(64) Utilisation and Prescribing Patterns of Antipsychotic Medication in The Scottish Primary Care Setting (2010-2020)

Friday, August 26, 2022

8:00 AM – 6:00 PM CEST

Location: Hall C

Publication Number: 395

Presenting Author(s)

Fatema Mahmoud
– University of Strathclyde, University of Strathclyde , Glasgow, Scotland, G1 1XQ, United Kingdom

Co-Author(s)

Siobhan McBride
– Glasgow, Glasgow City, United Kingdom
Amanj Kurdi, PhD
– Lecturer in Pharmacoepidemiology and Pharmacy Practice, University of Strathclyde, Glasgow, United Kingdom

Background: Most guidelines do not recommend one antipsychotic over the other for the management of schizophrenia, whilst other guidelines recommend starting with an atypical antipsychotic first. There is a lack of recent data assessing the utilisation of antipsychotics in Scotland.

Objectives: To assess the utilisation of antipsychotics in Scottish primary care and evaluate the trends seen.

Methods: This repeated cross-sectional study used Scottish Prescription Cost Analysis datasets (covers all prescriptions dispensed in Scottish primary care setting) from 2010-2020. Antipsychotics use was measured using number of items dispensed/1000 inhabitants and number of Defined Daily Doses (DDDs)/1000 inhabitants/day.

Results: Both utilisation metrics showed an overall increase in total antipsychotics (increased by 26.5%; 1.97 DDDs), an increase in atypicals (increased by 54.8%; 2.84 DDDs) and a decrease in typicals (decreased by 38.6%; 0.87 DDDs). In terms of atypicals, quetiapine had the highest number of items dispensed/1000 inhabitants (increased by 98.4%; 36.4 items), whereas Olanzapine had the highest number of DDD/1000 inhabitants/day (increased by 32.3%; 0.71 DDDs). For typicals, prochlorperazine had the highest number of items dispensed/1000 inhabitants but chlorpromazine had the largest number of DDD/1000 inhabitants/day over the study period and still the number of DDDs decreased by 49.2% (0.31 DDDs) over the 10 years.

Conclusions: The utilisation of antipsychotics has increased considerably, with atypical antipsychotics markedly taking the lead over typicals. Despite the popularity of certain antipsychotics, particularly atypicals, there is no clear evidence to suggest that one antipsychotic is more efficacious or beneficial than the other, which suggests the most prescribed drugs are prescribed for reasons other than patient/physician preference and tolerability. This highlights the need for medication reviews to make sure patients are on the most suitable antipsychotic.