RESUMEN
PURPOSE: In the literature, noncompliance to medication in patients with schizophrenia ranges from 20 to 89%. There is an urgent need for reliable and valid techniques that measure compliance in antipsychotic drug treatment. In this study, we use pharmacy-dispensing records to assess compliance by calculating the refill rate of antipsychotic medication. METHODS: Refill rates of chronic antipsychotic drug users in 1999 and in 2000 were established by dividing the number of prescribed days by the total number of calendar days that the patient was registered in a pharmacy prescription records database. RESULTS: More than 50% of patients using an antipsychotic drug show a refill rate that is associated with medication compliance (0.9-1.1). The number of daily antipsychotic drug intakes was associated with a divergent refill rate, more than once daily dosing was associated with a significantly elevated refill rate (p < 0.015). CONCLUSIONS: The refill rate is a valuable addition to the small arsenal of objective compliance measurement tools. It is an easy to obtain and inexpensive way to estimate (non)compliance. We recommend future studies to medication use in both mental and physical disorders, in order to further specify the actual value of refill rates in clinical practice.
Asunto(s)
Antipsicóticos/uso terapéutico , Monitoreo de Drogas/métodos , Cooperación del Paciente/estadística & datos numéricos , Esquizofrenia/tratamiento farmacológico , Autoadministración/estadística & datos numéricos , Adulto , Análisis de Varianza , Antipsicóticos/administración & dosificación , Servicios Comunitarios de Farmacia/estadística & datos numéricos , Bases de Datos Factuales , Prescripciones de Medicamentos/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Países Bajos , Factores de TiempoRESUMEN
Antipsychotic drugs are generally registered for treating schizophrenia, psychosis, mania, and conditions of severe (locomotor) agitation. In common practice, however, they are prescribed in a wide range of different psychiatric disorders. We conducted a retrospective, exploratory study to examine off-label use of antipsychotics and possibly sex differences. We defined antipsychotic use as quasi-label when used in non-registered disorders that have psychosis as an inherent co-morbidity. When antipsychotics were prescribed in disorders that are generally not known with psychosis, we defined this as off-label use. In this study, we combined pharmacy records with data from general practitioners in order to evaluate the range of diagnoses for which antipsychotic drugs are used. We focused on sex differences in type of disorder and in prescribed dosages of antipsychotic drugs. Among 97 male and 95 female antipsychotic users, we could classify women significantly more often as on-label antipsychotic drug users compared with men. Most often, this occurred with typical antipsychotic drug treatment. While female patients used equal dosages for on-label and quasi-/off-label indications, we found that male patients used significantly lower dosages in quasi-/off-label indications compared with on-label indications. We suggest elaborate future research on the characteristics of quasi- and off-label antipsychotic drug use in order to define effective and safe use of antipsychotic drugs among off-label indications.