A descriptive analysis of antipsychotic prescribing patterns for patients admitted to hospital with a primary diagnosis of schizophrenia

Abstract

Treatment with antipsychotic medication is recognized as the standard treatment for patients with schizophrenia. While evidence-based recommendations have been made on antipsychotic prescribing patterns for patients with schizophrenia, there is still a disconnect between these recommendations and the prescribing patterns that are seen in clinical practice. This study investigates the current antipsychotic prescribing patterns for inpatients with schizophrenia at Ontario Shores, a specialized mental health hospital in Whitby, Ontario. Most sociodemographic variables had no significant effect on the three outcomes variables: whether patients met a target antipsychotic dose by the second week post-admission; were prescribed an LAI; or whether, pending eligibility, patients were prescribed clozapine as a third-line treatment. Length of stay as well as race/ethnicity were associated with an increased likelihood of receiving treatment with an LAI, however there are a number of unobservable confounding variables which make it difficult to draw conclusions from these findings. Overall, the findings of this study suggest that the provider seen may be an influential factor in determining the type of treatment a patient receives. This study provides a baseline on the current antipsychotic prescribing patterns at Ontario Shores and may be used to inform the implementation of an antipsychotic order set as part of bundled care initiatives within the hospital moving forward. Future studies should investigate whether receiving treatment that aligns with evidence based recommendations correlates with improved symptom scale scores and, whether the successful implementation of an antipsychotic order set improves both the standard of care received and symptom scale scores of patients diagnosed with schizophrenia.