Atypical Antipsychotic Prescribing Patterns in an Italian District 2001-2009 and the Impact of Regulatory Warnings
[1]
Jenny Bolcato, Pharmaceutical Service, Local Health Authority (ULSS 9), Treviso, Italy.
[2]
Gianni Terrazzani, Pharmaceutical Service, Local Health Authority (ULSS 9), Treviso, Italy.
[3]
Pietro Giusti, Pharmaceutical and Pharmacological Studies, University of Padova, Italy.
[4]
Tom Walley, Department of Pharmacology and Therapeutics, University of Liverpool, UK.
[5]
Alessandro Chinellato, Pharmaceutical Service, Local Health Authority (ULSS 9), Treviso, Italy.
Purpose To evaluate the epidemiology and patterns of use of this class of drugs among a population in real clinical practice, in the real word, and the impact of regulatory warnings on antipsychotic prescribing patterns, we analyzed the prescription patterns of atypical antipsychotics and haloperidol in an Italian Health District between January 1, 2001 and December 31, 2009. Methods Data of 10,556 subjects who received at least one prescription of an antipsychotic drug during the above period were obtained from the Local Health Unit database, which allowed tracking of each individual’s prescribing history. Data recorded included age, gender, drug information, strength, and number of packs prescribed. Prescription dates allowed us to evaluate the incidence and prevalence of prescribing of each antipsychotic drug. The adopted indicators for drug utilization included the Defined Daily Dose (DDD), Received Daily Dose (RDD), and a surrogated Prescribed Daily Dose (sPDD), extrapolated from available prescription data. Results All drug-utilization indicators showed an increase in the use of atypical antipsychotics over the period of time covered, especially among older patients (≥65 years old, 476 prescribed out of 70,998 people of similar age in one town in 2001, versus 1,409 prescribed vs. 76,205 in the same town in 2009) and women, despite the warnings issued by Regulatory Agencies, and no corresponding decrease in use of haloperidol. Nonetheless, surrogated Prescribed Daily Dose and Received Daily Dose remained lower than Defined Daily Dose for all molecules. Conclusions We found an increase in the consumption of atypical antipsychotic drugs, despite the warnings issued by Regulatory Agencies. Furthermore, prescribed and received doses are lower than the corresponding Defined Daily Doses, perhaps suggesting an inappropriate use of these drugs.
Antipsychotics, Defined Daily Dose, Drug Utilization, Warnings, Pharmacoepidemiology
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