title: Trends in antipsychotic prescriptions for Japanese outpatients during 2006-2012: a descriptive epidemiological study.
abstract: OBJECTIVE
  This study aimed to assess the trends in antipsychotic prescriptions for outpatients in Japan, where a community-based approach to mental healthcare is emphasized.
  
  
  METHODS
  This descriptive epidemiological study used claims data from 1038 community pharmacies across Japan. Outpatients who were ≥18 years old and receiving their initial antipsychotic prescription during 2006-2012 were evaluated. The annual trends were reported for monotherapies, polypharmacy, antipsychotic doses, and the concurrent prescription of psychotropic medications.
  
  
  RESULTS
  The 152 592 outpatients included 101 133 (66%) adults (18-64 years old) and 51 459 (34%) older adults (≥65 years old). Among the adults, second-generation antipsychotic monotherapy prescriptions increased from 49% in 2006 to 71% in 2012, first-generation antipsychotic monotherapy prescriptions decreased from 29 to 14%, and antipsychotic polypharmacy decreased from 23 to 15%, respectively. Among the older adults, second-generation antipsychotic monotherapy prescriptions increased from 64 to 82%, first-generation antipsychotic monotherapy prescriptions decreased from 29 to 12%, and antipsychotic polypharmacy decreased from 7 to 6%, respectively. During the study period, >80% of the adults and >90% of the older adults received antipsychotics at risperidone-equivalent doses of <6 mg/day. Anxiolytics/hypnotics, antidepressants, antiparkinson agents, mood stabilizers, and anti-dementia agents were concurrently prescribed with antipsychotics for 70, 33, 20, 20, and 0.3% of the adults and for 43, 16, 19, 8, and 16% of the older adults, respectively.
  
  
  CONCLUSIONS
  The present study evaluated large-scale claims-based datasets and found that high-dose prescriptions and antipsychotic polypharmacy among Japanese outpatients were not as prevalent as has been previously thought. Copyright © 2017 John Wiley & Sons, Ltd.
authors.affiliation: Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.|Medical Affairs, Drug Development Division, Sumitomo Dainippon Pharma Co. Ltd, Tokyo, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Kochi
authors.affiliation: Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.|The Keihanshin Consortium for Fostering the Next Generation of Global Leaders in Research (K-CONNEX), Kyoto, Japan.
authors.forename: Izumi
authors.initials: I
authors.lastname: Sato
authors.affiliation: Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.|Department of Clinical Care Nursing, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Chika
authors.initials: C
authors.lastname: Nishiyama
authors.affiliation: Department of Medical Statistics, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Tanaka-Mizuno
authors.affiliation: Ain Holdings Inc, Tokyo, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Doi
authors.affiliation: Kraft Inc, Tokyo, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Arai
authors.affiliation: Ain Holdings Inc, Tokyo, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Fujii
authors.affiliation: Kraft Inc, Tokyo, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Matsunaga
authors.affiliation: Department of Health Promotion and Human Behavior, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ogawa
authors.affiliation: Department of Health Promotion and Human Behavior, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
authors.forename: Toshi A
authors.initials: TA
authors.lastname: Furukawa
authors.affiliation: Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
authors.forename: Koji
authors.identifier: http://orcid.org/0000-0002-7477-4071
authors.initials: K
authors.lastname: Kawakami
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000639:trends*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003157:Community Pharmacy Services / Q000639:trends*; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D007344:Insurance Claim Reporting / Q000639:trends*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D012559:Schizophrenia / Q000188:drug therapy / Q000453:epidemiology; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents
keywords: Japanese outpatient; antipsychotics; high-dose polypharmacy; mental healthcare; pharmacoepidemiology; prescription trends