Clozapine use reduced psychiatric hospitalization and emergency room visits in patients with bipolar disorder independent of improved treatment regularity in a three-year follow-up period
Journal
Bipolar Disorders
Journal Volume
17
Journal Issue
4
Pages
415-423
Date Issued
2015
Author(s)
Abstract
Objectives: The efficacy of clozapine in bipolar disorder remains to be systemically examined. In the current study, we sought to disentangle the effect of clozapine from that of improved treatment regularity and to compare the effect of clozapine with the effect of regular treatment for bipolar disorder by exploring the complete 10-year clozapine prescription data from a Taiwanese total population health claims database. Methods: In the period between 2000 and 2009, 3,874 (3.3%) out of the 117,785 patients identified as having bipolar disorder in a Taiwanese total population health claims database were ever prescribed clozapine. Among them, 920 patients with bipolar disorder who had good pre-clozapine medication compliance and received at least two clozapine prescriptions were further categorized according to their clozapine medication possession ratio (MPR) as regular users (MPR???0.8; n?=?476) and irregular users (MPR??0.8), was effective in reducing the numbers of ER visits, hospitalizations, and total hospital days in patients with bipolar disorder with previous frequent hospitalizations and ER visits despite regular pre-clozapine treatment for bipolar disorder. However, high early attrition and suboptimal treatment compliance need to be rectified in order to optimize the outcome of clozapine treatment in bipolar disorders. ? 2014 John Wiley & Sons A/S.
Subjects
Bipolar disorder; Clozapine; Hospitalization; Medication possession ratio (MPR); Treatment regularity
SDGs
Other Subjects
clozapine; mood stabilizer; neuroleptic agent; clozapine; adult; Article; bipolar disorder; comparative effectiveness; controlled study; drug use; emergency treatment; female; follow up; hospitalization; human; length of stay; major clinical study; male; patient compliance; prescription; priority journal; psychiatric treatment; Taiwanese; treatment outcome; aged; bipolar disorder; emergency health service; hospitalization; medication compliance; middle aged; psychology; statistics and numerical data; Taiwan; utilization; utilization review; Adult; Aged; Antipsychotic Agents; Bipolar Disorder; Clozapine; Emergency Service, Hospital; Female; Follow-Up Studies; Hospitalization; Humans; Length of Stay; Male; Medication Adherence; Middle Aged; Taiwan; Utilization Review
Type
journal article