Trends in treatment of newly treated schizophrenia-spectrum disorder patients in Taiwan from 1999 to 2006

Pharmacoepidemiol Drug Saf. 2012 Sep;21(9):989-96. doi: 10.1002/pds.3254. Epub 2012 Mar 14.

Abstract

Purpose: This study aimed to examine trends in the first-year pharmacological treatment of newly treated schizophrenia patients in Taiwan between 1999 and 2006.

Method: We collected data from the National Health Insurance Research Database of all newly treated patients with a diagnosis of schizophrenia-spectrum disorder (ICD-9 295.x). We analyzed all prescription records after diagnosis of schizophrenia and described the patterns of antipsychotics use, other concomitant psychotropic agents use, and mental health system utilization. We tested for trend using multivariate logistic regression and Spearman's partial correlation rank test.

Results: A total of 2895 newly treated patients with schizophrenia were enrolled. The percentage of prescriptions of second-generation antipsychotics (SGAs) was found to have increased significantly, from 27.5% in 1999 to 76.9% in 2006. The ratio of good antipsychotics adherence (medication possession ratio >0.8) also increased, from 23.2% in 1998 to 38.9% in 2006. Corresponding to this, the percentage of usage of first-generation antipsychotic drugs, anticholinergic agents, and long-term combination therapy declined. However, the prescription of antidepressants and mood stabilizers and the hospitalization rate increased. No change was noted in the number of psychiatric visits.

Conclusion: In the first-year treatment of newly treated schizophrenic patients between 1999 and 2006, we found pharmacological treatment had changed in terms of types of antipsychotics, adherence, and the use of other concomitant psychotropic agents, with the introduction of SGAs. The benefits and costs of the changes with a trend toward an increasing prescription of SGAs warrant further investigation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antipsychotic Agents / administration & dosage
  • Antipsychotic Agents / therapeutic use*
  • Databases, Factual
  • Drug Therapy, Combination
  • Humans
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Medication Adherence
  • Mental Health Services / statistics & numerical data
  • Middle Aged
  • Multivariate Analysis
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Practice Patterns, Physicians' / trends
  • Psychotropic Drugs / administration & dosage
  • Psychotropic Drugs / therapeutic use*
  • Schizophrenia / drug therapy*
  • Statistics, Nonparametric
  • Taiwan
  • Time Factors
  • Young Adult

Substances

  • Antipsychotic Agents
  • Psychotropic Drugs