Antipsychotic prescribing practices in Connecticut's public mental health system: Rates of changing medications and prescribing styles
Antipsychotic prescribing practices in Connecticut's public mental health system: Rates of changing medications and prescribing styles
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DOI：
10.1093/oxfordjournals.schbul.a006920
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发表时间：
2002-01-01
影响因子：
6.6
通讯作者：
Essock, SM
中科院分区：
文献类型：
--
作者：
Covell, NH;Jackson, CT;Essock, SM
我们的特点是在康涅狄格州的公共精神卫生系统的处方，以评估实施循证用药算法的可行性。随机抽取的诊断为精神分裂症谱系障碍的门诊患者的用药记录显示，处方模式与整个美国相似。改变抗精神病药物的基本比率为中等。超过一半的患者接受癸酸类药物治疗，多药治疗并不常见，医生的处方模式存在差异。白种人患者更可能接受非典型抗精神病药物治疗，而不太可能接受癸酸药物治疗，拉丁美洲患者不太可能改变药物治疗。由于改变药物的基本比率是中等的，相当大比例的患者被规定使用较新的抗精神病药物，引入一种研究衍生的药物治疗算法，使用较新的非典型抗精神病药物作为一线药物，可能与当前的实践非常吻合。此外，实现这样的算法可以减少处方模式中的种族和民族差异。
We characterized prescribing in Connecticut's State public mental health system to assess the feasibility of implementing an evidence-based medication algorithm. Medication records for a random sample of outpatients with diagnoses of schizophrenia spectrum disorders showed prescribing patterns similar to the entire United States. The base rate of changing antipsychotic medications was moderate. Over half of patients received decanoate medications, polypharmacy was nontrivial, and there was variability in prescribing patterns across physicians. Caucasian patients were more likely to receive an atypical antipsychotic and less likely to have a decanoate medication, and Latino patients were less likely to change medications. Because the base rate of changing medications was moderate and a considerable proportion of patients were prescribed newer antipsychotic medications, introducing a research-derived medication algorithm with newer atypical antipsychotics as first line agents may fit well with current practice. Further, implementing such an algorithm may reduce racial and ethnic disparities in prescribing patterns.