Survey on the management of physical risks induced by psychotropic agents in Japan

Abstract

Purpose: Several treatment guidelines recommend periodic monitoring (i.e., once per year) of side-effects in patients taking psychotropic agents. However, the actual frequency of side-effects monitoring is unclear. Accordingly, we investigated the frequency of side-effects monitoring in Japanese patients.

Methods: We used the national insurance claim database to identify patients prescribed with psychotropic agents for more than 3 years. Among these patients, we identified those who had undergone electrocardiogram, liver or kidney function, serum lipid level, blood glucose level, and serum prolactin level assessment at least once per year for 3 years of treatment. We classified these patients into adults and children and compared the frequency of each examination between the two groups.

Results: A total of 8822 patients were included in the analysis. The frequencies of electrocardiogram, blood glucose level, serum lipid level, liver or kidney function, and serum prolactin level monitoring were <0.1%, 16.4%, 16.5%, 20.6%, and 1.1%, respectively. In patients taking antipsychotic agents, children were significantly less frequently screened for blood glucose level, serum lipid level, and liver or kidney function compared with adults (p < 0.01).

Conclusion: Our data suggest that the frequency of side-effects monitoring in persistent users of psychotropic agents in Japan was lower than that recommended by several guidelines.