Background:
In the past decade, there has been an evolution of psychiatric services, moving to a community model with the closing of mental hospital beds by 2000. During this period, new, arguably more efficient antipsychotics have been introduced. There are no longitudinal studies available of antipsychotic use based on individual subject case audits. This paper presents a pharmacoepidemiological perspective on this issue, comparing two large mental health service entities subject to the same statewide ‘Framework’ document for service provision and yet with unique prescribing philosophies.
Methods:
Using a purpose-built database, prescribing information, sociodemographics and legal status data were collected from Australia, New Zealand and Asia. Data were acquired from community-treated patients or out patients. Data for two major centers in Victoria, Geelong and Northwestern MH network, were abstracted and analyzed with respect to their comparative usage trends. This analysis is performed for those with schizophrenia and those with bipolar disorder.
Results:
The data indicate that although both centers evolved their prescribing as deinstitutionaliza-tion progressed, their disparate prescribing patternstended converge over time. Antipsychotic dynamics are presented individually and by class, showing that Australia has a pattern of antipsychotic use that has no clear similarity to the US, UK or Asian practices.
Conclusion:
Despite differences in prescribing earlier on, the convergence of prescribing patterns may indicate that there has been a diffusion of knowledge, perhaps based on CPGs, that has resulted in a common approach to antipsychotic use in the community.
