title: National changes in oral antipsychotic treatment for people with schizophrenia in primary care between 1998 and 2007 in the United Kingdom.
abstract: OBJECTIVE
  There is little information regarding antipsychotic prescription in primary care, despite general practitioners issuing most ongoing prescriptions. We sought to investigate changes in oral antipsychotic prescriptions in primary care from January 1998 to December 2007.
  
  
  METHODS
  We conducted a cohort analysis of patients diagnosed with schizophrenia in primary care in the United Kingdom, using The Health Improvement Network database, to determine the proportions of prescribed antipsychotics. We investigated the yearly estimates of the overall time patients spent in treatment with any antipsychotic as well as the class of antipsychotic and individual antipsychotic agent.
  
  
  RESULTS
  We found that in any one calendar year, approximately 24% of patients previously prescribed antipsychotics do not receive treatment in primary care. Over the last decade, people with schizophrenia have been prescribed antipsychotic treatment for greater proportions of time. The greatest increase was observed in older women. The overall increase in treatment time can be attributed to the increased prescription of second-generation antipsychotics (SGAs). The annual proportion of time in SGA treatment increased from 16.6% to 51.2% within the study period, whereas time in first-generation antipsychotic treatment reduced from 37.1% to 15.0%. Overall, olanzapine, risperidone and sulpiride were prescribed for the longest periods of time.
  
  
  CONCLUSIONS
  Over the last decade, the general practice of prescribing SGAs has increased whereas first-generation antipsychotic prescriptions have declined. By 2007, patients with schizophrenia were prescribed antipsychotics for greater proportions of time, perhaps reflecting the greater acceptability of SGAs or a shift from secondary to primary care prescription.
authors.affiliation: MRC General Practice Research Framework, London, UK. p.prah@gprf.mrc.ac.uk
authors.forename: Philip
authors.initials: P
authors.lastname: Prah
authors.forename: Irene
authors.initials: I
authors.lastname: Petersen
authors.forename: Irwin
authors.initials: I
authors.lastname: Nazareth
authors.forename: Kate
authors.initials: K
authors.lastname: Walters
authors.forename: David
authors.initials: D
authors.lastname: Osborn
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015331:Cohort Studies; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends*; D011320:Primary Health Care / Q000379:methods / Q000639:trends*; D012559:Schizophrenia / Q000188:drug therapy*; D012737:Sex Factors; D013997:Time Factors; D006113:United Kingdom; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents