(C-011) Geographic and Temporal Patterns of Psychotropic Prescriptions for Patients with Schizophrenia in Brazilian Public Healthcare System

Background: Schizophrenia requires continuous treatment with antipsychotics, and a lack of these medications can lead to worsening of symptoms. By mapping the prescription of these medications, it is possible to assess whether treatment adherence rates are adequate or whether there are areas with higher dropout rates, allowing corrective measures to be taken.

Objectives: To analyze the profile and trends in the spatial distribution of antipsychotics prescribed for the treatment of schizophrenia among Brazilian states in the period 2011–2022.

Methods: : Ecological study with patients registered in the Integrated Outpatient System (SIA) who received medications for schizophrenia between 2011–2022. The population was divided into the five regions of the country: North, Northeast, Central-West, Southeast and South. The medications dispensed by the Unified Health System (SUS) were selected. The trend was verified using Prais-Winsten regression and the mean percentage variation (MPV) of antipsychotic prescription rates. Spatial exploratory techniques estimated general (Moran's I) and local (LISA) spatial correlation coefficients.

Results: In total, 15,085,933 prescriptions for schizophrenia were recorded during this period. The highest prescription rates were identified in the following regions: Northeast (33.8%; 5,099,166), South (25.9%; 3,909,374), Southeast (24.1%; 3,638,953), Central-West (12.6%; 1,894,879) and North (3.6%; 543,561). Olanzapine was the most frequently dispensed antipsychotic. There was a trend towards higher prescription rates for quetiapine (APC: 5.11%; 95% CI 5.10 to 5.12%) and lower prescription rates for risperidone and ziprasidone (APC: –4.30%; 95% CI –4.31 to –4.29%; and APC: –8.15%; 95% CI –8.17 to –8.13%, respectively).

Conclusions: This article provides a comprehensive understanding of antipsychotic prescriptions in Brazil for the treatment of schizophrenia via the Unified Health System (SUS), as well as their regional variations, showing that regional variations are influenced by local factors, such as the epidemiological profile and access to treatment.