DISCHARGE PRESCRIPTION PATTERNS OF ANTIPSYCHOTICS IN PATIENTS WITH MENTAL ILLNESS HOSPITALIZED COMPULSORILY BY PREFECTURAL GOVERNORS
Author(s)
Inagaki A1, Seto H2, Shimada T3, Oguchi Y4, Endoh Y5, Koizumi N6, Yoshizumi A7
1Aoyama Gakuin University, Shibuya, Tokyo, Japan, 2Nagasaki Medical Center of Psychiatry, Ohmura, Nagasaki, Japan, 3Tochigi Prefectural Okamotodai Hospital, Utsunomiya, Tochigi, Japan, 4Japan Agency for Medical Research and Development, Chiyoda, Tokyo, Japan, 5Seiwa Hospital, Institute of Neuropsychiatry, Shinjuku, Tokyo, Japan, 6Nagano Prefectural Mental Health and Welfare Center, Nagano, Nagano, Japan, 7Yahata Kosei Hospital, Kitakyusyu, Fukuoka, Japan
OBJECTIVES: To examine the discharge prescription patterns of antipsychotics in patients with mental illness hospitalized compulsorily by prefectural governors in accordance with the provisions of Article 29 of the Japanese Mental Health Act. METHODS: This was a retrospective cohort study conducted on the Article 29 patients admitted during fiscal year 2010 to 79 Japanese mental hospitals. We analyzed patients who were diagnosed with psychotic disorders (ICD-10: F2) and prescribed at least one antipsychotic. Extracted data included gender, age, principal psychiatric diagnosis (based on ICD-10), treatment history, and types and doses of antipsychotics at discharge. RESULTS: The cohort consisted of 440 males and 222 females, with an average age (standard deviation) of 43.6 years (13.3). The most frequent diagnostic subcategory was schizophrenia (F20; n=542), followed by acute and transient psychotic disorders (F23; n=33), schizoaffective disorders (F25; n=29), and persistent delusional disorders (F22; n=26). Of the 662 patients, 258 had never experienced psychiatric hospitalization before the index admission, and 133 of these had never undergone psychiatric treatment. Oral antipsychotics were prescribed for 651 patients; of these, 241 and 588 were prescribed first-generation and second-generation antipsychotics (SGAs), respectively. Among the SGAs, risperidone (39.7%; n=263) had the highest prescription rate, followed by olanzapine (n=223), aripiprazole (n=70), quetiapine (n=66), blonanserin (n=42), perospirone (n=8), paliperidone (n=8), and clozapine (n=2). Antipsychotic long-acting injections (LAIs) were administered in 84 (12.7%) patients; of these, haloperidol LAI (5.6%; n=37) had the highest utilization rate, followed by risperidone LAI (4.4%; n=29) and fluphenazine LAI (3.0%; n=20). Antipsychotic polypharmacy was conducted in 297 (44.9%) patients; of these, 89 (13.4%) were prescribed three or more concurrent antipsychotics. CONCLUSIONS: At discharge, about four ninths of the Article 29 patients in Japan are apparently treated with antipsychotic polypharmacy.
Conference/Value in Health Info
2016-10, ISPOR Europe 2016, Vienna, Austria
Value in Health, Vol. 19, No. 7 (November 2016)
Code
PMH41
Topic
Health Service Delivery & Process of Care
Topic Subcategory
Prescribing Behavior
Disease
Mental Health