Original Paper 1 Weinbrenner S et al. Drug Prescription Patterns in Schizophrenia Outpatients … Pharmacopsychiatry 2008; 41: 1–6 Phpsy/644/19.11.2008/Macmillan received 13.05.2008 revised 04.10.2008 accepted 10.10.2008 Bibliography DOI 10.1055/s-0028-1103293 Pharmacopsychiatry 2008; 41: 1–6 © Georg Thieme Verlag KG Stuttgart · New York ISSN 0176-3679 Correspondence G. Juckel, MD, PhD Department of Psychiatry Ruhr-University Bochum LWL University Hospital Alexandrinenstr. 1 44791 Bochum Germany Tel.: + 49/234/5077 201 Fax: + 49/234/5077 204 georg.juckel@wkp-lwl.org Drug Prescription Patterns in Schizophrenia Outpatients: Analysis of Data from a German Health Insurance Fund antipsychotic drug treatment and lifetime prog- nosis and treatment adherence is extremely important [15]. Thus, prevention of relapse and avoidance of a chronic course of illness are major therapeutic goals [7, 9]. One of the major causes of relapse is the discon- tinuation of drug therapy which is frequently linked to either insufficiently controlled symp- toms of schizophrenia or specific side effects of antipsychotic medication. Antipsychotic drugs may cause a variety of side effects, some of them indistinguishable from dis- ease symptoms themselves [19]. The most com- mon symptoms especially with typical anti- psychotic medication drugs are extrapyramidal Introduction & Despite the fact that the lifetime prevalence of schizophrenia accounts only for about 0.7–1.0 % of cases in industrialised countries [5, 27], the WHO Global Burden of Disease Study ranked schizophrenia fifth amongst the diseases leading to permanent disability [17, 26]. Schizophrenia affects a broad range of mental, psychological and social functions and thus has a very strong impact on many aspects of daily liv- ing for the patients themselves as well as for their relatives and society [12]. Keeping in mind that every episode of schizophrenia worsens the patient’s quality of life, overall responsiveness to Authors S. Weinbrenner 1 , H.-J. Assion 2 , T. Stargardt 1 , R. Busse 1 , G. Juckel 2 , C. A. Gericke 1, 3 Affiliations 1 Department of Health Care Management, WHO Collaborating Centre for Health Systems Research and Management, Berlin University of Technology, Berlin, Germany 2 Department of Psychiatry, Ruhr-University of Bochum, LWL University Hospital, Bochum, Germany 3 Centre for Health Services Research, The University of Adelaide, Adelaide, Australia Abstract & Introduction: The aim of this study was to investigate routine administrative data from a major German health insurance fund, Techniker Krankenkasse, which covers 5.4 million insured individuals. Using a retrospective cohort design, this study analysed data collected from patients with a hospital diagnosis of schizophrenia in 2003 (index hospitalisation) in order to evaluate prescription patterns of antipsychotic drugs. Methods: Patients with an ICD-10 diagnosis of schizophrenia, at least one year prior member- ship with the insurance fund and a follow-up period of one year were identified. Results were standardised by age and stratified by the severity of their illness, defined by the number of hospi- tal bed days during the three years preceding the index hospitalisation. Results: A total of 3 121 patients with schizo- phrenia (male 56.4 %, female 43.6 %) received 56 692 single prescriptions of antipsychotics. Of these, 35.4 % of the prescriptions were for typical and 64.6 % for atypical antipsychotics; 55 % were for high-potency, 45 % for low-potency typical antipsychotics. The most frequently prescribed drugs were olanzapine (26.6 %), clozapine (21.3 %) and risperidone (19 %). There were no relevant gender differences concerning prescription pat- terns. During a 12-month follow-up period after the first hospitalisation, 1 372 patients (43.9 %) were treated exclusively with an atypical anti- psychotic, another 499 patients (16 %) had a combination of an atypical plus a low-potency typical antipsychotic. Thus, basal therapy with an atypical was observed in 59.9 % of our study population. Only 327 patients (10.5 %) were treated exclusively with a typical antipsychotic. A total of 645 patients (20.7 %) were treated with a combination of atypical plus typical antipsy- chotic. Changes of medication within one sub- stance group occurred more often with typical antipsychotics (50 %) as compared to atypical antipsychotics (25 %). Discussion: At 60 %, the proportion of patients in this study treated with atypical antipsychot- ics was surprisingly high. Of significant interest is the frequent prescription of clozapine (14 %). The results are discussed in comparison to com- parable studies from other countries.