The treatment characteristics of oral antipsychotics in treatment of adolescents with schizophrenia in China

BackgroundEvidence on treatment for adolescent with schizophrenia in China is limited. Understanding the current practice of antipsychotics utilization is imperative to inform appropriate use in this population.MethodsThis retrospective cohort study used electronic medical records (2018-2022) from two hospitals in China. Adolescents (12-17y) with schizophrenia (ICD-10: F20.x) who were prescribed oral antipsychotics during the study period were included. Index date was the date of the first antipsychotics prescription. Patients were followed up until the earliest of last antipsychotics prescription, 18y, or study end. Antipsychotic utilization was described by commonly prescribed antipsychotics, polypharmacy, dosage and medication adherence (indicated by proportion of days covered [PDC]). Dosage was converted using defined daily dose(DDD) for unified measurement.ResultsOverall, 869 (mean age: 15.6y, male 50.6%) and 618 (mean age: 16.1y, male 50.7%) patients were included in PKU6H and XJH, respectively. Most patients (99.65% and 100.00%) had ever used second-generation antipsychotics (SGAs), while relatively few (4.14% and 4.21%) had ever used first-generation antipsychotics (FGAs). The top three ever-prescribed SGAs were aripiprazole (50.46%), olanzapine (38.45%), risperidone (34.41%) in PKU6H, and aripiprazole (35.76%), risperidone (28.96%), paliperidone (27.83%) in XJH, 32.34% and 11.49% patients had polypharmacy, respectively. The average daily dose was 0.77(SD 0.40) DDDs and 1.00(SD 0.52) DDDs, respectively, with most (81.59% and 63.27%) <= 1 DDD. Medication adherence was both around 0.8 and observed with a steady trend over long-term.ConclusionsIn Chinese adolescent patients, SGA is the mainstream mostly prescribed as monotherapy. Polypharmacy is observed with a steady pattern. Antipsychotics were prescribed with equal or reduced dose compared to adults DDD, and good adherence observed.Clinical trial numberNot applicable.