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. |
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| 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] |
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| Database: | Psychology and Behavioral Sciences Collection |
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