title: Antipsychotic prescribing and its correlates in New Zealand.
abstract: OBJECTIVE
  Antipsychotics are the cornerstone of schizophrenia management. There is substantial literature on their efficacy and optimal use. Doubts remain, however, regarding the translation of this knowledge into day-to-day practice. This study aimed to investigate antipsychotic prescribing in three New Zealand regions and its relationship to clinical guidelines and patient characteristics.
  
  
  METHODS
  We studied 451 patients discharged from inpatient units with a diagnosis of schizophrenia or a related disorder (International Classification of Disease, version 10) between July 2009 and December 2011. Available information included patient demography, legal status, prescribed medications, duration of index admission and prescriber's country of postgraduate training and years of postgraduate experience.
  
  
  RESULTS
  There was a high rate (33.7%) of multiple antipsychotic prescription, and lower than expected clozapine use (20%); Maori were prescribed clozapine more frequently than non-Maori (24% vs. 13%, respectively). Compulsory treatment was associated with more use of injectable medication and increased length of stay in hospital. Clinician characteristics did not significantly influence prescribing.
  
  
  CONCLUSIONS
  Observed prescribing practice aligned with existing guidelines except for antipsychotic polypharmacy and clozapine under-utilisation.
authors.affiliation: Waikato Clinical Campus, University of Auckland, Hamilton, New Zealand; Psychiatrist (FRANZCP), Waikato District Health Board, Hamilton, New Zealand sangeeta.dey@waikatodhb.health.nz.
authors.forename: Sangeeta
authors.initials: S
authors.lastname: Dey
authors.affiliation: Associate Professor of psychiatry, Waikato Clinical Campus, University of Auckland, Hamilton, New Zealand; Psychiatrist (FRANZCP), Waikato District Health Board, Hamilton, New Zealand.
authors.forename: David B
authors.initials: DB
authors.lastname: Menkes
authors.affiliation: Statistician, Waikato Clinical Campus, University of Auckland, Hamilton, New Zealand.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Obertova
authors.affiliation: Psychiatrist (MRCP, Locum), Tairawhiti District Health Board, Gisborne, New Zealand.
authors.forename: Sreemanti
authors.initials: S
authors.lastname: Chaudhuri
authors.affiliation: Professor of psychiatry, Waikato Clinical Campus, University of Auckland, Hamilton, New Zealand; Psychiatrist (FRANZCP), Waikato District Health Board, Hamilton, New Zealand.
authors.forename: Graham
authors.initials: G
authors.lastname: Mellsop
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use; D003024:Clozapine / Q000627:therapeutic use; D015331:Cohort Studies; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005006:Ethnicity; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009520:New Zealand; D000077152:Olanzapine; D010818:Practice Patterns, Physicians' / Q000592:standards*; D012044:Regression Analysis; D012559:Schizophrenia / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D003024:Clozapine; D000077152:Olanzapine
keywords: Maori; antipsychotic; effectiveness; hospitalisation; schizophrenia