Trends in antipsychotic prescriptions for Japanese outpatients during 2006–2012: a descriptive epidemiological study. Issue 6 (7th March 2017)

• Record Type: Journal Article
• Authors: Kochi, Kenji; Sato, Izumi; Nishiyama, Chika; Tanaka‐Mizuno, Sachiko; Doi, Yuko; Arai, Masaru; Fujii, Yosuke; Matsunaga, Toshiyuki; Ogawa, Yusuke; Furukawa, Toshi A.; Kawakami, Koji
• Is Part Of: Pharmacoepidemiology and drug safety. Volume 26:Issue 6(2017)
• Page Start: 642
• Page End: 656
• Publication Date: 2017-03-07
• Subjects: antipsychotics -- prescription trends -- high‐dose polypharmacy -- Japanese outpatient -- mental healthcare -- pharmacoepidemiology; Pharmacoepidemiology -- Periodicals; Chemotherapy -- Periodicals; Epidemiology -- Periodicals; 615.705
• DOI: 10.1002/pds.4187
• Languages: English
• ISSNs: 1053-8569

Abstract

Abstract: Purpose: This study aimed to assess the trends in antipsychotic prescriptions for outpatients in Japan, where a community‐based approach to mental healthcare is emphasized. Methods: This descriptive epidemiological study used claims data from 1038 community pharmacies across Japan. Outpatients who were ≥18 years old and receiving their initial antipsychotic prescription during 2006–2012 were evaluated. The annual trends were reported for monotherapies, polypharmacy, antipsychotic doses, and the concurrent prescription of psychotropic medications. Results: The 152 592 outpatients included 101 133 (66%) adults (18–64 years old) and 51 459 (34%) older adults (≥65 years old). Among the adults, second‐generation antipsychotic monotherapy prescriptions increased from 49% in 2006 to 71% in 2012, first‐generation antipsychotic monotherapy prescriptions decreased from 29 to 14%, and antipsychotic polypharmacy decreased from 23 to 15%, respectively. Among the older adults, second‐generation antipsychotic monotherapy prescriptions increased from 64 to 82%, first‐generation antipsychotic monotherapy prescriptions decreased from 29 to 12%, and antipsychotic polypharmacy decreased from 7 to 6%, respectively. During the study period, >80% of the adults and >90% of the older adults received antipsychotics at risperidone‐equivalent doses of <6 mg/day. Anxiolytics/hypnotics, antidepressants, antiparkinson agents, mood stabilizers, and anti‐dementia agents were concurrently prescribed with antipsychotics for 70, 33, 20, 20, and 0.3% of the adults and for 43, 16, 19, 8, and 16% of the older adults, respectively. Conclusions: The present study evaluated large‐scale claims‐based datasets and found that high‐dose prescriptions and antipsychotic polypharmacy among Japanese outpatients were not as prevalent as has been previously thought. Copyright © 2017 John Wiley & Sons, Ltd.