Adherence patterns with first- versus second-generation antipsychotics for newly diagnosed schizophrenia in Taiwan

Psychiatr Serv. 2012;63(5):504-7. doi: 10.1176/appi.ps.201100011.

Abstract

Objective: The aim of this study was to compare the early adherence patterns for first-generation antipsychotics and second-generation antipsychotics during the first month of treatment for patients newly diagnosed as having schizophrenia.

Methods: With a random sample from the Taiwan national health insurance database, persons with a schizophrenia diagnosis (ICD-9-CM code 295.X) and a concurrent initial antipsychotic prescription from 1998 to 2006 were defined as being newly treated for schizophrenia. Adherence patterns within one month of diagnosis were categorized into four independent groups: refill, switch, admission, and discontinuation.

Results: Treatment initiated with first-generation or second-generation antipsychotics resulted in similar rates of refill (57% versus 59%). However, patients who started with first-generation antipsychotics were significantly less likely to switch (9% versus 14%) but more likely to discontinue (34% versus 26%) medications than those whose treatment was initiated with second-generation antipsychotics.

Conclusions: The data substantiated previous observations of the magnitude of adherence problems in Asian populations and highlight the importance of developing new strategies for intervention.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antipsychotic Agents / administration & dosage
  • Antipsychotic Agents / therapeutic use*
  • Drug Prescriptions / statistics & numerical data*
  • Drug Substitution / statistics & numerical data
  • Humans
  • Insurance, Health / statistics & numerical data
  • Logistic Models
  • Medication Adherence / statistics & numerical data*
  • Retrospective Studies
  • Schizophrenia / diagnosis
  • Schizophrenia / drug therapy*
  • Taiwan

Substances

  • Antipsychotic Agents