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Antipsychotic utilisation and persistence in Australia: A nationwide 5-year study.

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Title: Antipsychotic utilisation and persistence in Australia: A nationwide 5-year study.
Authors: Taylor, Mark, Dangelo-Kemp, Dante, Liu, Dennis, Kisely, Steve, Graham, Simon, Hartmann, Jodie, Colman, Sam
Source: Australian & New Zealand Journal of Psychiatry. Sep2022, Vol. 56 Issue 9, p1155-1163. 9p.
Subjects: Drug therapy for schizophrenia, Injections, Oral drug administration, Time, Retrospective studies, Disease relapse, Clozapine, Survival analysis (Biometry), Drugs, Descriptive statistics, Drug utilization, Patient compliance, Antipsychotic agents, Proportional hazards models
Geographic Terms: Australia
Abstract: Objectives: To evaluate the utilisation and persistence of antipsychotics for the treatment of schizophrenia in Australia. Methods: A retrospective study using the Australian Pharmaceutical Benefits Scheme database of a representative 10% sample. All adults with schizophrenia who were dispensed three or more supplies of oral (including clozapine) or long-acting injectable antipsychotics between 1 June 2015 and 31 May 2020 were included. Persistence time in treatment was evaluated using survival analysis and Cox hazard ratios. Results: In all, 26,847 adults with schizophrenia were studied. Oral second-generation antipsychotics were more frequently dispensed than the other antipsychotic groups studied. Median treatment persistence times were 18.3 months for second-generation antipsychotic long-acting injectables, 10.7 months for oral second-generation antipsychotics and were significantly lower for both formulations of first-generation antipsychotics at 5.2 months (long-acting injectables) and 3.7 months (oral). The median persistence time for clozapine was significantly longer than all other antipsychotics groups. Conclusions: Oral second-generation antipsychotics and second-generation antipsychotic long-acting injectables accounted for over 75% and 13% of all antipsychotics in Australia, respectively. Concerns over medication adherence and subsequent relapse have not translated into increased long-acting injectable usage despite their significantly longer persistence. Clozapine, the single most 'persistent' antipsychotic, was only used in 9% of people, although up to a third of all cases are likely to be treatment-resistant. Our data suggest clinicians should give consideration to the earlier use of second-generation antipsychotic long-acting injectables and clozapine, to ameliorate prognosis in schizophrenia. [ABSTRACT FROM AUTHOR]
Copyright of Australian & New Zealand Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Antipsychotic utilisation and persistence in Australia: A nationwide 5-year study.
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  Data: <searchLink fieldCode="JN" term="%22Australian+%26+New+Zealand+Journal+of+Psychiatry%22">Australian & New Zealand Journal of Psychiatry</searchLink>. Sep2022, Vol. 56 Issue 9, p1155-1163. 9p.
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  Data: <searchLink fieldCode="DE" term="%22Drug+therapy+for+schizophrenia%22">Drug therapy for schizophrenia</searchLink><br /><searchLink fieldCode="DE" term="%22Injections%22">Injections</searchLink><br /><searchLink fieldCode="DE" term="%22Oral+drug+administration%22">Oral drug administration</searchLink><br /><searchLink fieldCode="DE" term="%22Time%22">Time</searchLink><br /><searchLink fieldCode="DE" term="%22Retrospective+studies%22">Retrospective studies</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+relapse%22">Disease relapse</searchLink><br /><searchLink fieldCode="DE" term="%22Clozapine%22">Clozapine</searchLink><br /><searchLink fieldCode="DE" term="%22Survival+analysis+%28Biometry%29%22">Survival analysis (Biometry)</searchLink><br /><searchLink fieldCode="DE" term="%22Drugs%22">Drugs</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+utilization%22">Drug utilization</searchLink><br /><searchLink fieldCode="DE" term="%22Patient+compliance%22">Patient compliance</searchLink><br /><searchLink fieldCode="DE" term="%22Antipsychotic+agents%22">Antipsychotic agents</searchLink><br /><searchLink fieldCode="DE" term="%22Proportional+hazards+models%22">Proportional hazards models</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Australia%22">Australia</searchLink>
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  Label: Abstract
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  Data: Objectives: To evaluate the utilisation and persistence of antipsychotics for the treatment of schizophrenia in Australia. Methods: A retrospective study using the Australian Pharmaceutical Benefits Scheme database of a representative 10% sample. All adults with schizophrenia who were dispensed three or more supplies of oral (including clozapine) or long-acting injectable antipsychotics between 1 June 2015 and 31 May 2020 were included. Persistence time in treatment was evaluated using survival analysis and Cox hazard ratios. Results: In all, 26,847 adults with schizophrenia were studied. Oral second-generation antipsychotics were more frequently dispensed than the other antipsychotic groups studied. Median treatment persistence times were 18.3 months for second-generation antipsychotic long-acting injectables, 10.7 months for oral second-generation antipsychotics and were significantly lower for both formulations of first-generation antipsychotics at 5.2 months (long-acting injectables) and 3.7 months (oral). The median persistence time for clozapine was significantly longer than all other antipsychotics groups. Conclusions: Oral second-generation antipsychotics and second-generation antipsychotic long-acting injectables accounted for over 75% and 13% of all antipsychotics in Australia, respectively. Concerns over medication adherence and subsequent relapse have not translated into increased long-acting injectable usage despite their significantly longer persistence. Clozapine, the single most 'persistent' antipsychotic, was only used in 9% of people, although up to a third of all cases are likely to be treatment-resistant. Our data suggest clinicians should give consideration to the earlier use of second-generation antipsychotic long-acting injectables and clozapine, to ameliorate prognosis in schizophrenia. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Australian & New Zealand Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=158747353
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        Value: 10.1177/00048674211051618
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      – Code: eng
        Text: English
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      Pagination:
        PageCount: 9
        StartPage: 1155
    Subjects:
      – SubjectFull: Drug therapy for schizophrenia
        Type: general
      – SubjectFull: Injections
        Type: general
      – SubjectFull: Oral drug administration
        Type: general
      – SubjectFull: Time
        Type: general
      – SubjectFull: Retrospective studies
        Type: general
      – SubjectFull: Disease relapse
        Type: general
      – SubjectFull: Clozapine
        Type: general
      – SubjectFull: Survival analysis (Biometry)
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      – SubjectFull: Drugs
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      – SubjectFull: Descriptive statistics
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      – SubjectFull: Drug utilization
        Type: general
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      – SubjectFull: Antipsychotic agents
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      – SubjectFull: Australia
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      – TitleFull: Antipsychotic utilisation and persistence in Australia: A nationwide 5-year study.
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              M: 09
              Text: Sep2022
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              Y: 2022
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