Background:
Following deinstitutionalization in Australia, there is little published literature on the use of antipsychotics in treating psychotic disorders under the new community-based paradigm of care. The present pharmacoepidemiological study was undertaken to examine the trends in antipsychotic prescribing in a number of service settings in Victoria from 1998 to 2003 to understand how such trends relate to community care.
Methods:
Patients in community care teams from Northwestern Mental Health, Barwon Health, Grampians Health and Austin were sampled at various time points from 1998 (T1) to 2003 (T4) (n = 3966). Prescribing information and a slew of sociodemo-graphic and adjunct treatment variables such as community treatment order status were ascertained.
Results:
Between 1998 and 2003, prescriptions of second-generation (‘atypical’) antipsychotics grew to account for 78% of patients with schizophrenia being treated with these agents (RR 2.1, P < 0.01). Firstgeneration (‘typical’) antipsychotics decreased to <3% of prescriptions (RR .11, P < 0.01) and depots fell and stabilized at about 30% of prescriptions (RR .64, P < 0.01).
Conclusions:
Oral SGAs have largely replaced oral FGAs; yet, despite the apparent endorsement of the new agents, depot FGAs remain a mainstay of prescribing. This may reflect that up to 67% of patients show partial adherence with oral antipsychotics. The maintenance of depot prescribing meets the needs for prevention relapse as a primary outcome goal.
