title: Social and clinical descriptors of antipsychotic prescription.
abstract: OBJECTIVE
  To identify descriptors of Antipsychotic (AP) prescription, focusing on second generation antipsychotics (SGAs), polypharmacy, and long-acting injections (LAIs).
  
  
  METHODS
  Outpatients of the Bologna-Community-Mental-Health-Centres with at least one AP prescription were selected. Patients' characteristics, service utilization, and AP prescriptions were collected from administrative databases. Prescriptions were grouped by class (SGA vs. First Generation Antipsychotics), drug combination (polypharmacy vs. monotherapy), and preparation (LAIs vs. regular administration). Multi-variate analyses were performed to identify prescription descriptors among socio-demographic and clinical variables.
  
  
  RESULTS
  Among 6,074 patients and 41,121 AP prescriptions, SGAs were used in 70.7% of subjects, AP polypharmacy in 25.3%, and LAIs in 17.5%. SGAs were prescribed more often for young, Italian patients, with higher education, voluntary hospitalization, and high number of visits. Descriptors of AP polypharmacy were: high number of visits and hospitalization, length of treatment, non-urban residency, male gender, unemployment. Characteristics associated to LAI prescription were: long duration of treatment, high number of visits, compulsory admissions, non-Italian nationality, male gender, age > 34, low education, unmarried status.
  
  
  CONCLUSIONS
  Besides illness severity, this study identified different socio-demographic descriptors of AP choices, raising concerns on the equity of treatments. Efforts should be directed to investigate appropriateness of AP treatments especially in social disadvantaged populations.
authors.affiliation: University of Bologna, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Piccinni
authors.affiliation: Local Health Authority Bologna, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Piazza
authors.affiliation: University of Bologna, Italy elisabetta.poluzzi@unibo.it.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Poluzzi
authors.affiliation: University of Bologna, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Tarricone
authors.affiliation: University of Bologna, Italy.
authors.forename: Ariola
authors.initials: A
authors.lastname: Koci
authors.affiliation: University of Bologna, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Berardi
authors.affiliation: Local Health Authority Bologna, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Fioritti
authors.affiliation: University of Bologna, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: de Ponti
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D003692:Delayed-Action Preparations / Q000009:adverse effects / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D007558:Italy; D008297:Male; D008875:Middle Aged; D010554:Personality Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy*; D012959:Socioeconomic Factors
chemical_list: D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations
keywords: antipsychotics; atypical antipsychotics; long-acting injection; polypharmacy