An Investigation On The Drug Treatment Of Inpatients With Schizophrenia In Different Decades And Areas

Objective:To investigation the prevalence and correlates of antipsychotic polypharmacy (APP) across decades and regions,including therapeutic regimen of antipsychotics,types and dosages,the combination and augmentation of antipsychotics, provide the basis for clinical rational drug use.Methods:According to retrospective research designs, The data of459inpatients’discharge records from January1,1980to December31in three different hospitals from Anhui,Jiangsu,Zhejiang province respectively with stratified random sampling method, and recorded the drug treatment also related information,then use the SPSS16.0statistical software for statistical description and statistical analysis of the results with the statistical analysis methods:chi-square test, descriptive statistics analysis, variance analysis, P<0.05for the difference was statistically significant.Results:(1) Across three hospitals (459participants, who diagnosed with schizophrenia), the rate of APP was significantly different(P<0.05)between decades Most common combinations included first-generation antipsychotics (FGAs)+second-generation antipsychotics (SGAs)followed by FGAs+FGAs and SGAs+SGAs,but the antipsychotic mono-therapy rate was not statistically significant different(P>0.05)across decades. The comedication pattern that divided into two groups (one was less than two species,and the other was more than two species),was statistically significant difference (χ2=8.235, p=0.016<0.05). The comparative results of anti-cholinergic drugs were decreased(χ2=16.829,p=0.000<0.05), and anti-anxiety agents (χ2=9.678, P=0.008<0.05) and anticonvulsants (χ2=6.315, p=0.043<0.05) were increased by years. In addition, there was no statistically significant difference (p>0.05) for the stable therapeutic dose, and there was significant difference for the highest time dose (p男=0.002, p女=0.041) across years. In2000s, the stable therapeutic dose between men and women was significant different (p=0.010).(2)We found that the difference of APP among the three areas as follows:The antipsychotic mono-therapy rate was statistically significant different(χ2=13.430, P=0.001<0.05) among the three regions, the comparison of APP (FGA+FGA, SGA+FGA, SGA+SGA) also has the same result (χ2=26.363, p=0.000<0.05),in addition,The anti-cholinergic drugs (χ2=15.332, p=0.000<0.05), the anti-anxiety agents (χ2=44.261, p=0.000<0.05) and anticonvulsants (χ2=5.896, p=0.052).The comedication pattern that divided into two groups (one was less than two species,and the other was more than two species),was statistically significant difference (χ2=41.727, p=0.000<0.05). The difference of stable dosages among the regions was not significant,but the highest time dose in region A was higher than region B and C (p=0.030<0.05),moreover,the comparative result of the highest time dose between male and female in region C was significantly different (p=0.000, male>female),the comparative result of the stable dose between male and female in region C and A was significantly different (p=0.012, p=0.011, both male>female).Conclusions:(1)The antipsychotic polypharmacy and comedication pattern have changed over the last three decades, at the same time, the using rates of SGAs, antianxiety agents and anticonvulsants are increasing, and the highest time dose is declining.(2)The Comparison between the three regions show that most common use of atypical antipsychotics in region C followed by B and A; in other treatment of drug combinations,the use rate of anti-cholinergic drugs and anti-anxiety agents in region C was higher than B and A,at meanwhile, the phenomenon of use more than two drugs is more common in region A and B.