Jonathan Brett1, Benjamin Daniels1, Emily A Karanges1, Nicholas A Buckley2, Carl Schneider3, Atheer Nassir3, Andrew J McLachlan3,4, Sallie-Anne Pearson1,2,5. 1. Medicines Policy Research Unit, Centre for Big Data Research in Health, University of New South Wales, Australia. 2. School of Medicine, The University of Sydney, Sydney, Australia. 3. Faculty of Pharmacy, The University of Sydney, Sydney, Australia. 4. Centre for Education and Research on Ageing, Concord Hospital, Sydney, Australia. 5. Menzies Centre for Health Policy, The University of Sydney, Sydney, Australia.
Abstract
AIMS: To describe psychotropic polypharmacy in Australia between 2006 and 2015. METHODS: We used pharmaceutical claims from a national 10% sample of people with complete dispensing histories to estimate the annual prevalence of the combined use (overlap of >60 days exposure) of ≥2 psychotropics overall and within the same class or subclass (class and subclass polypharmacy). We also estimated the proportion of polypharmacy episodes involving one, two, three and four or more unique prescribers. RESULTS: The prevalence of class polypharmacy between 2006 and 2015 in people dispensed specific psychotropic classes was 5.9-7.3% for antipsychotics, 2.1-3.7% for antidepressants and 4.3-2.9% for benzodiazepines. The prevalence of antipsychotic polypharmacy was higher than expected given the prevalence of antipsychotic exposure and combinations of sedating agents were notably common. Overall, 26.7% of polypharmacy episodes involved multiple prescribers but having multiple prescribers occurred more frequently for class and subclass polypharmacy and people with four or more concomitant psychotropics. DISCUSSION: Psychotropic polypharmacy is common, despite limited evidence of risks and benefits. Increases in polypharmacy with multiple prescribers may be due to poor communication with patients and between health care professionals.
AIMS: To describe psychotropic polypharmacy in Australia between 2006 and 2015. METHODS: We used pharmaceutical claims from a national 10% sample of people with complete dispensing histories to estimate the annual prevalence of the combined use (overlap of >60 days exposure) of ≥2 psychotropics overall and within the same class or subclass (class and subclass polypharmacy). We also estimated the proportion of polypharmacy episodes involving one, two, three and four or more unique prescribers. RESULTS: The prevalence of class polypharmacy between 2006 and 2015 in people dispensed specific psychotropic classes was 5.9-7.3% for antipsychotics, 2.1-3.7% for antidepressants and 4.3-2.9% for benzodiazepines. The prevalence of antipsychotic polypharmacy was higher than expected given the prevalence of antipsychotic exposure and combinations of sedating agents were notably common. Overall, 26.7% of polypharmacy episodes involved multiple prescribers but having multiple prescribers occurred more frequently for class and subclass polypharmacy and people with four or more concomitant psychotropics. DISCUSSION: Psychotropic polypharmacy is common, despite limited evidence of risks and benefits. Increases in polypharmacy with multiple prescribers may be due to poor communication with patients and between health care professionals.
Authors: Nicholas A Keks; Graham D Burrows; David L Copolov; Richard Newton; Nick Paoletti; Isaac Schweitzer; John Tiller Journal: Med J Aust Date: 2007-02-05 Impact factor: 7.738
Authors: Christoph U Correll; Christine Rummel-Kluge; Caroline Corves; John M Kane; Stefan Leucht Journal: Schizophr Bull Date: 2008-04-15 Impact factor: 9.306
Authors: Jonathan Brett; Claire E Wylie; Jacques Raubenheimer; Geoff K Isbister; Nick A Buckley Journal: Br J Clin Pharmacol Date: 2019-07-17 Impact factor: 4.335
Authors: Mikkel Højlund; Anton Pottegård; Erik Johnsen; Rune A Kroken; Johan Reutfors; Povl Munk-Jørgensen; Christoph U Correll Journal: Br J Clin Pharmacol Date: 2019-05-11 Impact factor: 4.335
Authors: María Isabel Santos-Pérez; Inmaculada Fierro; M Esther Salgueiro-Vázquez; María Sáinz-Gil; Luis H Martín-Arias Journal: Eur J Hosp Pharm Date: 2019-06-11
Authors: Rebecca Mellor; Andrew Khoo; Elise Saunders-Dow; Ella Raguz; Meng-Wong Taing; Leila Shafiee Hanjani; Chris Freeman; Darrell Crawford Journal: Drugs Real World Outcomes Date: 2022-05-17
Authors: Sallie-Anne Pearson; Nicole Pratt; Juliana de Oliveira Costa; Helga Zoega; Tracey-Lea Laba; Christopher Etherton-Beer; Frank M Sanfilippo; Alice Morgan; Lisa Kalisch Ellett; Claudia Bruno; Erin Kelty; Maarten IJzerman; David B Preen; Claire M Vajdic; David Henry Journal: Int J Environ Res Public Health Date: 2021-12-18 Impact factor: 3.390