Factors associated with high-dose prescription of antipsychotics in outpatients with schizophrenia

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  • Ochiai Hidenobu
    Department of Healthcare Economics and Quality Management, School of Public Health, Kyoto University
  • Otsubo Tetsuya
    Department of Healthcare Economics and Quality Management, School of Public Health, Kyoto University
  • Ikai Hiroshi
    Department of Healthcare Economics and Quality Management, School of Public Health, Kyoto University
  • Imanaka Yuichi
    Department of Healthcare Economics and Quality Management, School of Public Health, Kyoto University

Bibliographic Information

Other Title
  • 統合失調症外来患者における抗精神病薬大量処方の関連因子
  • 統合失調症外来患者における抗精神病薬大量処方の関連因子 : 広域レセプトデータの活用
  • トウゴウ シッチョウショウ ガイライ カンジャ ニ オケル コウセイシンビョウヤク タイリョウ ショホウ ノ カンレン インシ : コウイキ レセプトデータ ノ カツヨウ
  • ── 広域レセプトデータの活用 ──
  • ── An analysis of claims data from a Japanese prefecture ──

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Abstract

In Japan, the use of high-dose prescription of antipsychotics is higher than in most other developed countries. The aim of this study was to identify the factors associated with high-dose prescription of antipsychotics in outpatients with schizophrenia using claims data from a single prefecture. High-dose prescription was defined as chlorpromazine equivalent doses above 1,000 mg/day per patient.<br>The overall ratio of high-dose prescriptions （RHP） of antipsychotic medications for patients with schizophrenia was 7.9%. The distribution of the RHP varied among the types of facilities, with RHP at 13.1% in psychiatric hospitals, 8.3% in psychiatric clinics, 5.0% in general hospitals, and 2.0% in general clinics. The results of multiple logistic regression analyses showed that RHP was lower in elderly patients. In contrast, RHP was significantly higher for patients who received rehabilitation services （odds ratio: 1.89-4.38）. From the perspective of medical policy, the RHP may be a useful indicator for monitoring the current status of high-dose prescription of antipsychotic drugs at the regional and facility levels.

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