scholarly journals Changes in prescribing for bipolar disorder between 2009 and 2016: national-level data linkage study in Scotland

2019 ◽  
Vol 215 (01) ◽  
pp. 415-421 ◽  
Author(s):  
Laura M. Lyall ◽  
Nagore Penades ◽  
Daniel J. Smith
Keyword(s):  
Bipolar Disorder ◽  
Odds Ratio ◽  
Data Linkage ◽  
Treatment Guidelines ◽  
National Level ◽  
Logistic Models ◽  
Linkage Study ◽  
Prescribing Patterns ◽  
Level Data ◽  
Evidence Based Guidelines

BackgroundPeople with bipolar disorder typically require long-term pharmacological treatment to prevent episodes of depression or mania. However, evidence-based guidelines are often not followed by prescribers and, in some countries, prescribing of lithium is in decline. Polypharmacy is also common in bipolar disorder.AimsTo employ a data linkage approach to describe and evaluate prescribing patterns in bipolar disorder in Scotland between 2009 and 2016.MethodBy linking prescribing data to the electronic Scottish Morbidity Records, we identified a cohort of 23 135 patients with bipolar disorder who were prescribed psychotropic medication between 2009 and 2016. We examined trends in proportions of patients prescribed each of six drug categories. Random effects logistic models examined change in prescribing over years of interest.ResultsThe most common form of treatment was antidepressant monotherapy (24.96%), with only 5.90% of patients receiving lithium monotherapy. Prescribing of antipsychotics and anti-epileptics increased from 2009 to 2016 (antipsychotics: odds ratio 1.16, 95% CI 1.15–1.18; anti-epileptics: odds ratio 1.34, 95% CI 1.32–1.36), whereas prescribing of lithium decreased (odds ratio 0.83, 95% CI 0.82–0.85). Prescribing of valproate decreased from 2009–2016 in women, but increased in men (women: odds ratio 0.93, 95% CI 0.90–0.97; men: odds ratio 1.11, 95% CI 1.04–1.18).ConclusionsAntidepressant monotherapy was the most common form of treatment for bipolar disorder in Scotland and prescribing of lithium has declined between 2009 and 2016. The findings are concerning and represent a gap between treatment guidelines and clinical practice.Declaration of interestNone.

scholarly journals Pharmacotherapy prescribing patterns in the treatment of bipolar disorder in a South African outpatient population

2018 ◽  
Vol 1 (2) ◽  
pp. 39-52 ◽  
Author(s):  
Eleanor Mari Holzapfel ◽  
Christopher Paul Szabo
Keyword(s):  
South Africa ◽  
Bipolar Disorder ◽  
Categorical Data ◽  
Best Practice ◽  
Treatment Guidelines ◽  
Statistical Tests ◽  
Standard Of Care ◽  
Prescribing Patterns ◽  
Psychiatric Clinic ◽  
International Studies

AbstractObjectivesTo describe the range and frequency of psychotropics used in the management of bipolar disorder in a specific setting as well as describe the nature and frequency of monotherapy versus polypharmacy use. Specifically to determine congruence with recommended standard of care that might inform a review and refinement of prescribing within this context.MethodsThe study was a retrospective file review for patients with bipolar disorder (ICD 10 and or DSM IV TR diagnostic criteria) attending the outpatient clinic of a specialised psychiatric hospital (Tara Hospital) affiliated to the Department of Psychiatry (University of the Witwatersrand) in Johannesburg, South Africa. Data were presented both descriptively (continuous, discrete and categorical data) and with a range of appropriate statistical tests used for associations between categorical data (Chi Square; Fisher’s exact test; Cramer’s V and the phi coefficient).ResultsThe majority of patients (93.8%) were prescribed polypharmacy, with 3.2 as the mean number of psychotropic medications prescribed per patient (as determined from the last prescription written during the period of review, i.e. one year). There was a notable variety in the combinations used with no particular combination being prescribed in the majority of patients, noting, however, that 47% of the combinations used included a standard mood stabiliser prescribed together with an antipsychotic.ConclusionsThe current study provides data on the prescribing patterns for bipolar disorder in a specialist psychiatric clinic within an academic complex in South Africa. The findings reflect international studies and highlight polypharmacy and combination treatment as common in such settings. Where polypharmacy is prescribed, the variation in combinations prescribed indicate that whilst treatment guidelines may provide a best practice approach, studies determining the most useful combinations are few and ultimately clinical requirements for individual patients will dictate treatment.

scholarly journals EPS5.5 How does having cystic fibrosis impact on birth weight? A population level data linkage study in Wales

2017 ◽  
Vol 16 ◽  
pp. S48
Author(s):  
D.K. Schlüter ◽  
R. Griffiths ◽  
A. Akbari ◽  
M. Heaven ◽  
P.J. Diggle ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Birth Weight ◽  
Data Linkage ◽  
Population Level ◽  
Linkage Study ◽  
Level Data

The Link between Male Genital Anomalies and Adult Male Reproductive Disorders: A Population-Based Data Linkage Study Spanning Over 40 Years

2018 ◽  
Author(s):  
Francisco Schneuer ◽  
Elizabeth Milne ◽  
Sarra E. Jamieson ◽  
Gavin Pereira ◽  
Michele Hansen ◽  
...  
Keyword(s):  
Adult Male ◽  
Data Linkage ◽  
Population Based ◽  
Linkage Study ◽  
Reproductive Disorders ◽  
Over 40 Years ◽  
Male Genital
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