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Stability of antipsychotic prescribing: description and relationship to readmission

Published online by Cambridge University Press:  24 June 2014

T Lambert and
B Singh
T Lambert
Affiliation:
OPEN/ORYGENThe University of Melbourne, Melbourne, Australia
B Singh
Affiliation:
The University of Melbourne, Melbourne, Australia
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Abstract

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Information

Type
Abstracts from ‘Brainwaves’— The Australasian Society for Psychiatric Research Annual Meeting 2006, 6–8 December, Sydney, Australia
Information
Acta Neuropsychiatrica , Volume 18 , Issue 6 , December 2006, pp. 260
Copyright
Copyright © 2006 Blackwell Munksgaard

Background:

As showed by the CATIE study, anti-psychotic prescribing/switching stability appears to be less than robust. Little is known of longitudinal stability in other treatment cultures. This paper presents Australian data to outline trends in routine clinical practice of CCT-treated patients.

Methods:

A cohort abstracted from our large database is described. Prescribing stability and readmission were examined in patients with schizophrenia treated with antipsychotic monotherapy at T1 and T2 (18 months panel data). Of the 817 patients, 302 were on monotherapy at both times.

Results:

A matrix of prescribing/switching stability indicating the rate of persistence on one medicine and, if switched, to what antipsychotic will be presented. Eighteen-month monotherapy persistence rates were as follows: clozapine 81.3%, olanzapine 71.0%, FGA depots 65.3%, risperidone 51.4% and FGA orals 34.0%. Numerically, the largest switching traffic occurred from depot to olanzapine and vice versa. Readmission, only 13.4% were readmitted. Being on a depot at T1 was 2.33 times more likely than being on an oral to result in admission in the study period (P = 0.004). If clozapine is excluded, there is no difference between depots and SGAs (RR 1.62, P > 0.05). Overall readmission was 2.15 times more likely to occur in those in whom antipsychotic switching occurs (direction of causality undetermined).

Conclusions:

Stability is somewhat higher in Australia than reported for the United States. However, the general comparative trends in terms of the various an-tipsychotics are supported. Clozapine and olanzapine appear to have particularly stable use.