Patrones de prescripción de antipsicóticos en pacientes afiliados al sistema general de seguridad social en salud de Colombia

Abstract

Introduction: Schizophrenia alters individual perception, thought, affection and behavior. Drug therapy can improve these manifestations. Objective: To determine prescription patterns of antipsychotic drugs in a group of patients affiliated to the Social Security Health System in Colombia. Materials and methods: This was a descriptive study with a 6.2 million people database. We selected 3,075 patients medicated with antipsychotics, of both sexes, and all ages, with continuous treatment from March to June, 2012, and residing in 57 Colombian cities. We designed a database on drug consumption, obtained by the company that distributes the drugs to the patients. Results: A total of 3,075 patients were studied, with an age mean of 55.8 ± 21.5 years; 50.3% of the participants were women. Of all patients, 81.9% were receiving monotherapy and 18.1% two or more antipsychotics. Prescription order was 77.1% atypical and 31.9% conventional. The most frequently used drugs were: quetiapine (on 30.3% of the patients), clozapine (23.7%), levomepropamize (18.4%), and risperidone (14.9%). The most common combinations were: haloperidol + levomepromazine (n=67, 12.1%), clozapine + pipotiazine (n=54, 9.7%), clozapine + risperidone (n=45, 8.1%), and quetiapine + levomepromazine (n=40, 7.2%). The most prescribed co-medications were: antidepressants (n=998, 32.5%), anxiolytic (n=799, 26.0%), statins (n=672, 21.9%); antiparkinsonians (n=341, 11.1%), and antidiabetic drugs (n=327, 10.6%). Conclusions: The practice of prescribing drugs with a high therapeutic value predominates mainly in antipsychotic monotherapy. Most agents were used in higher doses than recommended. This raises the need to design educational strategies to address these prescribing habits and research for evaluating the effectiveness of the treatment.