Trend in psychopharmaca uses

Project introduction: Polypharmacy remains a major concern in treating mental disorders, especially considering the presence of multimorbidity (Doos et al. 2014; Calderón‐Larrañaga et al. 2018). When treating a specific condition, physicians may opt for polypharmacy regimens without exploring the optimal dose range of a medication (Tsutsumi et al. 2011). The switch from monotherapy to polypharmacy is not always beneficial for the patients, and in some cases, the use of polypharmacy is not evidently recommended (Kok and Reynolds 2017; Kim, Salstein, and Goldberg 2021).

Research question: (1) How is the trend of switching from a monotherapy to polypharmacy regimens in patients receiving anxiolytics and antidepressants? (2) What is the duration of taking a monotherapy before switching to polypharmacy regimens?

Project impetus: Research on polypharmacy regimens in mental disorders mostly revolve around schizophrenia spectrum disorders. This might overshadow polypharmacy in other mental disorders, including anxiety, mood, behavioral, and personality disorders. In the previous research, three anxiolytic and antidepressant classes are likely a part of polypharmacy regimens, warranting the need of further evaluations.

Project objective: This project aims to investigate prescription registry to evaluate the observed duration before a patient has their prescription switched from a monotherapy to polypharmacy regimens.

Project results: The output of this project is a scientific manuscript reporting the trend of medications for people taking anxiolytics and antidepressants.

Outside scope of the project: This project will only consider evaluating a five-year trend from 2018 to 2022 using data from IADB. Asides from total polypharmacy, other types of psychopharmaca polypharmacy is not further investigated. Psychopharmaca included in this analysis are limited to antidepressants and anxiolytics.

Effects: Evaluate the trend of polypharmacy in the general population prescribed for psychopharmaca. The prevalence of anxiolytics and antidepressants claims will be used as a base parameter in the agent-based model project.

Users: Researcher and subject matter experts in health economics and outcome research.

Constraints: This project relies on a prescription registry, no clinical diagnosis is included in the analysis. Sociodemographic data is limited to include only gender and age.

Relation with other projects: Nothing to disclose.

References

Calderón‐Larrañaga, A., D. L. Vetrano, L. Ferrucci, S. W. Mercer, A. Marengoni, G. Onder, M. Eriksdotter, and L. Fratiglioni. 2018. “Multimorbidity and Functional Impairment–Bidirectional Interplay, Synergistic Effects and Common Pathways.” Journal of Internal Medicine 285 (3): 255–71. https://doi.org/10.1111/joim.12843.
Doos, Lucy, Eyitope O Roberts, Nadia Corp, and Umesh T Kadam. 2014. “Multi-Drug Therapy in Chronic Condition Multimorbidity: A Systematic Review.” Family Practice 31 (6): 654–63. https://doi.org/10.1093/fampra/cmu056.
Kim, Anna M., Lisa Salstein, and Joseph F. Goldberg. 2021. “A Systematic Review of Complex Polypharmacy in Bipolar Disorder: Prevalence, Clinical Features, Adherence, and Preliminary Recommendations for Practitioners.” The Journal of Clinical Psychiatry 82 (3). https://doi.org/10.4088/jcp.20r13263.
Kok, Rob M., and Charles F. Reynolds. 2017. “Management of Depression in Older Adults: A Review.” JAMA 317 (20): 2114. https://doi.org/10.1001/jama.2017.5706.
Tsutsumi, Chisa, Hiroyuki Uchida, Takefumi Suzuki, Koichiro Watanabe, Hiroyoshi Takeuchi, Shinichiro Nakajima, Yoshie Kimura, et al. 2011. “The Evolution of Antipsychotic Switch and Polypharmacy in Natural Practice — a Longitudinal Perspective.” Schizophrenia Research 130 (1–3): 40–46. https://doi.org/10.1016/j.schres.2011.05.013.
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