Utilisation and prescribing patterns of antipsychotics in primary care in Wales (2010-2020)

Background: Due to a lack of data on antipsychotic utilisation in Wales there is unclarity surrounding prescribing patterns in the country, particularly in this era of the COVID-19 pandemic. Objectives: Evaluate the prescribing patterns of antipsychotics over a 10-year period in Wales, UK. Methods: Following a repeated cross-sectional design, this study used prescription cost analysis data of Wales from January 2010 to December 2020 which covered all antipsychotic prescriptions dispensed in primary care in Wales. Antipsychotic utilisation was quantified using number of items dispensed/ 1000 inhabitants and defined daily doses (DDD)/ 1000 inhabitants/ day. Analysis of the data was achieved using descriptive measures involving calculation of absolute and relative change, and use of linear regression with p values.
Results
There was an increasing trend observed for total (37.0-53.2%) and atypical (60.6-79.1%) antipsychotic utilisation from 2010 to 2020, in terms of both metrics. Typical antipsychotic utilisation, however, decreased over time (41.6-42.7%). Atypical antipsychotics were the most utilised class. In terms of the ‘number of items’ metric, quetiapine was the most utilised atypical (39.5%) while with the DDD metric, it was olanzapine (38.4%). For typical antipsychotics, haloperidol was most utilised drug using both metrics (22.5-26.5%). Conclusions: Overall, prescribing of antipsychotics increased over time. Atypical antipsychotics were the most prescribed class, increasingly being prescribed over time while typical antipsychotic prescribing decreased. Within both classes the level of prescribing varied significantly between individual drugs. These findings were in line with current UK treatment guidelines.