Race and long-acting antipsychotic prescription at a community mental health center: a retrospective chart review

J Clin Psychiatry. 2012 Apr;73(4):513-7. doi: 10.4088/JCP.11m07161.

Abstract

Objective: There has been concern that racial minorities are disproportionately prescribed long-acting injectable antipsychotic drugs.

Method: Comprehensive administrative data and clinician survey were used to identify all patients with a DSM-IV diagnosis of schizophrenia who received long-acting antipsychotic prescriptions from July 2009 to June 2010 at a community mental health center. Charts were reviewed retrospectively to validate long-acting antipsychotic prescription (eg, medication, dosage) and merged with administrative data from all center patients documenting sociodemographic characteristics (ie, age, race, gender) and comorbid diagnoses. We used bivariate χ2, t tests, and multivariate logistic regression to compare the subsample of patients receiving long-acting injectable drugs (n = 102) to patients not receiving long-acting injectable drugs (n = 799) who were diagnosed with schizophrenia for the same period.

Results: White patients were significantly less likely to receive long-acting antipsychotic prescriptions than minority patients (OR = 0.52, P < .007); ie, nonwhites were 1.89 times more likely to receive such drugs. Age, gender, and comorbid diagnoses, including substance abuse, were unrelated to long-acting injectable prescription, and race/ethnicity was not associated with use of specific agents (haloperidol decanoate, fluphenazine decanoate, or risperidone microspheres) (P = .73).

Conclusions: Racial minorities are more likely than other patients with schizophrenia to receive long-acting injectionable antipsychotics, a finding that suggests their prescribers may consider them less adherent to antipsychotic prescriptions.

MeSH terms

  • Antipsychotic Agents / administration & dosage
  • Antipsychotic Agents / therapeutic use*
  • Black People / statistics & numerical data
  • Chi-Square Distribution
  • Community Mental Health Centers / statistics & numerical data
  • Delayed-Action Preparations
  • Female
  • Healthcare Disparities
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Psychotic Disorders / drug therapy
  • Racial Groups / statistics & numerical data*
  • Retrospective Studies
  • Schizophrenia / drug therapy*
  • White People / statistics & numerical data

Substances

  • Antipsychotic Agents
  • Delayed-Action Preparations