title: Prescription preferences in antipsychotics and attitude towards the pharmaceutical industry in Belgium.
abstract: The number of antipsychotic prescriptions are increasing rapidly worldwide, a trend which is mainly driven by the steep rise in second-generation antipsychotic (SGA) prescriptions. However, the success of SGA, compared with the older first-generation antipsychotics (FGAs), cannot be explained by evidence. Several studies concluded on equal efficacy of FGA and SGA on positive, negative and cognitive symptoms of schizophrenia. Next to that, the influence of the pharmaceutical industry on prescription behaviour has drawn considerable interest. Therefore, the relationship between antipsychotic prescription patterns and exposure to information directly provided by pharmaceutical companies was studied.
  
  
  
  A cross-sectional online survey, addressing psychiatrists, general practitioners (GPs) and trainees in Flanders, was carried out. Respondents were questioned about their prescription behaviour, opinion about efficacy of SGA versus FGA and the nature and frequency of their contact with the pharmaceutical industry. Using Spearman's rank correlations and χ2tests, the relationship between different variables and group differences were examined.
  
  
  
  Psychiatrists, GPs and trainees in Flanders clearly favour olanzapine and risperidone, followed by quetiapine and aripiprazole above all other agents. This behaviour is supported by the conviction that SGAs have superior efficacy and a more benign side effect profile, compared with FGA. Frequent contact with drug representatives is correlated with a preference of SGA over FGA. 41% of the respondents acknowledge to be influenced by the pharmaceutical industry, which is more than that previously reported.
authors.affiliation: Collaborative Antwerp Psychiatric Research Institute (CAPRI), Universiteit Antwerpen, Antwerpen, Belgium.
authors.forename: Stijn
authors.initials: S
authors.lastname: Cleymans
authors.affiliation: Collaborative Antwerp Psychiatric Research Institute (CAPRI), Universiteit Antwerpen, Antwerpen, Belgium.|Psychiatric Hospital Duffel, Duffel, Belgium.
authors.forename: Manuel
authors.initials: M
authors.lastname: Morrens
authors.affiliation: Collaborative Antwerp Psychiatric Research Institute (CAPRI), Universiteit Antwerpen, Antwerpen, Belgium.|Universitary Psychiatric Center KULEUVEN, Leuven, Belgium.
authors.forename: Chris
authors.initials: C
authors.lastname: Bervoets
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D000068180:Aripiprazole / Q000627:therapeutic use; D001530:Belgium; D001569:Benzodiazepines / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D004345:Drug Industry; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D017723:Drug Utilization Review; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D000069348:Quetiapine Fumarate / Q000627:therapeutic use; D018967:Risperidone / Q000627:therapeutic use; D012559:Schizophrenia / Q000188:drug therapy
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D000069348:Quetiapine Fumarate; D000068180:Aripiprazole; D018967:Risperidone; D000077152:Olanzapine
keywords: Clinical Ethics; Demographic Surveys/Attitudes; Drugs and Drug Industry; Health Care Economics; Psychiatry