title: Race and long-acting antipsychotic prescription at a community mental health center: a retrospective chart review.
abstract: OBJECTIVE
  There has been concern that racial minorities are disproportionately prescribed long-acting injectable antipsychotic drugs.
  
  
  METHODS
  Comprehensive administrative data and clinician survey were used to identify all patients with a DSM-IV diagnosis of schizophrenia who received long-acting antipsychotic prescriptions from July 2009 to June 2010 at a community mental health center. Charts were reviewed retrospectively to validate long-acting antipsychotic prescription (eg, medication, dosage) and merged with administrative data from all center patients documenting sociodemographic characteristics (ie, age, race, gender) and comorbid diagnoses. We used bivariate χ2, t tests, and multivariate logistic regression to compare the subsample of patients receiving long-acting injectable drugs (n = 102) to patients not receiving long-acting injectable drugs (n = 799) who were diagnosed with schizophrenia for the same period.
  
  
  RESULTS
  White patients were significantly less likely to receive long-acting antipsychotic prescriptions than minority patients (OR = 0.52, P < .007); ie, nonwhites were 1.89 times more likely to receive such drugs. Age, gender, and comorbid diagnoses, including substance abuse, were unrelated to long-acting injectable prescription, and race/ethnicity was not associated with use of specific agents (haloperidol decanoate, fluphenazine decanoate, or risperidone microspheres) (P = .73).
  
  
  CONCLUSIONS
  Racial minorities are more likely than other patients with schizophrenia to receive long-acting injectionable antipsychotics, a finding that suggests their prescribers may consider them less adherent to antipsychotic prescriptions.
authors.affiliation: Connecticut Mental Health Center, Department of Psychiatry, Yale University, New Haven, CT 06511, USA. neil.k.aggarwal@gmail.com
authors.forename: Neil Krishan
authors.initials: NK
authors.lastname: Aggarwal
authors.forename: Robert A
authors.initials: RA
authors.lastname: Rosenheck
authors.forename: Scott W
authors.initials: SW
authors.lastname: Woods
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Sernyak
mesh_terms: D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D044383:Black People / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D003155:Community Mental Health Centers / Q000706:statistics & numerical data; D003692:Delayed-Action Preparations; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000188:drug therapy; D044469:Racial Groups / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy*; D044465:White People / Q000706:statistics & numerical data
chemical_list: D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations