Abstract
Objective: This study aims to clarify the relevant factors influencing practitioners' methods of prescribing medications for bipolar disorder, in a nation-wide survey in Japan. Methods: The clinical records of 3130 outpatients with bipolar disorder were consecutively reviewed from 176 psychiatric outpatient clinics. Fifteen parameters, that is, five patients' including five general characteristics (sex, age, education, occupation, and social adjustment), five patients' aspects of mental functioning (onset age, comorbid mental illness, rapid-cycling, psychopathologic severity, and followed-up years), and five practitioners' characteristics (sex, age, specialist experience, clinic standing years, and location), were evaluated. The number of psychotropic drugs (mood stabilizers, antidepressants, antipsychotic drugs, anxiolytics, and hypnotics) was used as an index of pharmacotherapy. Converted data from each practitioner-unit were analyzed. Results: Seven factors (patient's social adjustment, patient's psychopathology, patient's comorbid mental disorders, patient's followed-up years, doctor's age, clinic running years, and patient's education years) were correlated to the number of psychotropic drugs. Multiple regression analysis showed that the severity of illness (poor social adjustment, and comorbid mental illness) and an intractable disease course (long followed-up years), were significantly associated with the number of psychotropic drugs. Conclusion: Our findings indicated that patient-related conditions affected psychotropic polypharmacy more strongly than did practitioner-related conditions.
Original language | English |
---|---|
Journal | Human Psychopharmacology |
DOIs | |
Publication status | Accepted/In press - 2020 |
Keywords
- bipolar disorder
- course of disease
- polypharmacy
- prescribing manners
- psychosocial function
- psychotropic drugs
ASJC Scopus subject areas
- Neurology
- Clinical Neurology
- Psychiatry and Mental health
- Pharmacology (medical)
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Estimated model of psychotropic polypharmacy for bipolar disorder : Analysis using patients' and practitioners' parameters in the MUSUBI study. / Adachi, Naoto; Azekawa, Takaharu; Edagawa, Kouji; Goto, Eiichiro; Hongo, Seiji; Kato, Masaki; Katsumoto, Eiichi; Kikuchi, Toshiaki; Kubota, Yukihisa; Miki, Kazuhira; Nakagawa, Atsuo; Tsuboi, Takashi; Ueda, Hitoshi; Watanabe, Koichiro; Watanabe, Yoichiro; Yasui-Furukori, Norio; Yoshimura, Reiji.
In: Human Psychopharmacology, 2020.Research output: Contribution to journal › Article › peer-review
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TY - JOUR
T1 - Estimated model of psychotropic polypharmacy for bipolar disorder
T2 - Analysis using patients' and practitioners' parameters in the MUSUBI study
AU - Adachi, Naoto
AU - Azekawa, Takaharu
AU - Edagawa, Kouji
AU - Goto, Eiichiro
AU - Hongo, Seiji
AU - Kato, Masaki
AU - Katsumoto, Eiichi
AU - Kikuchi, Toshiaki
AU - Kubota, Yukihisa
AU - Miki, Kazuhira
AU - Nakagawa, Atsuo
AU - Tsuboi, Takashi
AU - Ueda, Hitoshi
AU - Watanabe, Koichiro
AU - Watanabe, Yoichiro
AU - Yasui-Furukori, Norio
AU - Yoshimura, Reiji
N1 - Funding Information: Authors would like to thank Dr. Yasushi Adachi for advice on data analysis, and Editage (www. Editage.com) for English language editing. We also acknowledged that the MUSUBI study was cooperated with the following consultant psychiatrists belonging to the JAPC; Dr. Toshihiko Lee, Dr. Norio Okamoto, Dr. Makoto Nakamura, Dr. Junkou Sato, Dr. Kazunori Otaka, Dr. Satoshi Terada, Dr. Tadashi Ito, Dr. Munehide Tani, Dr. Atsushi Satomura, Dr. Hiroshi Sato, Dr. Hideki Nakano, Dr. Yoichi Nakaniwa, Dr. Eiichi Hirayama, Dr. Keiichi Kobatake, Dr. Koji Tanaka, Dr. Mariko Watanabe, Dr. Shiguyuki Uehata, Dr. Asana Yuki, Dr. Nobuko Akagaki, Dr. Michie Sakano, Dr. Akira Matsukubo, Dr. Yasuyuki Inada, Dr. Hiroshi Oyu, Dr. Tsuneo Tsubaki, Dr. Tatsuji Tamura, Dr. Shigeki Akiu, Dr. Atsuhiro Kikuchi, Dr. Keiji Sato, Dr. Kazuyuki Fujita, Dr. Fumio Handa, Dr. Hiroyuki Karasawa, Dr. Kazuhiro Nakano, Dr. Kazuhiro Omori, Dr.Seiji Tagawa, Dr. Daisuke Maruno, Dr. Hiroaki Furui, Dr. You Suzuki, Dr. Takeshi Fujita, Dr. Yukimitsu Hoshino, Dr. Kikuko Ota, Dr. Akira Itami, Dr. Kenichi Goto, Dr. Yoshiaki Yamano, Dr. Kiichiro Koshimune, Dr. Junko Matsushita, Dr. Takatsugu Nakayama, Dr. Kazuyoshi Takamuki, Dr. Nobumichi Sakamoto, Dr. Miho Shimizu, Dr. Muneo Shimura, Dr. Norio Kawase, Dr. Ryouhei Takeda, Dr. Takuya Hirota, Dr. Hideko Fujii, Dr. Riichiro Narabayashi, Dr. Yutaka Fujiwara, Dr. Kazu Kobayashi, Dr. Yuko Urabe, Dr. Miyako Oguru, Dr. Osamu Miura, Dr. Yoshio Ikeda, Dr. Hidemi Sakamoto, Dr. Yosuke Yonezawa, Dr. Yoichi Takei, Dr. Toshimasa Sakane, Dr. Kiyoshi Oka, Dr. Kyoko Tsuda, Dr. Shigemitsu Hayashi, Dr. Kunihiko Kawamura, Dr. Yasushi Furuta, Dr. Kazuko Miyauchi, Dr. Yoshio Miyauchi, Dr. Mikako Oyama, Dr. Keizo Hara, Dr. Misako Sakamoto, Dr. Shigeki Masumoto, Dr. Yasuhiro Kaneda, Dr. Yoshiko Kanbe, Dr. Masayuki Iwai, Dr. Naohisa Waseda, Dr. Nobuhiko Ota, Dr. Takahiro Hiroe, Dr. Ippei Ishii, Dr. Hideki Koyama, Dr. Terunobu Otani, Dr. Osamu Takatsu, Dr. Takashi Ito, Dr. Norihiro Marui, Dr. Toru Takahashi, Dr. Tetsuro Oomori, Dr. Toshihiko Fukuchi, Dr. Kazumichi Egashira, Dr. Kiyoshi Kaminishi, Dr. Ryuichi Iwata, Dr. Satoshi Kawaguchi, Dr. Yoshinori Morimoto, Dr. Hirohisa Endo, Dr. Yasuo Imai, Dr. Eri Kohno, Dr. Aki Yamamoto, Dr. Naomi Hasegawa, Dr. Sadamu Toki, Dr. Hideyo Yamada, Dr. Hiroyuki Taguchi, Dr. Hiroshi Yamaguchi, Dr. Hiroki Ishikawa, Dr. Sakura Abe, Dr. Kazuhiro Uenoyama, Dr. Kazunori Koike, Dr. Yoshiko Kamekawa, Dr. Michihito Matsushima, Dr. Ken Ueki, Dr. Sintaro Watanabe, Dr. Tomohide Igata, Dr. Yoshiaki Higashitani, Dr. Eiichi Kitamura, Dr. Junko Sanada, Dr. Takanobu Sasaki, Dr. Kazuko Eto, Dr. Ichiro Nasu, Dr. Kenichiro Sinkawa, Dr. Yukio Oga, Dr. Michio Tabuchi, Dr. Daisuke Tsujimura, Dr. Tokunai Kataoka, Dr. Kyohei Noda, Dr. Nobuhiko Imato, Dr. Ikuko Nitta, Dr. Yoshihiro Maruta, Dr. Satoshi Seura, Dr. Toru Okumura, Dr. Osamu Kino, Dr. Tomoko Ito, Dr. Ryuichi Iwata, Dr. Wataru Konno, Dr. Toshio Nakahara, Dr. Masao Nakahara, Dr. Hiroshi Yamamura, Dr. Masatoshi Teraoka, Dr. Masato Nishio, Dr. Miwa Mochizuki, Dr. Tsuneo Saitoh, Dr. Tetsuharu Kikuchi, Dr. Chika Higa, Dr. Hiroshi Sasa, Dr. Yuichi Inoue, Dr. Muneyoshi Yamada, Dr. Yoko Fujioka, Dr. Kuniaki Maekubo, Dr. Hiroaki Jitsuiki, Dr. Toshihito Tsutsumi, Dr. Yasumasa Asanobu, Dr. Seiji Inomata, Dr. Kazuhiro Kodama, Dr.Aikihiro Takai, Dr. Asako Sanae, Dr. Shinichiro Sakurai, Dr. Kazuhide Tanaka, Dr. Masahiko Shido, Dr. Haruhisa Ono, Dr. Wataru Miura, Dr. Yukari Horie, Dr. Tetso Tashiro, Dr. Tomohide Mizuno, Dr. Naohiro Fujikawa, Dr. Hiroshi Terada, Dr. Kenji Taki, Dr. Kyoko Kyotani, Dr. Masataka Hatakoshi, Dr. Katsumi Ikeshita, Dr. Keiji Kaneta, Dr. Ritsu Shikiba, Dr. Tsuyoshi Iijima, Dr. Masaru Yoshimura, Dr. Masumi Ito, Dr. Shunsuke Murata, Dr. Mio Mori, and Dr. Toshio Yokouchi. This study was partially supported by Ken Tanaka Memorial Research Grant (Tokyo, Japan, 2016). No commercial organizations had any roles in the completion and publication of this study. Funding Information: Dr. Azekawa has received speaker's honoraria from Eli Lilly, Otsuka, and Pfizer. Dr. Edagawa has received speaker's honoraria from Eli Lilly, Meiji Seika Pharma, Mitsubishi Tanabe Pharma, MSD, Otsuka, Pfizer, Sumitomo Dainippon Pharma, Kyowa and Yoshitomi Yakuhin. Dr. Goto has received manuscript fees or speaker's honoraria from Eli Lilly, Janssen Pharmaceutical, Meiji Seika Pharma, Mitsubishi Tanabe Pharma, MSD, Otsuka, Sumitomo Dainippon Pharma. Dr. Hongo has received manuscript fees or speaker's honoraria from Eli Lilly, Janssen Pharmaceutical, Kyowa Pharmaceutical, Meiji Seika Pharma, Mitsubishi Tanabe Pharma, Otsuka, Pfizer, Shionogi, Sumitomo Dainippon Pharma, and Yoshitomi Yakuhin. Dr. Kato has received grant funding from Japan Society for the Promotion of Science, SENSHIN Medical Research Foundation and Japan Research Foundation for Clinical Pharmacology, and speaker's honoraria from Dainippon‐Sumitomo Pharma, Otsuka, Meiji‐Seika Pharma, Eli Lilly, MSD, GlaxoSmithkline, Pfizer, Janssen Pharmaceutical, Shionogi, Mitsubishi Tanabe Pharma, Takeda Pharmaceutical and Ono Pharmaceutical. Dr. Katsumoto has received speaker's honoraria from Daiichi Sankyo, Eisai, Eli Lilly, Janssen Pharmaceutical, Kyowa, Meiji Seika Pharma, Mitsubishi Tanabe Pharma, MSD, Otsuka, Pfizer, Sumitomo Dainippon Pharma, UCB. Dr. Kikuchi has received consultant fees from Takeda Pharmaceutical and Center for Cognitive Behavioral Therapy and Training. Dr. Kubota has received consultant fees from Pfizer and Meiji‐Seika Pharma and speaker's honoraria from Meiji‐Seika Pharma, Eli Lilly, Janssen Pharmaceutical, Dainippon Sumitomo Pharma, Mitsubishi Tanabe Pharma, Yoshitomi Yakuhin, Otsuka, and Eisai. Dr. Nakagawa has received lecture fees from Pfizer, Eli Lilly, Otsuka, Janssen Pharmaceutical, Mitsubishi Tanabe, Mochida, Dainippon Sumitomo and NTT Docomo, and participated in an advisory board for Takeda, Meiji Seika and Tsumura. Dr. Tsuboi has received consultant fees from Pfizer and speaker's honoraria from Eli Lilly, Meiji‐Seika Pharma, MSD, Janssen Pharmaceutical, Dainippon Sumitomo Pharma, Mitsubishi Tanabe Pharma, Yoshitomi Yakuhin, Mochida Pharmaceutical, Otsuka, Kyowa, and Takeda Pharmaceutical. Dr. Ueda has received manuscript fees or speaker's honoraria from Eli Lilly, Janssen Pharmaceutical, Meiji Seika Pharma, Mitsubishi Tanabe Pharma, MSD, Otsuka, Pfizer, Sumitomo Dainippon Pharma, Takeda Pharmaceutical, and Yoshitomi Yakuhin. Dr. Watanabe has received manuscript fees or speaker's honoraria from Daiichi Sankyo, Eisai, Eli Lilly, GlaxoSmithKline, Janssen Pharmaceutical, Kyowa, Meiji Seika Pharma, Mitsubishi Tanabe Pharma, MSD, Otsuka, Pfizer, Shionogi, Sumitomo Dainippon Pharma, Takeda Pharmaceutical, Yoshitomi Yakuhin, and has received research/grant support from Astellas Pharma, Daiichi Sankyo, Eisai, MSD, Mitsubishi Tanabe Pharma, Meiji Seika Pharma, Otsuka, Pfizer, Shionogi, Sumitomo Dainippon Pharma, and is a consultant of Eisai, Eli Lilly, Kyowa, Otsuka, Pfizer, Sumitomo Dainippon Pharma, Taisho Toyama, and Takeda Pharmaceutical. Dr. Yasui‐Furukori has received grant/research support or honoraria from, and been on the speakers of Dainippon‐Sumitomo Pharma, Mochida Pharmaceutical, MSD, and Otsuka Pharmaceutical. Dr. Yoshimura has received speaker's honoraria from Eli Lilly, Janssen, Dainippon Sumitomo, Otsuka, Meiji, Pfizer and Shionogi.
PY - 2020
Y1 - 2020
N2 - Objective: This study aims to clarify the relevant factors influencing practitioners' methods of prescribing medications for bipolar disorder, in a nation-wide survey in Japan. Methods: The clinical records of 3130 outpatients with bipolar disorder were consecutively reviewed from 176 psychiatric outpatient clinics. Fifteen parameters, that is, five patients' including five general characteristics (sex, age, education, occupation, and social adjustment), five patients' aspects of mental functioning (onset age, comorbid mental illness, rapid-cycling, psychopathologic severity, and followed-up years), and five practitioners' characteristics (sex, age, specialist experience, clinic standing years, and location), were evaluated. The number of psychotropic drugs (mood stabilizers, antidepressants, antipsychotic drugs, anxiolytics, and hypnotics) was used as an index of pharmacotherapy. Converted data from each practitioner-unit were analyzed. Results: Seven factors (patient's social adjustment, patient's psychopathology, patient's comorbid mental disorders, patient's followed-up years, doctor's age, clinic running years, and patient's education years) were correlated to the number of psychotropic drugs. Multiple regression analysis showed that the severity of illness (poor social adjustment, and comorbid mental illness) and an intractable disease course (long followed-up years), were significantly associated with the number of psychotropic drugs. Conclusion: Our findings indicated that patient-related conditions affected psychotropic polypharmacy more strongly than did practitioner-related conditions.
AB - Objective: This study aims to clarify the relevant factors influencing practitioners' methods of prescribing medications for bipolar disorder, in a nation-wide survey in Japan. Methods: The clinical records of 3130 outpatients with bipolar disorder were consecutively reviewed from 176 psychiatric outpatient clinics. Fifteen parameters, that is, five patients' including five general characteristics (sex, age, education, occupation, and social adjustment), five patients' aspects of mental functioning (onset age, comorbid mental illness, rapid-cycling, psychopathologic severity, and followed-up years), and five practitioners' characteristics (sex, age, specialist experience, clinic standing years, and location), were evaluated. The number of psychotropic drugs (mood stabilizers, antidepressants, antipsychotic drugs, anxiolytics, and hypnotics) was used as an index of pharmacotherapy. Converted data from each practitioner-unit were analyzed. Results: Seven factors (patient's social adjustment, patient's psychopathology, patient's comorbid mental disorders, patient's followed-up years, doctor's age, clinic running years, and patient's education years) were correlated to the number of psychotropic drugs. Multiple regression analysis showed that the severity of illness (poor social adjustment, and comorbid mental illness) and an intractable disease course (long followed-up years), were significantly associated with the number of psychotropic drugs. Conclusion: Our findings indicated that patient-related conditions affected psychotropic polypharmacy more strongly than did practitioner-related conditions.
KW - bipolar disorder
KW - course of disease
KW - polypharmacy
KW - prescribing manners
KW - psychosocial function
KW - psychotropic drugs
UR - http://www.scopus.com/inward/record.url?scp=85093536721&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85093536721&partnerID=8YFLogxK
U2 - 10.1002/hup.2764
DO - 10.1002/hup.2764
M3 - Article
AN - SCOPUS:85093536721
JO - Human Psychopharmacology
JF - Human Psychopharmacology
SN - 0885-6222
ER -