title: Antipsychotic polypharmacy and quality of life in patients with schizophrenia treated in primary care in China.
abstract: OBJECTIVE
  In China, maintenance treatment for clinically stable patients with schizophrenia is usually provided by primary care physicians, but their prescribing patterns have not been studied. This study examined the frequency as well as demographic and clinical correlates of antipsychotic polypharmacy (APP) and its impact on quality of life (QOL) in patients with schizophrenia treated in primary care in China.
  
  
  METHODS
  A total of 623 community-dwelling patients from 18 randomly selected primary care services were interviewed. Patients' socio-demographic and clinical characteristics, including number of hospitalizations, antipsychotic drug-induced side effects, and QOL were recorded using a standardized protocol and data collection procedure.
  
  
  RESULTS
  The rate of APP prescription was 31% (193/623). Of the patients on APP, 89.6% received 2 antipsychotics, 10.4% received 3 or more antipsychotics. Clozapine (35.6%) was the most commonly prescribed second generation antipsychotic (SGA), while perphenazine (17.8%) was the most commonly prescribed first generation antipsychotic (FGA). Multiple logistic regression analyses revealed that patients on APP were more likely to receive SGAs and anticholinergics, had fewer hospitalizations, younger age of onset, and higher doses of antipsychotics. There were no significant differences between the two groups in any of the QOL domains.
  
  
  CONCLUSIONS
  Approximately a third of Chinese patients with schizophrenia in primary care receive APP. Further examination of the rationale and appropriateness of APP and its alternatives is warranted.
authors.forename: Cai-Lan
authors.initials: CL
authors.lastname: Hou
authors.forename: Xin-Rong
authors.initials: XR
authors.lastname: Ma
authors.forename: Yu
authors.initials: Y
authors.lastname: Zang
authors.forename: Fu-Jun
authors.initials: FJ
authors.lastname: Jia
authors.forename: Yong-Qiang
authors.initials: YQ
authors.lastname: Lin
authors.forename: Helen F K
authors.initials: HF
authors.lastname: Chiu
authors.forename: Gabor S
authors.initials: GS
authors.lastname: Ungvari
authors.forename: Chee H
authors.initials: CH
authors.lastname: Ng
authors.forename: Bao-Liang
authors.initials: BL
authors.lastname: Zhong
authors.forename: Xiao-Lan
authors.initials: XL
authors.lastname: Cao
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.forename: Mei-Ying
authors.initials: MY
authors.lastname: Cai
authors.forename: Yu-Tao
authors.initials: YT
authors.lastname: Xiang
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019338:Polypharmacy; D011320:Primary Health Care; D011788:Quality of Life; D012559:Schizophrenia / Q000188:drug therapy*
chemical_list: D014150:Antipsychotic Agents