Gender differences in antipsychotics prescribed to veterans with serious mental illness

Elana Schwartz; Melanie Charlotte; Eric Slade; Deborah Medoff; Lan Li; Lisa Dixon; Amy Kilbourne; Julie Kreyenbuhl

doi:10.1016/j.genhosppsych.2015.03.018

Gender differences in antipsychotics prescribed to veterans with serious mental illness

Elana Schwartz, Melanie Charlotte, Eric Slade, Deborah Medoff, Lan Li, Lisa Dixon, Amy Kilbourne, Julie Kreyenbuhl

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

Objective: To examine gender differences in prescribing of antipsychotic medications (APMs) according to their liability for weight gain and other metabolic side effects. Method: We identified 4510 patients with schizophrenia or bipolar disorders receiving usual care in a Veterans Affairs (VA) health care network in the U.S. mid-Atlantic region who initiated treatment with an APM between October 2006 and September 2011. We used multivariable logistic regression to examine gender differences in the likelihood of incident prescription of APMs with low versus medium/high metabolic risk, adjusting for fiscal year of prescribing and selected Veteran demographic, mental health and physical health characteristics. Results: Overall, 58% of women were prescribed an APM with a low risk of metabolic side effects compared to 45% of men (P<. .001). In multivariable analysis, women Veterans were 1.47 times as likely as men to be prescribed a low-metabolic-risk APM (95% confidence interval: 1.26-1.73, P<. .001). Several demographic and clinical covariates were also independently related to prescribing of APMs by level of metabolic risk. Conclusions: The results may suggest that prescribing choices for APMs by VA mental health prescribers and female Veterans reflect a growing awareness of the potential adverse health consequences of these treatments in women.

Original language	English (US)
Pages (from-to)	347-351
Number of pages	5
Journal	General Hospital Psychiatry
Volume	37
Issue number	4
DOIs	https://doi.org/10.1016/j.genhosppsych.2015.03.018
State	Published - Jul 1 2015
Externally published	Yes

Keywords

Antipsychotic medication
Serious mental illness
Veterans
Women's health

ASJC Scopus subject areas

Psychiatry and Mental health

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10.1016/j.genhosppsych.2015.03.018

Cite this

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title = "Gender differences in antipsychotics prescribed to veterans with serious mental illness",

abstract = "Objective: To examine gender differences in prescribing of antipsychotic medications (APMs) according to their liability for weight gain and other metabolic side effects. Method: We identified 4510 patients with schizophrenia or bipolar disorders receiving usual care in a Veterans Affairs (VA) health care network in the U.S. mid-Atlantic region who initiated treatment with an APM between October 2006 and September 2011. We used multivariable logistic regression to examine gender differences in the likelihood of incident prescription of APMs with low versus medium/high metabolic risk, adjusting for fiscal year of prescribing and selected Veteran demographic, mental health and physical health characteristics. Results: Overall, 58% of women were prescribed an APM with a low risk of metabolic side effects compared to 45% of men (P<. .001). In multivariable analysis, women Veterans were 1.47 times as likely as men to be prescribed a low-metabolic-risk APM (95% confidence interval: 1.26-1.73, P<. .001). Several demographic and clinical covariates were also independently related to prescribing of APMs by level of metabolic risk. Conclusions: The results may suggest that prescribing choices for APMs by VA mental health prescribers and female Veterans reflect a growing awareness of the potential adverse health consequences of these treatments in women.",

keywords = "Antipsychotic medication, Serious mental illness, Veterans, Women's health",

author = "Elana Schwartz and Melanie Charlotte and Eric Slade and Deborah Medoff and Lan Li and Lisa Dixon and Amy Kilbourne and Julie Kreyenbuhl",

note = "Funding Information: This study was funded by the VA Capitol Healthcare Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC) . The findings included in this manuscript were presented in poster form at the Academy Health Annual Research Meeting in Baltimore, MD, held in June 2013. They were also presented in poster form at the VA HSR&D National Meeting on Partnerships for Research & Care of Women Veterans: Building the Evidence Base for Clinical and Policy Action held July 31–August 1, 2014, in Arlington, VA. This reflects the authors{\textquoteright} personal views and in no way represents the official view of the Department of Veterans Affairs or the U.S. Government. Publisher Copyright: {\textcopyright} 2015.",

year = "2015",

month = jul,

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doi = "10.1016/j.genhosppsych.2015.03.018",

language = "English (US)",

volume = "37",

pages = "347--351",

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T1 - Gender differences in antipsychotics prescribed to veterans with serious mental illness

AU - Schwartz, Elana

AU - Charlotte, Melanie

AU - Slade, Eric

AU - Medoff, Deborah

AU - Li, Lan

AU - Dixon, Lisa

AU - Kilbourne, Amy

AU - Kreyenbuhl, Julie

N1 - Funding Information: This study was funded by the VA Capitol Healthcare Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC) . The findings included in this manuscript were presented in poster form at the Academy Health Annual Research Meeting in Baltimore, MD, held in June 2013. They were also presented in poster form at the VA HSR&D National Meeting on Partnerships for Research & Care of Women Veterans: Building the Evidence Base for Clinical and Policy Action held July 31–August 1, 2014, in Arlington, VA. This reflects the authors’ personal views and in no way represents the official view of the Department of Veterans Affairs or the U.S. Government. Publisher Copyright: © 2015.

PY - 2015/7/1

Y1 - 2015/7/1

N2 - Objective: To examine gender differences in prescribing of antipsychotic medications (APMs) according to their liability for weight gain and other metabolic side effects. Method: We identified 4510 patients with schizophrenia or bipolar disorders receiving usual care in a Veterans Affairs (VA) health care network in the U.S. mid-Atlantic region who initiated treatment with an APM between October 2006 and September 2011. We used multivariable logistic regression to examine gender differences in the likelihood of incident prescription of APMs with low versus medium/high metabolic risk, adjusting for fiscal year of prescribing and selected Veteran demographic, mental health and physical health characteristics. Results: Overall, 58% of women were prescribed an APM with a low risk of metabolic side effects compared to 45% of men (P<. .001). In multivariable analysis, women Veterans were 1.47 times as likely as men to be prescribed a low-metabolic-risk APM (95% confidence interval: 1.26-1.73, P<. .001). Several demographic and clinical covariates were also independently related to prescribing of APMs by level of metabolic risk. Conclusions: The results may suggest that prescribing choices for APMs by VA mental health prescribers and female Veterans reflect a growing awareness of the potential adverse health consequences of these treatments in women.

AB - Objective: To examine gender differences in prescribing of antipsychotic medications (APMs) according to their liability for weight gain and other metabolic side effects. Method: We identified 4510 patients with schizophrenia or bipolar disorders receiving usual care in a Veterans Affairs (VA) health care network in the U.S. mid-Atlantic region who initiated treatment with an APM between October 2006 and September 2011. We used multivariable logistic regression to examine gender differences in the likelihood of incident prescription of APMs with low versus medium/high metabolic risk, adjusting for fiscal year of prescribing and selected Veteran demographic, mental health and physical health characteristics. Results: Overall, 58% of women were prescribed an APM with a low risk of metabolic side effects compared to 45% of men (P<. .001). In multivariable analysis, women Veterans were 1.47 times as likely as men to be prescribed a low-metabolic-risk APM (95% confidence interval: 1.26-1.73, P<. .001). Several demographic and clinical covariates were also independently related to prescribing of APMs by level of metabolic risk. Conclusions: The results may suggest that prescribing choices for APMs by VA mental health prescribers and female Veterans reflect a growing awareness of the potential adverse health consequences of these treatments in women.

KW - Antipsychotic medication

KW - Serious mental illness

KW - Veterans

KW - Women's health

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EP - 351

JO - General Hospital Psychiatry

JF - General Hospital Psychiatry

IS - 4

ER -

Gender differences in antipsychotics prescribed to veterans with serious mental illness

Abstract

Keywords

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