8.6 Prescribing Data
The prescribing of mental health medication in South Gloucestershire compared with nationally is reported in this section. Based on the British National Formulary, the main categories of mental health drugs are:
- Hypnotics and Anxiolytics. Hypnotics are used to treat insomnia. Anxiolytics are used to treat anxiety states. The most commonly used anxiolytics and hypnotics are benzodiazepines. These medicines can cause dependence (psychological and physical) and tolerance
- Drugs used in psychoses and related disorders. These include antipsychotic drugs (used to treat schizophrenia), antipsychotic depot injections (long acting medicines which tend to be used when compliance with oral treatment is unreliable) and drugs used for mania and hypomania (for example treatment of bipolar disorder)
- Antidepressant drugs (for treating moderate to severe depression)
- CNS stimulants and drugs used for Attention Deficit Hyperactivity Disorder (ADHD). Usually CNS stimulants are prescribed for children with severe and persistent symptoms of ADHD. However, treatment of ADHD often needs to be continued into adolescence and may need to be continued into adulthood
- Drugs for dementia (data are not reported as Dementia is outside the scope of this needs assessment)
To enable comparison of local data with national data, the Age, Sex and Temporary Resident Originated Prescribing Unit (ASTRO-PU) is used. This is a nationally developed indicator for weighted prescribing volume based on individual GP practice population adjusted for patients’ age, sex and temporary residents. Data were obtained from the Commissioning Support Unit. The data source was ePACT.net.
From Q2 2009/2010 to Q4 2013/2014 there have been increases in the numbers of antidepressant items per ASTRO-PU in South Gloucestershire and England (Figure 8.14). By Q4 2013/2014 antidepressant costs in South Gloucestershire and England were higher than in Q2 2009/2010.
Figure 8.16 shows the number of items per ASTRO-PU of anxiolytics for South Gloucestershire and England. Anxiolytic prescribing has remained stable over the time period for both South Gloucestershire and England. The cost of prescribing Anxiolytics has decreased over time in both South Gloucestershire and England (Figure 8.17)
The number of antipsychotic items per ASTRO-PU prescribed from Q2 2009/2010 to Q4 2013/2014 is shown in Figure 8.18. Prescribing in England has remained stable, however prescribing in South Gloucestershire declined declined sharply from Q4 2010/2011 to Q1 2011/2012 remaining relatively constant until Q4 2013/2014. In South Gloucestershire and England the costs of antipsychotics remained stable from Q2 2009/2010 until Q2 2011/2012, declined from Q2 2011/2012 to Q1 2012/2013, remaining steady until Q4 2013/2014 (Figure 8.19).
For hypnotics the number of items per ASTRO-PU has shown a small decline over time for both England and South Gloucestershire (Figure 8.20). The number of items per ASTRO-PU for South Gloucestershire is less than England for the entire time period (Figure 8.20). The costs of hypnotics increased markedly from Q2 2012/2013 to Q1 2013/2014.
Drugs used for hypomania and mania
For these drugs the number of items per ASTRO-PU has remained more or less steady for England and South Gloucestershire although the number of items prescribed in South Gloucestershire was less than England for the entire time period (Figure 8.22). The costs of drugs used in mania and hypomania increased over time in both England and South Gloucestershire (Figure 8.23).
CNS Stimulants and Drugs used for ADHD
For CNS stimulants and drugs used for ADHD there was an increase in the number of items per ASTRO-PU prescribed in South Gloucestershire and England (Figure 8.24). Increases in costs of these items were also seen over the entire time period (Figure 8.25).