Ethnic Differences in Use of Antipsychotic Medication Among Texas Medicaid Clients With Schizophrenia
J Clin Psychiatry 2003;64:635-639
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Culture and ethnicity have been
suggested to influence the presentation of patients with
schizophrenia. These factors are thought to affect the diagnoses,
courses of treatment, and medical utilization patterns of
patients with schizophrenia. Specifically, the differences
between whites, African Americans, and Mexican Americans are of
particular importance, as these groups comprise the majority of
the population in the United States today. The traditional course
of treatment for many patients with schizophrenia is the drug
haloperidol. However, research has shown that some ethnic groups
(African Americans and Mexican Americans) may respond better to
atypical drugs, such as olanzapine, but may be less likely to
receive these drugs. A better response to the course of treatment
results in improved medical utilization patterns. The purpose of
this study was to examine if ethnicity helped predict whether
Texas Medicaid patients were prescribed haloperidol versus
olanzapine when other factors were controlled for.
Method: The study population consisted of 726
patients whose index drug was haloperidol and 1875 patients whose
index drug was olanzapine. Patients had an ICD-9-CM diagnosis of
schizophrenia or schizoaffective disorder. Texas medical and
prescription claims data were used in a logistic regression
analysis to determine significant predictors of the type of
antipsychotic (haloperidol vs. olanzapine) patients were
prescribed. Variables included in the analysis were ethnicity,
gender, age, region, other mental illness comorbidities, and
previous utilization of medications and resources. Data were
collected from Jan. 1, 1996, to Aug. 31, 1998.
Results: The results show that when other
demographic and utilization factors were controlled for, African
Americans were less likely than whites to receive olanzapine
rather than haloperidol.
Conclusion: Ethnicity is a significant predictor
of the type of antipsychotic that is prescribed.