Association between race/ethnicity and the receipt of outpatient second-generation antipsychotic agents stratified by metabolic effects
MetadataShow full item record
Background: Use of first-generation antipsychotics (FGAs) has been largely replaced by second-generation antipsychotics (SGAs) in the United States (US) due to the lower risk of extrapyramidal symptoms (EPS) associated with SGAs. However, SGAs have higher risk of metabolic adverse effects than FGAs do, and some SGA agents have higher metabolic risk than the other SGA agents. Historically, patients of racial/ethnic minorities were less likely than those of non-Hispanic White (NHW) to receive adequate mental health care. Our investigation sought to identify if there is an association between the patient race/ethnicity (NHW or ‘Others') and the receipt of lower-metabolic-risk SGAs (LMRS) or higher-metabolic-risk SGAs (HMRS) in the outpatient settings. Methods: This was a retrospective study using the nationally representative data from the Medical Expenditure Panel Survey from 2008 to 2013. The chi-square test was used to determine the relationship between race/ethnicity (NHW or ‘Others’) and the receipt of LMRS or HMRS. Results: From 2008 to 2013, we estimated about 4 million patients using SGAs per year. Approximately 2.8 million patients were NHW, and 1.2 million patients were ‘Others’. Approximately 29.7% (1.2 million) used LMRS, and 70.3% (2.8 million) used HMRS. The disproportionate use of LMRS and HMRS was significant between races/ethnicities. More patients of NHW received LMRS than those of ‘Others’ (p = 0.021), and less patients of NHW received HMRS than those of ‘Others’ (p = 0.021). Conclusion: With our 2-group categorization of LMRS and HMRS, there appeared to be a racial/ethnic disparity in the receipt of LMRS. Patients of racial/ethnic minorities were less likely to receive LMRS than those of NHW.