Kim S J Lao1, Anthony W Y Tam1, Ian C K Wong1,2, Frank M C Besag2,3,4, Kenneth K C Man1,5,6, Celine S L Chui1,7, Esther W Chan1. 1. Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong, China. 2. Research Department of Practice and Policy, UCL School of Pharmacy, London, UK. 3. East London NHS Foundation Trust, Bedfordshire, London, UK. 4. Institute of Psychiatry, Psychology and Neuroscience, London, UK. 5. Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China. 6. Department of Medical Informatics, Erasmus University Medical Centre, Rotterdam, The Netherlands. 7. School of Public health, The University of Hong Kong, Hong Kong, China.
Abstract
PURPOSE: Antipsychotic-prescribing patterns remain unclear in Asia. The aims of our study were to investigate prescribing trends of antipsychotic medication in the general population, children, and older patients by drug generation (first or second), the prescribing trend in pregnant women, the probable indication for antipsychotic prescription, and the prescribing trend by dosage form. METHODS: This descriptive study identified and included all patients prescribed with antipsychotic in Hong Kong from 2004 to 2014 using the Clinical Data Analysis and Report System. This study calculated and reported the prevalence of antipsychotic prescribing in patient groups of interest, the percentage with diagnoses of mental disorders were derived, and the prevalence of antipsychotic by dosage forms. RESULTS: The study included 10 109 206 prescriptions of any antipsychotics to 256 903 patients. Over the study period, the prevalence of antipsychotic prescribing increased from 1.06% to 1.54% in the general population, from 0.10% to 0.23% in children (3-17 years old), and from 2.61% to 3.26% in older patients (≥65 years old). The prevalence of second-generation antipsychotics increased, but the prevalence of first-generation antipsychotics did not. Prevalence of antipsychotic prescribing in prepregnancy, pregnancy, and postpartum timeframes varied from 0.18% to 0.38%. The percentage of incident prescriptions with a diagnosis of psychosis decreased from 54.1% to 47.5%. CONCLUSIONS: Antipsychotics have been increasingly prescribed in the general population, children, and older patients. There is an increase in second-generation antipsychotic prescribing. Over half of incident users had a recent diagnosis of a nonpsychotic mental disorder in 2014, suggesting that off-label prescribing of antipsychotics might be common.
PURPOSE: Antipsychotic-prescribing patterns remain unclear in Asia. The aims of our study were to investigate prescribing trends of antipsychotic medication in the general population, children, and older patients by drug generation (first or second), the prescribing trend in pregnant women, the probable indication for antipsychotic prescription, and the prescribing trend by dosage form. METHODS: This descriptive study identified and included all patients prescribed with antipsychotic in Hong Kong from 2004 to 2014 using the Clinical Data Analysis and Report System. This study calculated and reported the prevalence of antipsychotic prescribing in patient groups of interest, the percentage with diagnoses of mental disorders were derived, and the prevalence of antipsychotic by dosage forms. RESULTS: The study included 10 109 206 prescriptions of any antipsychotics to 256 903 patients. Over the study period, the prevalence of antipsychotic prescribing increased from 1.06% to 1.54% in the general population, from 0.10% to 0.23% in children (3-17 years old), and from 2.61% to 3.26% in older patients (≥65 years old). The prevalence of second-generation antipsychotics increased, but the prevalence of first-generation antipsychotics did not. Prevalence of antipsychotic prescribing in prepregnancy, pregnancy, and postpartum timeframes varied from 0.18% to 0.38%. The percentage of incident prescriptions with a diagnosis of psychosis decreased from 54.1% to 47.5%. CONCLUSIONS: Antipsychotics have been increasingly prescribed in the general population, children, and older patients. There is an increase in second-generation antipsychotic prescribing. Over half of incident users had a recent diagnosis of a nonpsychotic mental disorder in 2014, suggesting that off-label prescribing of antipsychotics might be common.
Authors: Kim S J Lao; Angel Y S Wong; Ian C K Wong; Frank M C Besag; W C Chang; Edwin H M Lee; Eric Y H Chen; Joseph E Blais; Esther W Chan Journal: CNS Drugs Date: 2020-02 Impact factor: 5.749
Authors: Kenneth K C Man; Shih-Chieh Shao; Nathorn Chaiyakunapruk; Piyameth Dilokthornsakul; Kiyoshi Kubota; Junqing Li; Nobuhiro Ooba; Nicole Pratt; Anton Pottegård; Lotte Rasmussen; Elizabeth E Roughead; Ju-Young Shin; Chien-Chou Su; Ian C K Wong; Yea-Huei Kao Yang; Edward Chia-Cheng Lai Journal: Eur Child Adolesc Psychiatry Date: 2020-11-13 Impact factor: 4.785