Skip to main content
Full access
Article
Published Online: 1 January 2006

Patient- and Facility-Level Factors Associated With Diffusion of a New Antipsychotic in the VA Health System

Abstract

OBJECTIVE: When new medications are introduced, a period of diffusion, evaluation, and adoption follows. This study evaluated the influence of patient- and facility-level characteristics on the early use of a new antipsychotic, ziprasidone, among Department of Veterans Affairs (VA) patients with schizophrenia. METHODS: Data on demographic characteristics, diagnoses, and outpatient pharmacy dispensings were obtained from the VA National Psychosis Registry for VA patients who received both a diagnosis of schizophrenia and oral antipsychotic medications during the fiscal years (FYs) 2001 (N=77,397), 2002 (N=74,724), and 2003 (N=74,399). Generalized estimating equations were used to examine associations between patient- and facility-level factors and ziprasidone use for each fiscal year. RESULTS: In FY2001, 1.2 percent of patients used ziprasidone. Ziprasidone use more than tripled to 4.0 percent by FY2002 and more than quadrupled to 5.9 percent by FY2003. In all study years, patients who were white, younger, and female were more likely to receive ziprasidone. Patients who had previous psychiatric hospitalizations or who had diabetes were also more likely to receive ziprasidone. Differences by race diminished over time. Facility academic affiliation and region were only minimally associated with use. CONCLUSIONS: Ziprasidone use increased rapidly among patients with schizophrenia after FDA approval, which suggests that both patients and providers remain eager to try new antipsychotic medications. Earlier dissemination was associated with clinical factors, such as comorbid diabetes, and with nonclinical factors, such as race or ethnicity. Differences by race diminished over time. The underlying processes and implications for affected patient groups are unclear.

Formats available

You can view the full content in the following formats:

Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Pages: 70 - 76
PubMed: 16399965

History

Published online: 1 January 2006
Published in print: January 2006

Authors

Details

Marcia Valenstein, M.D., M.S.
John F. McCarthy, Ph.D.
Rosalinda V. Ignacio, M.S.
Gregory W. Dalack, M.D.
Thomas Stavenger, R.Ph.
Frederic C. Blow, Ph.D.

Metrics & Citations

Metrics

Citations

Export Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

For more information or tips please see 'Downloading to a citation manager' in the Help menu.

Format
Citation style
Style
Copy to clipboard

View Options

View options

PDF/ePub

View PDF/ePub

Full Text

View Full Text

Get Access

Login options

Already a subscriber? Access your subscription through your login credentials or your institution for full access to this article.

Personal login Institutional Login Open Athens login
Purchase Options

Purchase this article to access the full text.

PPV Articles - Psychiatric Services

PPV Articles - Psychiatric Services

Not a subscriber?

Subscribe Now / Learn More

PsychiatryOnline subscription options offer access to the DSM-5-TR® library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Media

Figures

Other

Tables

Share

Share

Share article link

Share