Dataset Information

Primary Nonadherence to Antipsychotic Treatment Among Persons with Schizophrenia.

ABSTRACT: It has remained unclear what factors relate to primary nonadherence to antipsychotic treatment and whether specific agents and routes of administration differ in how patients adhere to them. We collected electronic prescriptions and their dispensings from the Finnish electronic prescription database for 29 956 patients with schizophrenia prescribed antipsychotics via electronic prescription during 2015-2016. We defined primary nonadherence as being prescribed an antipsychotic, which was not dispensed from the pharmacy within one year from prescription. Using logistic regression, we analyzed whether several sociodemographic and clinical factors related to nonadherence. We found that 31.7% (N = 9506) of the patients demonstrated primary nonadherence to any of their prescribed antipsychotics. We found that young age (OR = 1.77, 95%CI = 1.59-1.96), concomitant benzodiazepines (OR = 1.47, 95%CI = 1.40-1.55) and mood stabilizers (OR = 1.29, 95%CI = 1.21-1.36), substance abuse (OR = 1.26 95%CI = 1.19-1.35), previous suicide attempt (OR = 1.21, 95%CI = 1.11-1.31), diabetes (OR = 1.15, 95%CI = 1.06-1.25), asthma/COPD (OR = 1.14, 95%CI = 1.04-1.25), and cardiovascular disease (OR = 1.12, 95%CI = 1.05-1.19), were related to primary nonadherence to antipsychotic treatment. Patients using clozapine showed the lowest nonadherence (4.77%, 95%CI = 4.66-4.89), and patients using long-acting injectables were more adherent to treatment (7.27%, 95%CI = 6.85-7.71) when compared to respective oral agents (10.26%, 95%CI = 10.02-10.49). These results suggest that selection between different pharmacological agents and routes of administration while taking into account patients' concomitant medications (benzodiazepines in particular) and comorbidities play a key role in primary nonadherence to antipsychotic treatment.

SUBMITTER: Lieslehto J

PROVIDER: S-EPMC9077427 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

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Primary Nonadherence to Antipsychotic Treatment Among Persons with Schizophrenia.

Lieslehto Johannes J Tiihonen Jari J Lähteenvuo Markku M Tanskanen Antti A Taipale Heidi H

Schizophrenia bulletin 20220501 3

It has remained unclear what factors relate to primary nonadherence to antipsychotic treatment and whether specific agents and routes of administration differ in how patients adhere to them. We collected electronic prescriptions and their dispensings from the Finnish electronic prescription database for 29 956 patients with schizophrenia prescribed antipsychotics via electronic prescription during 2015-2016. We defined primary nonadherence as being prescribed an antipsychotic, which was not disp ...[more]

PMID: 35253056

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Project description:BackgroundSince the introduction of antipsychotics, especially the so called atypicals, the treatment of schizophrenia has shown important improvements. At the present time, it is preferred to label clozapine and other antipsychotics sharing similar profiles as second-generation antipsychotics (SGAs). These medications have been proposed by some experts as a first line treatment for schizophrenia. It is critical to have reliable data about antipsychotic prescription in Mexico and to create management guidelines based on expert meetings and not only on studies carried out by the pharmaceutical industry. Only this approach will help to make the right decisions for the treatment of schizophrenia.MethodsA translated version of Rabinowitz's survey was used to evaluate antipsychotic prescription preferences and patterns in Mexican psychiatrists. The survey questionnaire was sent by mail to 200 psychiatrists from public institutions and private practice in Mexico City and Guadalajara, Mexico.ResultsRecommendations for antipsychotics daily doses at different stages of the treatment of schizophrenia varied widely. Haloperidol was considered as the first choice for the treatment of positive symptoms. On the contrary, risperidone was the first option for negative symptoms. For a patient with a high susceptibility for developing extrapyramidal symptoms (EPS), risperidone was the first choice. It was also considered that SGAs had advantages over typical antipsychotics in the management of negative symptoms, cognitive impairment and fewer EPS.Besides, there was a clear tendency for prescribing typical antipsychotics at higher doses than recommended and inadequate doses for the atypical ones.ConclusionsSome of the obstacles for the prescription of SGAs include their high cost, deficient knowledge about their indications and dosage, the perception of their being less efficient for the treatment of positive symptoms and the resistance of some Mexican physicians to change their prescription pattern. It is necessary to reach a consensus, in order to establish and standardize the treatment of schizophrenia, based on the information reported in clinical trials and prevailing economic conditions in Mexico.

Dataset Information

Primary Nonadherence to Antipsychotic Treatment Among Persons with Schizophrenia.

Publications

Primary Nonadherence to Antipsychotic Treatment Among Persons with Schizophrenia.

Similar Datasets

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