© 2002 by Oxford University Press and the Maryland Psychiatric Research Center (MPRC)
Antipsychotic Prescribing Practices in Connecticut's Public Mental Health System: Rates of Changing Medications and Prescribing Styles
Connecticut Department of Mental Health and Addiction Services Hartford, CT Department of Psychology, University of Connecticut Storrs, CT
Department of Mental Health and Addiction Services Hartford, CT Department of Psychology, University of Connecticut Storrs, CT
Department of Mental Health and Addiction Services Hartford, CT Assistant Clinical Professor Department of Psychiatry, Yale School of Medicine New Haven, CT
Division of Health Services Research, Department of Psychiatry, Mount Sinai School of Medicine of New York University New York, NY Evaluation Director, Veterans Affairs New York Healthcare System, Mental Illness Research, Education, and Clinical Center New York, NY
Send reprint requests to Dr. N.H. Covell, Connecticut Department of Mental Health and Addiction Services, Research Division, 410 Capitol Avenue, MS#14RSD, P.O. Box 341431, Hartford, CT 06134; e-mail: nancy.covell{at}po.state.ct.us
We characterized prescribing in Connecticut's State public mental health system to assess the feasibility of implementing an evidence-based medication algorithm. Medication records for a random sample of outpatients with diagnoses of schizophrenia spectrum disorders showed prescribing patterns similar to the entire United States. The base rate of changing antipsychotic medications was moderate. Over half of patients received decanoate medications, polypharmacy was nontrivial, and there was variability in prescribing patterns across physicians. Caucasian patients were more likely to receive an atypical antipsychotic and less likely to have a decanoate medication, and Latino patients were less likely to change medications. Because the base rate of changing medications was moderate and a considerable proportion of patients were prescribed newer antipsychotic medications, introducing a research-derived medication algorithm with newer atypical antipsychotics as first line agents may fit well with current practice. Further, implementing such an algorithm may reduce racial and ethnic disparities in prescribing patterns.
Keywords: Schizophrenia / antipsychotics / prescribing patterns / polypharmacy / race / ethnicity
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