Factors in choosing atypical antipsychotics

Toward understanding the bases of physicians' prescribing decisions

Jennifer Hoblyn, Art Noda, Jerome A. Yesavage, John O. Brooks, Javaid Sheikh, Tina Lee, Jared R. Tinklenberg, Bret Schneider, Ruth O'Hara, Douglas L. Leslie, Robert A. Rosenheck, Helena C. Kraemer

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objective: Off-label prescribing of medications, polypharmacy, and other questionable prescribing practices have led investigators to examine a large VA pharmacy database to determine if physician prescribing decisions appear reasonable. Method: The current study addresses the question of physician prescribing of atypical antipsychotics in 34,925 veterans with schizophrenia, using a series of signal detection analyses. Results: These results suggest that only three factors (hospital size, age, and secondary diagnosis) allow classification of patients prescribed atypicals into three groups with frequencies of use of atypicals ranging from 43% to 79%, and that these results are consistent with reasonable clinical practice. Conclusions: Results of two-stage signal detection analyses are readily interpretable by clinicians and administrators who are faced with the task of evaluating how physicians prescribe medications in clinical practice. Physicians' decisions to prescribe atypical antipsychotics are based on both patient and fiscal considerations. This likely reflects a combination of clinical judgment and institutional guidelines.

Original languageEnglish
Pages (from-to)160-166
Number of pages7
JournalJournal of Psychiatric Research
Volume40
Issue number2
DOIs
Publication statusPublished - Mar 2006
Externally publishedYes

Fingerprint

Antipsychotic Agents
Physicians
Health Facility Size
Off-Label Use
Polypharmacy
Veterans
Administrative Personnel
Schizophrenia
Research Personnel
Databases
Guidelines
Psychological Signal Detection

Keywords

  • Age
  • Logistic regression
  • MeSH antipsychotics
  • Schizophrenia
  • Signal detection

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry
  • Psychology(all)

Cite this

Factors in choosing atypical antipsychotics : Toward understanding the bases of physicians' prescribing decisions. / Hoblyn, Jennifer; Noda, Art; Yesavage, Jerome A.; Brooks, John O.; Sheikh, Javaid; Lee, Tina; Tinklenberg, Jared R.; Schneider, Bret; O'Hara, Ruth; Leslie, Douglas L.; Rosenheck, Robert A.; Kraemer, Helena C.

In: Journal of Psychiatric Research, Vol. 40, No. 2, 03.2006, p. 160-166.

Research output: Contribution to journalArticle

Hoblyn, J, Noda, A, Yesavage, JA, Brooks, JO, Sheikh, J, Lee, T, Tinklenberg, JR, Schneider, B, O'Hara, R, Leslie, DL, Rosenheck, RA & Kraemer, HC 2006, 'Factors in choosing atypical antipsychotics: Toward understanding the bases of physicians' prescribing decisions', Journal of Psychiatric Research, vol. 40, no. 2, pp. 160-166. https://doi.org/10.1016/j.jpsychires.2005.06.004
Hoblyn, Jennifer ; Noda, Art ; Yesavage, Jerome A. ; Brooks, John O. ; Sheikh, Javaid ; Lee, Tina ; Tinklenberg, Jared R. ; Schneider, Bret ; O'Hara, Ruth ; Leslie, Douglas L. ; Rosenheck, Robert A. ; Kraemer, Helena C. / Factors in choosing atypical antipsychotics : Toward understanding the bases of physicians' prescribing decisions. In: Journal of Psychiatric Research. 2006 ; Vol. 40, No. 2. pp. 160-166.
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