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Published Online: 1 January 2013

Racial-Ethnic Differences in Incident Olanzapine Use After an FDA Advisory for Patients With Schizophrenia

Abstract

Objective:

Prior investigations suggest that olanzapine use declined rapidly after a U.S. Food and Drug Administration (FDA) communication and consensus statement warning of the drug’s increased metabolic risks, but whether declines differed by racial-ethnic groups is unknown.

Methods:

Changes in olanzapine use over time by race-ethnicity was assessed among 7,901 Florida Medicaid enrollees with schizophrenia.

Results:

Prior to the advisory, 57% of second-generation antipsychotic fills among Hispanics were for olanzapine, compared with 40% for whites or blacks (adjusted risk difference [ARD]=.17, 95% confidence interval [CI]=.13–.20). Olanzapine use declined among all racial-ethnic groups. Although Hispanics had greater olanzapine use than whites in each period, the differences in absolute risk were only 3% by the latest study period (ARD=.03, CI=.01–.04).

Conclusions:

After the FDA communication and consensus statement were issued, differences in olanzapine use between white and Hispanic enrollees narrowed considerably. Identifying high-use subgroups for targeted delivery of drug safety information may help eliminate any existing differences in prescribing.

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Published In

Go to Psychiatric Services
Go to Psychiatric Services
Cover: Birdie and Joseph, by Larry Rivers, 1955. Oil on canvas; 13 × 25 inches. Museum of Fine Arts, Boston, Melvin Blake and Frank Purnell Collection (2003.44). Photograph © 2013, Museum of Fine Arts, Boston.
Psychiatric Services
Pages: 83 - 87
PubMed: 23280461

History

Published online: 1 January 2013
Published in print: January 2013

Authors

Details

Stacie B. Dusetzina, Ph.D.
Benjamin L. Cook, Ph.D., M.P.H.
Alisa B. Busch, M.D., M.S.
G. Caleb Alexander, M.D., M.S.
Haiden A. Huskamp, Ph.D.
Dr. Dusetzina and Dr. Huskamp are affiliated with the Department of Health Care Policy and Dr. Cook and Dr. Busch are with the Department of Psychiatry, all at Harvard Medical School, 180 Longwood Ave., Boston, MA 02115 (e-mail: [email protected]).
Dr. Cook is also with the Center for Multicultural Mental Health Research, Cambridge Health Alliance, Cambridge, Massachusetts.
Dr. Busch is also with the Alcohol and Drug Abuse Treatment Program, McLean Hospital, Belmont, Massachusetts.
Dr. Alexander was with the Department of Psychiatry, University of Chicago, for the study and is now with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, and Department of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore.

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