title: A Non-Interventional Naturalistic Study of the Prescription Patterns of Antipsychotics in Patients with Schizophrenia from the Spanish Province of Tarragona.
abstract: BACKGROUND
  The analysis of prescribing patterns in entire catchment areas contributes to global mapping of the use of antipsychotics and may improve treatment outcomes.
  
  
  OBJECTIVE
  To determine the pattern of long-term antipsychotic prescription in outpatients with schizophrenia in the province of Tarragona (Catalonia-Spain).
  
  
  METHODS
  A naturalistic, observational, retrospective, non-interventional study based on the analysis of registries of computerized medical records from an anonymized database of 1,765 patients with schizophrenia treated between 2011 and 2013.
  
  
  RESULTS
  The most used antipsychotic was risperidone, identified in 463 (26.3%) patients, followed by olanzapine in 249 (14.1%), paliperidone in 225 (12.7%), zuclopenthixol in 201 (11.4%), quetiapine in 141 (8%), aripiprazole in 100 (5.7%), and clozapine in 100 (5.7%). Almost 8 out of 10 patients (79.3%) were treated with atypical or second-generation antipsychotics. Long-acting injectable (LAI) formulations were used in 44.8% of patients. Antipsychotics were generally prescribed in their recommended doses, with clozapine, ziprasidone, LAI paliperidone, and LAI risperidone being prescribed at the higher end of their therapeutic ranges. Almost 7 out of 10 patients (69.6%) were on antipsychotic polypharmacy, and 81.4% were on psychiatric medications aside from antipsychotics. Being prescribed quetiapine (OR 14.24, 95% CI 4.94-40.97), LAI (OR 9.99, 95% CI 6.45-15.45), psychiatric co-medications (OR 4.25, 95% CI 2.72-6.64), and paliperidone (OR 3.13, 95% CI 1.23-7.92) were all associated with an increased likelihood of polypharmacy. Being prescribed risperidone (OR 0.54, 95% CI 0.35-0.83) and older age (OR 0.98, 95% CI 0.97-0.99) were related to a low polypharmacy probability.
  
  
  CONCLUSIONS
  Polypharmacy is the most common pattern of antipsychotic use in this region of Spain. Use of atypical antipsychotics is extensive. Most patients receive psychiatric co-medications such as anxiolytics or antidepressants. Polypharmacy is associated with the use of quetiapine or paliperidone, use of a LAI, younger age, and psychiatric co-medication.
authors.affiliation: Hospital Universitari Institut Pere Mata, Universitat Rovira i Virgili, CIBERSAM, IISPV Reus, Spain.
authors.forename: Ana M
authors.initials: AM
authors.lastname: Gaviria
authors.affiliation: Hospital Universitari Institut Pere Mata, Universitat Rovira i Virgili, CIBERSAM, IISPV Reus, Spain.
authors.forename: José G
authors.initials: JG
authors.lastname: Franco
authors.affiliation: Hospital Universitari Institut Pere Mata, Reus, Spain.
authors.forename: Víctor
authors.initials: V
authors.lastname: Aguado
authors.affiliation: Hospital Universitari Institut Pere Mata, Reus, Spain.
authors.forename: Guillem
authors.initials: G
authors.lastname: Rico
authors.affiliation: Hospital Universitari Institut Pere Mata, Universitat Rovira i Virgili, CIBERSAM, IISPV Reus, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Labad
authors.affiliation: Hospital Universitari Institut Pere Mata, Universitat Rovira i Virgili, CIBERSAM, IISPV Reus, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: de Pablo
authors.affiliation: Hospital Universitari Institut Pere Mata, Universitat Rovira i Virgili, CIBERSAM, IISPV Reus, Spain.
authors.forename: Elisabet
authors.initials: E
authors.lastname: Vilella
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D019338:Polypharmacy; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology; D012565:Schizophrenic Psychology; D013030:Spain / Q000453:epidemiology
chemical_list: D014150:Antipsychotic Agents