Exploring the clinical and social determinants of prescribing anticholinergic medication for Chinese patients with schizophrenia.
OBJECTIVE
To-date few studies have investigated prescription patterns of anticholinergic medication (ACM) in Chinese patients with schizophrenia in general and outpatients in particular. This study examined the frequency and socio-demographic and clinical correlates of ACM in Hong Kong (HK) and Beijing (BJ), China.


METHODS
Five hundred and five clinically stable outpatients with schizophrenia were randomly selected and interviewed in HK and BJ using standardized assessment instruments. Basic socio-demographic and clinical data and psychotropic drug prescriptions were collected at the time of the diagnostic interview.


RESULTS
ACM was found in 47.7% of (n = 241) the whole sample and in 54.1 and 41.2% of the HK and BJ samples, respectively. ACM was associated with more frequent use of antipsychotic (AP) polypharmacy, typical AP drugs, and a combination of depot and oral AP, less use of clozapine and atypical and oral AP, a lack of health insurance, higher doses of APs, severity of extrapyramidal side effects (EPS), a higher number of APs prescribed, and study sites. In multiple logistic regression analysis, higher doses of APs, less frequent use of an atypical AP, and study sites all remained significantly associated with ACM.


CONCLUSIONS
Although the ethnic and clinical characteristics of the two samples were nearly identical, there was a wide variation in the frequency of ACM prescriptions between HK and BJ suggesting that socio-cultural and economical factors as well as traditions of psychiatric practice all played a role in determining the use of ACM. Prescribing ACM in neither site was in line with current recommendation.
Xiang
Yu-Tao
YT
Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China. xyutly@cuhk.edu.hk
Weng
Yong-Zhen
YZ
Leung
Chi-Ming
CM
Tang
Wai-Kwong
WK
Sandor
Ungvari Gabor
UG
D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002681:China / Q000453:epidemiology / Q000208:ethnology; D018680:Cholinergic Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D018680:Cholinergic Antagonists