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Changes in physician antipsychotic prescribing preferences, 2002-2007
Psychiatric Services (Washington, D.C.)
|December 17, 2013
Summary
Physician antipsychotic prescribing became less concentrated, especially among psychiatrists, between 2002 and 2007. Preferences shifted significantly, with quetiapine use increasing dramatically while olanzapine use declined.
Area of Science:
- Pharmacology
- Health Services Research
- Psychiatry
Background:
- Physician prescribing behavior for antipsychotics is influenced by drug effectiveness, safety warnings, and cost.
- Understanding how these factors affect physician treatment choices is crucial for optimizing patient care.
Purpose of the Study:
- To measure changes in physician treatment customization and preferences for specific antipsychotic agents.
- To analyze shifts in prescribing concentration and agent preference following key events.
Main Methods:
- Longitudinal analysis of 2002-2007 prescribing data from 7,399 physicians.
- Descriptive and multivariable regression analyses of physician-level prescribing concentration (Herfindahl index) and agent preferences.
- Adjustments for physician volume, specialty, demographics, practice setting, and education.
Main Results:
- Antipsychotic prescribing remained concentrated but decreased overall (mean Herfindahl index: 0.33 in 2002 to 0.29 in 2007).
- Psychiatrists showed a greater reduction in prescribing concentration than other specialists.
- Physician preference for olanzapine dropped significantly (29.9% to 10.3%), while quetiapine preference surged (9.4% to 44.5%).
Conclusions:
- Physician preferences for specific antipsychotics underwent dramatic shifts between 2002 and 2007.
- While prescribing remained concentrated, it became less so over time, particularly for psychiatrists.
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