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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]

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