Abstract
Objectives: To examine real-world patterns of antipsychotic use in
Australia. Methods: This retrospective cohort analysis was conducted
using the Australian Commonwealth Department of Human Services
Pharmaceutical Benefits Scheme (PBS) 10% sample data. Included data
were for patients aged 16-years or older who initiated treatment for the
first time with a PBS-reimbursed antipsychotic medication for
schizophrenia between July 2013 and September 2017. Patterns of
treatment usage were summarised descriptively. Differences in
prescribing patterns by age and prescribing year were reported.
Treatment persistence was estimated using Kaplan-Meier methods, with
differences explored using log-rank tests. Values of p<0.05
were considered statistically significant. Results: 6,740 patients,
representing 8,249 non-unique patients, received prescriptions for
antipsychotic medications. Patients were aged 16 years to over 85 years
(54.5% were < 55 years) and two-thirds of patients were male
(61%). The majority (62%, n=5139/8249) were prescribed an atypical
oral antipsychotic. Typical long-acting antipsychotic therapies (LATs)
were prescribed 19% of the time (n=1,608/8,249. There was a small
increase in prescribing of atypical LAT and typical LAT and a small
decrease in atypical oral and clozapine prescribing over the study
period. Treatment persistence was greatest in patients treated with
clozapine, than in those treated with atypical LATs. Conclusions: While
the majority of patients receive atypical antipsychotic medications, one
in five continue to user older typical LAT therapies. Patient age and
time on therapy may be associated with choice of therapy. Persistence to
atypical LAT therapy is better than for other treatment modalities in
this real-world cohort.