Racial disparity in the pharmacological management of schizophrenia.
This study investigated racial differences in the prescription of psychopharmacologic treatments to individuals with schizophrenia. Data were derived from a patient survey and medical record review for 344 persons with schizophrenia recruited from outpatient psychiatric facilities in two States in the Schizophrenia Patient Outcomes Research Team study. African-Americans were three times more likely to receive depot antipsychotic medications (odds ratio [OR]: 2.91; 95% confidence interval [CI]: 1.68-5.01) and 76 percent less likely to receive new-generation antipsychotic medications (OR: 0.24; 95% CI: 0.12-0.46), compared to their Caucasian counterparts. Chlorpromazine-equivalent antipsychotic dosages did not differ significantly between African-American and Caucasian patients. Compared to Caucasians, a larger proportion of African-Americans received antiparkinsonian medications (63% vs. 48%, chi2 = 7.01; df = 1; p = 0.008), but African-Americans were less than half as likely to receive adjunctive psychopharmacologic treatments (OR: 0.43; 95% CI: 0.27-0.71). Pronounced racial variations in the psychopharmacologic management of schizophrenia in typical clinical practice settings were observed and persisted when analyses were adjusted for selected patient demographic and clinical characteristics. A prospective, longitudinal evaluation is warranted to determine whether the observed patterns of prescribing are associated with poorer therapeutic outcomes in minority patients.
Kreyenbuhl
Julie
J
Mental Illness Research, Education, and Clinical Center, VAMHCS-Baltimore, MD 21201, USA. jkreyenb@rx.umaryland.edu
Zito
Julie M
JM
Buchanan
Robert W
RW
Soeken
Karen L
KL
Lehman
Anthony F
AF
D000328:Adult; D001741:Black or African American; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012559:Schizophrenia / Q000188:drug therapy*; D044465:White People
D014150:Antipsychotic Agents