Antipsychotic Polypharmacy in Older Adult Asian Patients With Schizophrenia: Research on Asian Psychotropic Prescription Pattern

Min Dong, Liang Nan Zeng, Qinge Zhang, Shu Yu Yang, Lian Yu Chen, Kang Sim, Yan Ling He, Helen Fung Kum Chiu, Norman Sartorius, Chay Hoon Tan, Mian Yoon Chong, Naotaka Shinfuku, Shih Ku Lin, Chee H. Ng, Gabor S. Ungvari, Yu Tao Xiang

Research output: Contribution to journalArticle

Abstract

Background and Objective: Antipsychotic polypharmacy (APP) is a controversial topic in the treatment of older adults with schizophrenia. The objective of this study was to examine the use of APP in older adult Asian patients with schizophrenia and its associated demographic and clinical factors. Methods: This study was based on the fourth survey of the consortium known as the Research on Asian Psychotropic Prescription Pattern for Antipsychotics. Fifteen Asian countries/territories participated in this survey, including Bangladesh, Mainland China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Myanmar, Pakistan, Singapore, Sri Lanka, Taiwan, Thailand, and Vietnam. Basic demographic and clinical characteristics were collected using a standardized data collection form. Results: Among the 879 older adults with schizophrenia included in the survey, the rate of APP was 40.5%. Multiple logistic regression analysis revealed that higher antipsychotic doses (P <.001, odds ratio [OR] = 1.003, 95% confidence interval [CI]: 1.002-1.003), longer duration of illness (P =.02, OR = 1.845, 95% CI: 1.087-3.132), and the prescription of anticholinergics (P <.001, OR = 1.871, 95% CI: 1.329-2.635), second-generation antipsychotics (P =.001, OR = 2.264, 95% CI: 1.453-3.529), and first-generation antipsychotics (P <.001, OR = 3.344, 95% CI: 2.307-4.847) were significantly associated with APP. Conclusion: Antipsychotic polypharmacy was common in older adult Asian patients with schizophrenia. Compared to the results of previous surveys, the use of APP showed a declining trend over time. Considering the general poor health status of older patients with schizophrenia and their increased risk of drug-induced adverse events, the use of APP in this population needs careful consideration.

Original languageEnglish
Pages (from-to)304-311
Number of pages8
JournalJournal of Geriatric Psychiatry and Neurology
Volume32
Issue number6
DOIs
Publication statusPublished - 1 Nov 2019

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Polypharmacy
Antipsychotic Agents
Prescriptions
Schizophrenia
Research
Odds Ratio
Confidence Intervals
Demography
Myanmar
Sri Lanka
Bangladesh
Indonesia
Vietnam
Malaysia
Pakistan
Singapore
Cholinergic Antagonists
Hong Kong
Thailand
Korea

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Dong, Min ; Zeng, Liang Nan ; Zhang, Qinge ; Yang, Shu Yu ; Chen, Lian Yu ; Sim, Kang ; He, Yan Ling ; Chiu, Helen Fung Kum ; Sartorius, Norman ; Tan, Chay Hoon ; Chong, Mian Yoon ; Shinfuku, Naotaka ; Lin, Shih Ku ; Ng, Chee H. ; Ungvari, Gabor S. ; Xiang, Yu Tao. / Antipsychotic Polypharmacy in Older Adult Asian Patients With Schizophrenia : Research on Asian Psychotropic Prescription Pattern. In: Journal of Geriatric Psychiatry and Neurology. 2019 ; Vol. 32, No. 6. pp. 304-311.
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abstract = "Background and Objective: Antipsychotic polypharmacy (APP) is a controversial topic in the treatment of older adults with schizophrenia. The objective of this study was to examine the use of APP in older adult Asian patients with schizophrenia and its associated demographic and clinical factors. Methods: This study was based on the fourth survey of the consortium known as the Research on Asian Psychotropic Prescription Pattern for Antipsychotics. Fifteen Asian countries/territories participated in this survey, including Bangladesh, Mainland China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Myanmar, Pakistan, Singapore, Sri Lanka, Taiwan, Thailand, and Vietnam. Basic demographic and clinical characteristics were collected using a standardized data collection form. Results: Among the 879 older adults with schizophrenia included in the survey, the rate of APP was 40.5{\%}. Multiple logistic regression analysis revealed that higher antipsychotic doses (P <.001, odds ratio [OR] = 1.003, 95{\%} confidence interval [CI]: 1.002-1.003), longer duration of illness (P =.02, OR = 1.845, 95{\%} CI: 1.087-3.132), and the prescription of anticholinergics (P <.001, OR = 1.871, 95{\%} CI: 1.329-2.635), second-generation antipsychotics (P =.001, OR = 2.264, 95{\%} CI: 1.453-3.529), and first-generation antipsychotics (P <.001, OR = 3.344, 95{\%} CI: 2.307-4.847) were significantly associated with APP. Conclusion: Antipsychotic polypharmacy was common in older adult Asian patients with schizophrenia. Compared to the results of previous surveys, the use of APP showed a declining trend over time. Considering the general poor health status of older patients with schizophrenia and their increased risk of drug-induced adverse events, the use of APP in this population needs careful consideration.",
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author = "Min Dong and Zeng, {Liang Nan} and Qinge Zhang and Yang, {Shu Yu} and Chen, {Lian Yu} and Kang Sim and He, {Yan Ling} and Chiu, {Helen Fung Kum} and Norman Sartorius and Tan, {Chay Hoon} and Chong, {Mian Yoon} and Naotaka Shinfuku and Lin, {Shih Ku} and Ng, {Chee H.} and Ungvari, {Gabor S.} and Xiang, {Yu Tao}",
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Dong, M, Zeng, LN, Zhang, Q, Yang, SY, Chen, LY, Sim, K, He, YL, Chiu, HFK, Sartorius, N, Tan, CH, Chong, MY, Shinfuku, N, Lin, SK, Ng, CH, Ungvari, GS & Xiang, YT 2019, 'Antipsychotic Polypharmacy in Older Adult Asian Patients With Schizophrenia: Research on Asian Psychotropic Prescription Pattern' Journal of Geriatric Psychiatry and Neurology, vol. 32, no. 6, pp. 304-311. https://doi.org/10.1177/0891988719862636

Antipsychotic Polypharmacy in Older Adult Asian Patients With Schizophrenia : Research on Asian Psychotropic Prescription Pattern. / Dong, Min; Zeng, Liang Nan; Zhang, Qinge; Yang, Shu Yu; Chen, Lian Yu; Sim, Kang; He, Yan Ling; Chiu, Helen Fung Kum; Sartorius, Norman; Tan, Chay Hoon; Chong, Mian Yoon; Shinfuku, Naotaka; Lin, Shih Ku; Ng, Chee H.; Ungvari, Gabor S.; Xiang, Yu Tao.

In: Journal of Geriatric Psychiatry and Neurology, Vol. 32, No. 6, 01.11.2019, p. 304-311.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Antipsychotic Polypharmacy in Older Adult Asian Patients With Schizophrenia

T2 - Research on Asian Psychotropic Prescription Pattern

AU - Dong, Min

AU - Zeng, Liang Nan

AU - Zhang, Qinge

AU - Yang, Shu Yu

AU - Chen, Lian Yu

AU - Sim, Kang

AU - He, Yan Ling

AU - Chiu, Helen Fung Kum

AU - Sartorius, Norman

AU - Tan, Chay Hoon

AU - Chong, Mian Yoon

AU - Shinfuku, Naotaka

AU - Lin, Shih Ku

AU - Ng, Chee H.

AU - Ungvari, Gabor S.

AU - Xiang, Yu Tao

PY - 2019/11/1

Y1 - 2019/11/1

N2 - Background and Objective: Antipsychotic polypharmacy (APP) is a controversial topic in the treatment of older adults with schizophrenia. The objective of this study was to examine the use of APP in older adult Asian patients with schizophrenia and its associated demographic and clinical factors. Methods: This study was based on the fourth survey of the consortium known as the Research on Asian Psychotropic Prescription Pattern for Antipsychotics. Fifteen Asian countries/territories participated in this survey, including Bangladesh, Mainland China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Myanmar, Pakistan, Singapore, Sri Lanka, Taiwan, Thailand, and Vietnam. Basic demographic and clinical characteristics were collected using a standardized data collection form. Results: Among the 879 older adults with schizophrenia included in the survey, the rate of APP was 40.5%. Multiple logistic regression analysis revealed that higher antipsychotic doses (P <.001, odds ratio [OR] = 1.003, 95% confidence interval [CI]: 1.002-1.003), longer duration of illness (P =.02, OR = 1.845, 95% CI: 1.087-3.132), and the prescription of anticholinergics (P <.001, OR = 1.871, 95% CI: 1.329-2.635), second-generation antipsychotics (P =.001, OR = 2.264, 95% CI: 1.453-3.529), and first-generation antipsychotics (P <.001, OR = 3.344, 95% CI: 2.307-4.847) were significantly associated with APP. Conclusion: Antipsychotic polypharmacy was common in older adult Asian patients with schizophrenia. Compared to the results of previous surveys, the use of APP showed a declining trend over time. Considering the general poor health status of older patients with schizophrenia and their increased risk of drug-induced adverse events, the use of APP in this population needs careful consideration.

AB - Background and Objective: Antipsychotic polypharmacy (APP) is a controversial topic in the treatment of older adults with schizophrenia. The objective of this study was to examine the use of APP in older adult Asian patients with schizophrenia and its associated demographic and clinical factors. Methods: This study was based on the fourth survey of the consortium known as the Research on Asian Psychotropic Prescription Pattern for Antipsychotics. Fifteen Asian countries/territories participated in this survey, including Bangladesh, Mainland China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Myanmar, Pakistan, Singapore, Sri Lanka, Taiwan, Thailand, and Vietnam. Basic demographic and clinical characteristics were collected using a standardized data collection form. Results: Among the 879 older adults with schizophrenia included in the survey, the rate of APP was 40.5%. Multiple logistic regression analysis revealed that higher antipsychotic doses (P <.001, odds ratio [OR] = 1.003, 95% confidence interval [CI]: 1.002-1.003), longer duration of illness (P =.02, OR = 1.845, 95% CI: 1.087-3.132), and the prescription of anticholinergics (P <.001, OR = 1.871, 95% CI: 1.329-2.635), second-generation antipsychotics (P =.001, OR = 2.264, 95% CI: 1.453-3.529), and first-generation antipsychotics (P <.001, OR = 3.344, 95% CI: 2.307-4.847) were significantly associated with APP. Conclusion: Antipsychotic polypharmacy was common in older adult Asian patients with schizophrenia. Compared to the results of previous surveys, the use of APP showed a declining trend over time. Considering the general poor health status of older patients with schizophrenia and their increased risk of drug-induced adverse events, the use of APP in this population needs careful consideration.

KW - antipsychotic polypharmacy

KW - Asian

KW - older adult patients

KW - schizophrenia

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U2 - 10.1177/0891988719862636

DO - 10.1177/0891988719862636

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