title: Racial-ethnic differences in incident olanzapine use after an FDA advisory for patients with schizophrenia.
abstract: OBJECTIVE
  Prior investigations suggest that olanzapine use declined rapidly after a U.S. Food and Drug Administration (FDA) communication and consensus statement warning of the drug's increased metabolic risks, but whether declines differed by racial-ethnic groups is unknown.
  
  
  METHODS
  Changes in olanzapine use over time by race-ethnicity was assessed among 7,901 Florida Medicaid enrollees with schizophrenia.
  
  
  RESULTS
  Prior to the advisory, 57% of second-generation antipsychotic fills among Hispanics were for olanzapine, compared with 40% for whites or blacks (adjusted risk difference [ARD]=.17, 95% confidence interval [CI]=.13-.20). Olanzapine use declined among all racial-ethnic groups. Although Hispanics had greater olanzapine use than whites in each period, the differences in absolute risk were only 3% by the latest study period (ARD=.03, CI=.01-.04).
  
  
  CONCLUSIONS
  After the FDA communication and consensus statement were issued, differences in olanzapine use between white and Hispanic enrollees narrowed considerably. Identifying high-use subgroups for targeted delivery of drug safety information may help eliminate any existing differences in prescribing.
authors.affiliation: Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave., Boston, MA 02115, USA. dusetzina@hcp.med.harvard.edu
authors.forename: Stacie B
authors.initials: SB
authors.lastname: Dusetzina
authors.forename: Benjamin L
authors.initials: BL
authors.lastname: Cook
authors.forename: Alisa B
authors.initials: AB
authors.lastname: Busch
authors.forename: G Caleb
authors.initials: GC
authors.lastname: Alexander
authors.forename: Haiden A
authors.initials: HA
authors.lastname: Huskamp
mesh_terms: D014150:Antipsychotic Agents / Q000009:adverse effects / Q000378:metabolism / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000009:adverse effects / Q000378:metabolism / Q000627:therapeutic use*; D044383:Black People / Q000706:statistics & numerical data; D016001:Confidence Intervals; D003920:Diabetes Mellitus / Q000139:chemically induced; D005431:Florida; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D006949:Hyperlipidemias / Q000139:chemically induced; D008484:Medicaid; D000077152:Olanzapine; D044469:Racial Groups; D012559:Schizophrenia / Q000188:drug therapy* / Q000208:ethnology*; D014481:United States; D014486:United States Food and Drug Administration; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D000077152:Olanzapine