TY - JOUR
T1 - Factors in choosing atypical antipsychotics
T2 - Toward understanding the bases of physicians' prescribing decisions
AU - Hoblyn, Jennifer
AU - Noda, Art
AU - Yesavage, Jerome A.
AU - Brooks, John O.
AU - Sheikh, Javaid
AU - Lee, Tina
AU - Tinklenberg, Jared R.
AU - Schneider, Bret
AU - O'Hara, Ruth
AU - Leslie, Douglas L.
AU - Rosenheck, Robert A.
AU - Kraemer, Helena C.
N1 - Funding Information:
This research was supported by the Sierra-Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), National Institute of Aging Grant AG17824, and the Medical Research Service of the Department of Veterans Affairs.
PY - 2006/3
Y1 - 2006/3
N2 - 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.
AB - 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.
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U2 - 10.1016/j.jpsychires.2005.06.004
DO - 10.1016/j.jpsychires.2005.06.004
M3 - Article
C2 - 16150458
AN - SCOPUS:31644435075
SN - 0022-3956
VL - 40
SP - 160
EP - 166
JO - Journal of Psychiatric Research
JF - Journal of Psychiatric Research
IS - 2
ER -
