Dataset Information

Prescription practices in the treatment of first-episode schizophrenia spectrum disorders: data from the national RAISE-ETP study.

ABSTRACT: Treatment guidelines suggest distinctive medication strategies for first-episode and multiepisode patients with schizophrenia. To assess the extent to which community clinicians adjust their usual treatment regimens for first-episode patients, the authors examined prescription patterns and factors associated with prescription choice in a national cohort of early-phase patients.Prescription data at study entry were obtained from 404 participants in the Recovery After an Initial Schizophrenia Episode Project's Early Treatment Program (RAISE-ETP), a nationwide multisite effectiveness study for patients with first-episode schizophrenia spectrum disorders. Treatment with antipsychotics did not exceed 6 months at study entry.The authors identified 159 patients (39.4% of the sample) who might benefit from changes in their psychotropic prescriptions. Of these, 8.8% received prescriptions for recommended antipsychotics at higher than recommended dosages; 32.1% received prescriptions for olanzapine (often at high dosages), 23.3% for more than one antipsychotic, 36.5% for an antipsychotic and also an antidepressant without a clear indication, 10.1% for psychotropic medications without an antipsychotic, and 1.2% for stimulants. Multivariate analysis showed evidence for sex, age, and insurance status effects on prescription practices. Racial and ethnic effects consistent with effects reported in previous studies of multiepisode patients were found in univariate analyses. Despite some regional variations in prescription practices, no region consistently had different practices from the others. Diagnosis had limited and inconsistent effects.Besides prescriber education, policy makers may need to consider not only patient factors but also service delivery factors in efforts to improve prescription practices for first-episode schizophrenia patients.

SUBMITTER: Robinson DG

PROVIDER: S-EPMC4358323 | biostudies-literature | 2015 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Prescription practices in the treatment of first-episode schizophrenia spectrum disorders: data from the national RAISE-ETP study.

Robinson Delbert G DG Schooler Nina R NR John Majnu M Correll Christoph U CU Marcy Patricia P Addington Jean J Brunette Mary F MF Estroff Sue E SE Mueser Kim T KT Penn David D Robinson James J Rosenheck Robert A RA Severe Joanne J Goldstein Amy A Azrin Susan S Heinssen Robert R Kane John M JM

The American journal of psychiatry 20141204 3

<h4>Objective</h4>Treatment guidelines suggest distinctive medication strategies for first-episode and multiepisode patients with schizophrenia. To assess the extent to which community clinicians adjust their usual treatment regimens for first-episode patients, the authors examined prescription patterns and factors associated with prescription choice in a national cohort of early-phase patients.<h4>Method</h4>Prescription data at study entry were obtained from 404 participants in the Recovery Af ...[more]

PMID: 25727536

Similar Datasets

Project description:OBJECTIVE:This study examined racial and ethnic differences in treatment outcomes among participants in a randomized controlled trial of an intervention for first-episode psychosis called NAVIGATE. METHODS:Secondary data analyses were conducted for participants randomly assigned to usual community care (N=181) and NAVIGATE (N=223). Generalized estimating equations assessed whether race and ethnicity were associated with psychiatric symptoms and service use (medication management, family psychoeducation, and individual therapy) over a 24-month treatment period, accounting for baseline symptoms, duration of untreated psychosis, and insurance status. RESULTS:Among persons in usual community care, non-Hispanic blacks scored significantly higher throughout treatment on measures of positive symptoms (?=2.15, p=.010), disorganized thoughts (?=1.15, p=.033), and uncontrolled hostility (?=.74, p=.027), compared with non-Hispanic whites, and non-Hispanic blacks were less likely than non-Hispanic whites to receive individual therapy (OR=.45, p=.001). Families of Hispanic participants in usual community care were less likely than non-Hispanic white families to receive family psychoeducation (OR=.20, p=.01). For NAVIGATE participants, race and ethnicity were not associated with differences in psychiatric symptoms over time; families of non-Hispanic black participants were less likely than those of non-Hispanic white participants to receive family psychoeducation (OR=.53, p=.009). Hispanic participants in NAVIGATE were more likely than non-Hispanic white participants to receive medication management (OR=2.93, p=.001). CONCLUSIONS:In usual community care, non-Hispanic blacks scored higher on measures of psychiatric symptoms and were less likely to receive important services, compared with non-Hispanic whites. In NAVIGATE, racial and ethnic differences in psychiatric symptoms were not evident, although non-Hispanic blacks were less likely than non-Hispanic whites to receive family psychoeducation.

Dataset Information

Prescription practices in the treatment of first-episode schizophrenia spectrum disorders: data from the national RAISE-ETP study.

Publications

Prescription practices in the treatment of first-episode schizophrenia spectrum disorders: data from the national RAISE-ETP study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets