| アブストラクト | BACKGROUND: Contemporary data relating to antipsychotic prescribing in UK primary care for patients diagnosed with severe mental illness (SMI) are lacking. AIMS: To describe contemporary patterns of antipsychotic prescribing in UK primary care for patients diagnosed with SMI. METHOD: Cohort study of patients with an SMI diagnosis (i.e. schizophrenia, bipolar disorder, other non-organic psychoses) first recorded in primary care between 2000 and 2017 derived from Clinical Practice Research Datalink. Patients were considered exposed to antipsychotics if prescribed at least one antipsychotic in primary care between 2000 and 2019. We compared characteristics of patients prescribed and not prescribed antipsychotics; calculated annual prevalence rates for antipsychotic prescribing; and computed average daily antipsychotic doses stratified by patient characteristics. RESULTS: Of 309 378 patients first diagnosed with an SMI in primary care between 2000 and 2017, 212,618 (68.7%) were prescribed an antipsychotic between 2000 and 2019. Antipsychotic prescribing prevalence was 426 (95% CI, 420-433) per 1000 patients in the year 2000, reaching a peak of 550 (547-553) in 2016, decreasing to 470 (468-473) in 2019. The proportion prescribed antipsychotics was higher among patients diagnosed with schizophrenia (81.0%) than with bipolar disorder (64.6%) and other non-organic psychoses (65.7%). Olanzapine, quetiapine, risperidone and aripiprazole accounted for 78.8% of all antipsychotic prescriptions. Higher mean olanzapine equivalent total daily doses were prescribed to patients with the following characteristics: schizophrenia diagnosis, ethnic minority status, male gender, younger age and greater relative deprivation. CONCLUSIONS: Antipsychotic prescribing is dominated by olanzapine, quetiapine, risperidone and aripiprazole. We identified potential disparities in both the receipt and prescribed doses of antipsychotics across subgroups. To inform efforts to optimise prescribing and ensure equity of care, further research is needed to understand why certain groups are prescribed higher doses and are more likely to be treated with long-acting injectable antipsychotics compared with others. |
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| ジャーナル名 | The British journal of psychiatry : the journal of mental science |
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| Pubmed追加日 | 2024/12/18 |
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| 投稿者 | Richards-Belle, Alvin; Launders, Naomi; Hardoon, Sarah; Man, Kenneth K C; Bramon, Elvira; Osborn, David P J; Hayes, Joseph F |
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| 組織名 | Division of Psychiatry, University College London, London, UK.;Research Department of Practice and Policy, School of Pharmacy, University;College London, London, UK.;Centre for Medicines Optimisation Research and Education, University College;London Hospitals NHS Foundation Trust, London, UK.;Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine,;University of Hong Kong, Hong Kong.;Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong;Kong.;Camden and Islington NHS Foundation Trust, London, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/39690823/ |
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