数的比例。采用描述性分析来确定AP的处方模式。使用卡方检验来确定各年份之间的使用差异。共识别出94989次就诊。使用SGA LAIs的口服/SAI制剂的就诊最为常见（n = 38621，41%）。使用FGA LAIs或SGA LAIs的就诊最不常见（n = 1047，1.1%）。在SGA LAI亚组分析（N = 6014）中，各年份的处方模式存在差异（< 0.05）。棕榈酸帕利哌酮（63%，N = 3799）和利培酮（31%，N = 1859）的使用最为频繁。棕榈酸帕利哌酮的使用率从30%增加到72%（< 0.001），而利培酮的使用率从70%下降到18%（< 0.001）。与口服或SAI制剂相比，2010年至2016年期间LAIs的使用不足。在SGA LAIs中，棕榈酸帕利哌酮和利培酮的处方模式发生了显著变化。
