Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #100531

Julie B. Mallinger, MPH¹, Susan Fisher, PhD¹, Steven Lamberti, MD², and Theodore Brown, PhD¹. (1) Department of Community and Preventive Medicine, University of Rochester, 606 Nottingham Road, Baltimore, MD 21229, (2) Department of Psychiatry, University of Rochester, 601 Elmwood Avenue Box PSYCH, Rochester, NY 14642, 585-275-9155, Steve_Lamberti@urmc.rochester.edu

Background: Despite recommendations that atypical antipsychotics be used as first-line treatment for schizophrenia, prior studies have shown that black patients are less likely to receive these newer drugs. The purpose of this study was to determine the rate at which atypical antipsychotic medications are currently prescribed to white patients and black patients treated for schizophrenia. Methods: Data was collected from a community mental health clinic affiliated with the University of Rochester in Rochester, New York. Clinical and sociodemographic data for white patients and black patients treated for schizophrenia during the years 2003-2004 was collected from an administrative database. Prescription data was collected from the clinic's on-site pharmacy, through which many patients obtain their prescription medications. Multivariate logistic regression was used to examine the association between race and receipt of an atypical antipsychotic medication. Results: Of the 681 patients identified as eligible, prescription data was available for 456 (67%). Almost all patients (95%) received an atypical antipsychotic medication. In multivariate analysis, white patients were approximately six times more likely to receive an atypical medication, after controlling for clinical and sociodemographic factors (p=.0001). Most of this difference appeared to be driven by a disparity in the use of clozapine. Discussion: Our study shows a higher proportion of patients receiving atypical antipsychotic medications than previous studies. Nevertheless, black patients in this sample were less likely to receive atypical antipsychotics than white patients, demonstrating a persistent gap in the quality of care for patients with schizophrenia.

Learning Objectives: The learner will be able to

• Describe the rationale for the use of atypical antipsychotic medication as first-line therapy for schizophrenia, and evaluate trends in the use of these drugs over the past fifteen years since their introduction.
• Assess the clinical and public health significance of racial differences in the use of atypical antipsychotic medications.
• Identify barriers to the use of atypical antipsychotic medications among black patients with schizophrenia.
• Recommend community-based interventions to increase access to and utilization of atypical antipsychotic medications among black patients with schizophrenia.

Keywords: Sever Mental Illness, Health Disparities

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.