Patterns and Predictors of Antipsychotic usage among U.S. Adults: A National Co-Morbidity Survey Replication Study

DOI:

https://doi.org/10.37285/ijpsn.2014.7.2.4

Authors

  • Rajender R Aparasu
  • Saurabh Nagar
  • Shivani K Mhatre
  • Mark D Hatfield

Abstract

The primary objective was to study patterns of antipsychotic usage among adults with mental health disorders in the U.S. using a national survey. The secondary objective was to examine patient and provider factors associated with antipsychotic usage. Data from the National Co-Morbidity Survey Replication study (NCS-R) of 2001-2003 was used to examine the prevalence of antipsychotic use among adults 18 years or older. Patient-reported adherence and effectiveness were reported. Multiple logistic regression analysis was used to determine the statistically significant determinants of antipsychotic use. Antipsychotic medications were used by 99 of 9282 (1.06%) NCS-R participants in the previous year. Among antipsychotic users, 42 (42.4%) used typical agents and 57 (57.6%) used atypical agents. Males over 65 (compared to age 18-45), non-white race, prescription by a psychiatrist, and presence of mood disorders were statistically significant predictors of increased antipsychotic use among patients with mental disorders, in the adjusted model. Mean adherence among typical users (17.78 ± 1.53 days) was less than atypical users (24.04 ± 0.82 days). No statistically significant difference in perceived effectiveness was found. In conclusion, these analysis shows that approximately 1% of Americans used antipsychotics within the past year, mostly using atypical over typical agents. Male, over 65, non-white race, prescription by a psychiatrist, and presence of mood disorders were the significant predictors of antipsychotic use.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Keywords:

Antipsychotics, predictors, patterns, NCS-R, mood, anxiety, ADHD

Downloads

Published

2014-05-31

How to Cite

1.
Aparasu RR, Nagar S, Mhatre SK, Hatfield MD. Patterns and Predictors of Antipsychotic usage among U.S. Adults: A National Co-Morbidity Survey Replication Study. Scopus Indexed [Internet]. 2014 May 31 [cited 2024 Nov. 20];7(2):2429-35. Available from: https://ijpsnonline.com/index.php/ijpsn/article/view/710

Issue

Section

Research Articles

References

AHRQ (2007). Evidence Lacking to Support Many Off-label Uses of Atypical Antipsychotics. AHRQ Press Releases. Available at: http://archive.ahrq.gov/news/press/pr2007/antipsypr.htm

Al-Zakwani IS, Barron JJ, Bullano MF, Arcona S, Drury CJ, Cockerham TR (2003). Analysis of healthcare utilization patterns and adherence in patients receiving typical and atypical antipsychotic medications. Curr Med Res Opin 19(7): 619-626.

Aparasu RR, Bhatara V (2006). Antipsychotic use and expenditure in the United States. Psychiat Serv 57(12): 1693-1693.

Aparasu RR, Bhatara V (2007). Patterns and determinants of antipsychotic prescribing in children and adolescents, 2003-2004. Curr Med Res Opin 23(1): 49-56.

Aparasu RR, Bhatara V, Gupta S (2005). US national trends in the use of antipsychotics during office visits, 1998-2002. Ann Clin Psychiat 17(3): 147-152.

Baumeister H, Harter M (2007). Prevalence of mental disorders based on general population surveys. Soc Psych Psychiat Epid 42(7): 537-546.

Colenda CC, Mickus MA, Marcus SC, Tanielian TL, Pincus HA (2002). Comparison of adult and geriatric psychiatric practice patterns: findings from the American Psychiatric Association's Practice Research Network. Am J Geriat Psychiat 10(5):609-617.

Daumit GL, Crum RM, Guallar E, Powe NR, Primm AB, Steinwachs DM, Ford DE. (2003). Outpatient prescriptions for atypical antipsychotics for African Americans, Hispanics, and whites in the United States. Arch Gen Psychiat 60(2): 121.

Dolder CR, Lacro JP, Dunn LB, Jeste DV (2002). Antipsychotic medication adherence: is there a difference between typical and atypical agents? Am J Psychiat 159(1): 103-108.

Domino ME, Swartz M (2008). Who are the new users of antipsychotic medications? Psychiat Serv 59(5): 507.

Eaton WW, Martins SS, Nestadt G, Bienvenu OJ, Clarke D, Alexandre P (2008). The burden of mental disorders. Epidemiol Rev 30(1): 1-14.

Geddes J, Freemantle N, Harrison P, Bebbington P (2000). Atypical antipsychotics in the treatment of schizophrenia: systematic overview and meta-regression analysis. Brit Med J 321(7273): 1371-1376.

Giron MST, Forsell Y, Bernsten C, Thorslund M, Winblad B, Fastbom J (2001). Psychotropic drug use in elderly people with and without dementia. Int J Geriatr Psych 16(9): 900-906.

Glick ID, Murray SR, Vasudevan P, Marder SR, Hu RJ (2001). Treatment with atypical antipsychotics: new indications and new populations. J Psychiat Res 35(3): 187-191.

Han E, Liu GG (2005). Racial disparities in prescription drug use for mental illness among population in US. J Ment Health Policy 8(3): 131.

Jano E, Johnson ML, Chen H, Aparasu RR (2008). Determinants of atypical antipsychotic use among antipsychotic users in community-dwelling elderly, 1996-2004. Curr Med Res Opin 24(3): 709-716.

Kessler RC, Avenevoli S, Costello EJ, Green JG, Gruber MJ, Heeringa S, Merikangas KR, Pennell B-E, Sampson NA, Zaslavsky AM (2009). National comorbidity survey replication adolescent supplement (NCS-A): II. Overview and design. J Am Acad Child Psy 48(4): 380-385.

Kessler RC, Berglund P, Chiu WT, Demler O, Heeringa S, Hiripi E, Jin R, Pennell BE, Walters EE, Zaslavsky A (2004). The US National Comorbidity Survey Replication (NCS‐R): design and field procedures. Int J Method Psych 13(2): 69-92.

Kessler RC, Demler O, Frank RG, Olfson M, Pincus HA, Walters EE, Wang P, Wells KB, Zaslavsky AM (2005). Prevalence and treatment of mental disorders, 1990 to 2003. New Engl J Med 352(24): 2515-2523.

Kessler RC, Merikangas KR (2004). The National Comorbidity Survey Replication (NCS‐R): background and aims. Int J Method Psych 13(2): 60-68.

Kessler RC, Wang PS (2008). The Descriptive Epidemiology of Commonly Occurring Mental Disorders in the United States. Annu Rev Publ Health 29: 115-129.

Konrad T, Ellis A, Thomas K, Holzer C, Morrissey J (2009). County-level estimates of need for mental health professionals in the United States. Psychiat Serv 60(10): 1307-1314.

Kuno E, Rothbard AB (2002). Racial disparities in antipsychotic prescription patterns for patients with schizophrenia. Am J Psychiat 159(4): 567-572.

Maglione M, Ruelaz MA, Hu J, Wang Z, Shanman R, Shekelle PG, Roth B, Hilton L, Suttorp MJ, Ewing BA, Motala A, Perry T (2011). Off-Label Use of Atypical Antipsychotics: An Update. Comparative Effectiveness Review No. 43. (Prepared by the Southern California Evidence-based Practice Center under Contract No. HHSA290-2007-10062-1.) Rockville, MD: Agency for Healthcare Research and Quality. September 2011. Available at: www.effectivehealthcare.ahrq.gov/reports/final.cfm.

Martin BC, Miller LS, Kotzan JA. (2001). Antipsychotic prescription use and costs for persons with schizophrenia in the 1990s: current trends and five year time series forecasts. Schizophr Res 47(2), 281-292.

Opolka JL, Rascati KL, Brown CM, Gibson P (2004). Ethnicity and prescription patterns for haloperidol, risperidone, and olanzapine. Psychiat Serv 55(2): 151-156.

Puyat JH, Law MR, Wong ST, Sutherland JM, Morgan SG (2012). The Essential and Potentially Inappropriate Use of Antipsychotics Across Income Groups: An Analysis of Linked Administrative Data. Can J Psychiat 57(8): 488-495.

Seeman MV (2004). Gender differences in the prescribing of antipsychotic drugs. Am J Psychiat 161(8): 1324-1333.

Segal SP, Bola JR, Watson MA (1996). Race, quality of care, and antipsychotic prescribing practices in psychiatric emergency services. Psychiat Serv 47(3): 281-286.

Sernyak MJ, Rosenheck RA (2008). Antipsychotic use in the treatment of outpatients with schizophrenia in the VA from fiscal years 1999 to 2006. Psychiat Serv 59(5): 567-569.

Stahl SM (2008). Antipsychotics and mood stabilizers: Stahl's essential psychopharmacology: Cambridge University Press, New York.

Stip E (2000). Novel antipsychotics: issues and controversies. Typicality of atypical antipsychotics. J Psychiatr Neurosci 25(2): 137.

Stockdale SE, Lagomasino IT, Siddique J, McGuire T, Miranda J (2008). Racial and ethnic disparities in detection and treatment of depression and anxiety among psychiatric and primary health care visits, 1995-2005. Med Care 46(7): 668-677.

U.S. Department of Health and Human Services (2001). Mental health: Culture, race, and ethnicity—a supplement to mental health: A report of the surgeon general. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services.

Van Brunt D, Gibson P, Ramsey J, Obenchain R (2003). Outpatient use of major antipsychotic drugs in ambulatory care settings in the United States, 1997-2000. MedGenMed 5(3): 16.

Wang CC, Farley JF (2013). Patterns and predictors of antipsychotic medication use among the US population: Findings from the Medical Expenditure Panel Survey. Res Social Adm Pharm 9(3): 263-275.

Woods SW, Sullivan MC, Neuse EC, Diaz E, Baker CB, Madonick SH, Griffith EE, Steiner JL (2003). Best practices: racial and ethnic effects on antipsychotic prescribing practices in a community mental health center. Psychiat Serv 54(2): 177-179.

Yang M, Barner JC, Lawson KA, Rascati KL, Wilson JP, Crismon ML, Worchel J, Mascarenas CA (2008). Antipsychotic medication utilization trends among Texas veterans: 1997-2002. Ann Pharmacother 42(9): 1229-1238.

Zuvekas SH (2005). Prescription drugs and the changing patterns of treatment for mental disorders, 1996–2001. Health Affair 24(1): 195-205.