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Original Research

Prescription patterns of psychotropic medications and use of electroconvulsive therapy in Chinese patients with dementia

Lu Li, Zhi-Min Wang, Helen F.K. Chiu, Gabor S. Ungvari, Chee H. Ng, Ada W.Y. Tse, Grace K.I. Lok, Jian-Song Zhou, and Yu-Tao Xiang

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Volume 53 p. 722 - 727

Abstract

International Journal of Clinical Pharmacology and Therapeutics, Vol. 53 – No. 9/2015 (722-727)

Prescription patterns of psychotropic medications and use of electroconvulsive therapy in Chinese patients with dementia

Lu Li¹, Zhi-Min Wang², Helen F.K. Chiu³, Gabor S. Ungvari⁴,⁵, Chee H. Ng⁶, Ada W.Y. Tse³, Grace K.I. Lok⁷, Jian-Song Zhou⁸, and Yu-Tao Xiang¹,²

¹Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, ²Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, ³Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China, ⁴The University of Notre Dame Australia / Marian Center, ⁵School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, ⁶Department of Psychiatry, University of Melbourne, Melbourne, Australia, ⁷Kiang Wu Nursing College of Macau, Macao SRA, and ⁸Mental Health Institute of the Second Xiangya Hospital, Central South University, Hunan and Key Laboratory of Psychiatry and Mental Health of Hunan Province, China
Background: Little is known about psychiatric pharmacotherapy and somatic treatments in dementia in China. This study examined the prescription patterns of psychotropic medications and use of electroconvulsive therapy (ECT) in dementia patients hospitalized in a psychiatric institution in Beijing, China. Methods: This was a retrospective chart review of 401 patients with dementia treated over a period of 7 years (2007 – 2013) in a university-affiliated psychiatric institution in Beijing. Socio-demographic and clinical data were collected from the electronic chart management system (ECMS) for discharged patients. Results: Nearly all patients (96.8%) received psychotropic medications in order of frequency: second-generation antipsychotics (83.0%), benzodiazepines (77.8%), first generation antipsychotics (39.7%), antidepressants (29.7%), and mood stabilizers (24.7%). The rate of polypharmacy and ECT use was 82.0% and 3.7%, respectively. Prescription of mood stabilizers was associated with longer length of hospitalization. Conclusions: In a major psychiatric hospital in China, ECT was sporadically used in patients with dementia, while the vast majority of patients received at least one type of psychotropic medication. Factors contributing to the high use of psychopharmacological interventions in this population warrant further investigations.Correspondence to:
Dr. Zhi-Min Wang
Mood Disorders Center, Beijing Anding Hospital, China
or
Dr. Yu-Tao Xiang
3/F, Building E12, Faculty of Health Sciences
University of Macau, Avenida da Universidade
Taipa, Macau SAR, China
Email: [email protected] or [email protected]

Original

Antipsychotic polypharmacy and quality of life in patients with schizophrenia treated in primary care in China

Cai-Lan Hou, Xin-Rong Ma, Yu Zang, Fu-Jun Jia, Yong-Qiang Lin, Helen F.K. Chiu, Gabor S. Ungvari, Chee H. Ng, Bao-Liang Zhong, Xiao-Lan Cao, Yan Li, Mei-Ying Cai, and Yu-Tao Xiang

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Volume 54 p. 36 - 42

Abstract

International Journal of Clinical Pharmacology and Therapeutics, Vol. 54 – No. 1/2016 (36-42)

Antipsychotic polypharmacy and quality of life in patients with schizophrenia treated in primary care in China

Cai-Lan Hou¹*, Xin-Rong Ma²,³*, Yu Zang⁴*, Fu-Jun Jia¹, Yong-Qiang Lin¹, Helen F.K. Chiu⁵, Gabor S. Ungvari⁶, Chee H. Ng⁷, Bao-Liang Zhong⁵, Xiao-Lan Cao⁴, Yan Li⁵, Mei-Ying Cai⁸, and Yu-Tao Xiang⁹

¹Guangdong Mental Health Center, Guangdong General Hospital & Guangdong Academy of Medical Sciences, ²Southern Medical University, Guangdong Province, ³Ningxia Mental Health Center, Ningxia Ning-An Hospital, Ningxia Province, ⁴Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, ⁵Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China, ⁶School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, ⁷Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia, and ⁸Guangzhou Yuexiu Center for Disease Control and Prevention, Guangdong Province, and ⁹Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
Objective: In China, maintenance treatment for clinically stable patients with schizophrenia is usually provided by primary care physicians, but their prescribing patterns have not been studied. This study examined the frequency as well as demographic and clinical correlates of antipsychotic polypharmacy (APP) and its impact on quality of life (QOL) in patients with schizophrenia treated in primary care in China. Method: A total of 623 community-dwelling patients from 18 randomly selected primary care services were interviewed. Patients’ socio-demographic and clinical characteristics, including number of hospitalizations, antipsychotic drug-induced side effects, and QOL were recorded using a standardized protocol and data collection procedure. Results: The rate of APP prescription was 31% (193/623). Of the patients on APP, 89.6% received 2 antipsychotics, 10.4% received 3 or more antipsychotics. Clozapine (35.6%) was the most commonly prescribed second generation antipsychotic (SGA), while perphenazine (17.8%) was the most commonly prescribed first generation antipsychotic (FGA). Multiple logistic regression analyses revealed that patients on APP were more likely to receive SGAs and anticholinergics, had fewer hospitalizations, younger age of onset, and higher doses of antipsychotics. There were no significant differences between the two groups in any of the QOL domains. Conclusions: Approximately a third of Chinese patients with schizophrenia in primary care receive APP. Further examination of the rationale and appropriateness of APP and its alternatives is warranted.

*These authors contributed equally to the paper.Correspondence to:
Dr. Fu-Jun Jia
Guang Dong Mental Health Centre
Guangdong province, China
or
Dr. Yu-Tao Xiang
3/F, Building E12
Faculty of Health Sciences, University of Macau
Avenida da Universidade, Taipa, Macau SAR, China
Email: [email protected]; or [email protected]

Original Research

Prevalence of overweight in schizophrenia patients in Asia: findings of the research on Asian psychotropic prescription patterns (REAP) study

Fei Wang, Yu-Tao Xiang, Gabor S. Ungvari, Chee H. Ng, Helen F.K. Chiu, Wei Zheng, Chay-Hoon Tan, and Naotaka Shinfuku

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Volume 54 p. 450 - 455

Abstract

International Journal of Clinical Pharmacology and Therapeutics, Vol. 54 – No. 6/2016 (450-454)

Prevalence of overweight in schizophrenia patients in Asia: findings of the research on Asian psychotropic prescription patterns (REAP) study

Fei Wang¹, Yu-Tao Xiang¹, Gabor S. Ungvari²,³, Chee H. Ng⁴, Helen F.K. Chiu⁵, Wei Zheng⁶, Chay-Hoon Tan⁷, and Naotaka Shinfuku⁸

¹Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China, ²School of Psychiatry & Clinical Neurosciences, University of Western Australia, ³University of Notre Dame Australia/Marian Center, Perth, ⁴Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia, ⁵Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, ⁶Guangzhou Brain Hospital (Guangzhou Huiai Hospital), Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China, ⁷Department of Pharmacology, National University of Singapore, Singapore, and ⁸International Center for Medical Research, Kobe University School of Medicine, Kobe, Japan
Objective: This study examined the proportion of overweight in schizophrenia inpatients in selected Asian countries and territories and its independent demographic and clinical correlates. Method: Data on 1,534 hospitalized schizophrenia patients in 9 Asian countries and territories were collected by a review of medical files supplemented by a clinical interview during a 1-month period. Patients’ sociodemographic and clinical characteristics, prescriptions of psychotropic drugs, and Body Mass Index (BMI) were recorded using a standardized protocol and data collection procedure. For analyzes, BMI ≥ 25 kg/m² was defined as overweight. Results: The proportion of overweight was 35.8% (549/1,534) in the entire sample, with 39.7% (224/564) in females and 33.5% (325/970) in males (p = 0.01) and with wide inter-country variations. Multiple logistic regression analysis revealed that after controlling for study sites, overweight was independently associated with more frequent use of mood stabilizers (p < 0.001, odds ration (OR) = 1.4, 95% confidence interval (CI) = 1.1 – 1.8) and longer length of illness (p < 0.001, OR = 1.6, 95% CI = 1.2 – 2.1) but was less likely found in male patients (p = 0.003, OR = 0.7, 95% CI = 0.5 – 0.8). Conclusions: The prevalence of overweight Asian schizophrenia patients is significantly lower than the reported figures among their Western counterparts. There is considerable variation in prevalence of overweight schizophrenia patients within Asian countries and territories.Correspondence to:
Dr. Yu-Tao Xiang, MD, PhD
3/F, Building E12, Faculty of Health Sciences
University of Macau
Avenida da Universidade, Taipa, Macau SAR, China
Email: [email protected]

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