OBJECTIVE: To assess factors that influence whether schizophrenia patients are prescribed second-generation antipsychotic medications.
METHODS: Data were obtained from the Schizophrenia Care and Assessment Program study. Participant information was collected through interviews and medical record abstraction (n=294). Treating physicians were surveyed about their demographic, professional, and practice characteristics (n=42). Patient and physician information was linked. Multivariate logistic regression was estimated.
RESULTS: The following variables were positively associated with second-generation use at p < 0.05: a higher baseline PANSSNS score (e.g. depressed affect), having a physician who has been in practice less than five years or greater than 20 years, one who has attended more than one professional meeting in the last five years, and one who sees more than 25 patients/week. Patient age < 35, race other than African-American or White, diagnosis of ‘other schizophrenia’, being uninsured, and having one or no prior psychotic episodes were positively associated with second-generation medication use at p < 0.1. Medicare, Medicaid, private insurance, CHAMPUS, and other insurance were not significant predictors.
CONCLUSIONS: A perceived advantage of second-generation antipsychotics is greater effectiveness at reducing negative symptoms of schizophrenia. Consistent with this belief, we find that physicians are prescribing newer antipsychotics to patients with more negative symptoms. Physicians may be prescribing second-generation antipsychotics to younger patients and those experiencing a first psychotic episode, thus using second-generation medications as first-line treatments. Physician characteristics seem to influenced whether patients are prescribed the second-generation medications. We do not find evidence that insurance status limits access to medications.
Learning Objectives: To understand the factors that influence the prescription of new medications for the treatment of schizophrenia
Keywords: Access, Drugs
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Eli Lilly & Company
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.