Race and long-acting antipsychotic prescription at a community mental health center: a retrospective chart review.

Abstract

OBJECTIVE:

There has been concern that racial minorities are disproportionately prescribed long-acting injectable antipsychotic drugs.

METHOD:

Comprehensive administrative data and clinician survey were used to identify all patients with a DSM-IV diagnosis of schizophrenia who received long-acting antipsychotic prescriptions from July 2009 to June 2010 at a community mental health center. Charts were reviewed retrospectively to validate long-acting antipsychotic prescription (eg, medication, dosage) and merged with administrative data from all center patients documenting sociodemographic characteristics (ie, age, race, gender) and comorbid diagnoses. We used bivariate χ2, t tests, and multivariate logistic regression to compare the subsample of patients receiving long-acting injectable drugs (n = 102) to patients not receiving long-acting injectable drugs (n = 799) who were diagnosed with schizophrenia for the same period.

RESULTS:

White patients were significantly less likely to receive long-acting antipsychotic prescriptions than minority patients (OR = 0.52, P < .007); ie, nonwhites were 1.89 times more likely to receive such drugs. Age, gender, and comorbid diagnoses, including substance abuse, were unrelated to long-acting injectable prescription, and race/ethnicity was not associated with use of specific agents (haloperidol decanoate, fluphenazine decanoate, or risperidone microspheres) (P = .73).

CONCLUSIONS:

Racial minorities are more likely than other patients with schizophrenia to receive long-acting injectionable antipsychotics, a finding that suggests their prescribers may consider them less adherent to antipsychotic prescriptions.

• Authors: Neil Krishan Aggarwal, Robert A Rosenheck, Scott W Woods, Michael J Sernyak
• Journal: The Journal of clinical psychiatry (J Clin Psychiatry) Vol. 73 Issue 4 Pg. 513-7 (Apr 2012) ISSN: 1555-2101 [Electronic] United States
• PMID: 22579151 (Publication Type: Journal Article)
• Copyright: © Copyright 2012 Physicians Postgraduate Press, Inc.

Chemical References

• Antipsychotic Agents
• Delayed-Action Preparations

Topics

• Antipsychotic Agents (administration & dosage, therapeutic use)
• Black People (statistics & numerical data)
• Chi-Square Distribution
• Community Mental Health Centers (statistics & numerical data)
• Delayed-Action Preparations
• Female
• Healthcare Disparities
• Humans
• Logistic Models
• Male
• Middle Aged
• Psychotic Disorders (drug therapy)
• Racial Groups (statistics & numerical data)
• Retrospective Studies
• Schizophrenia (drug therapy)
• White People (statistics & numerical data)