Antipsychotic drug use in Greenland and Denmark: longitudinal and cross-sectional data

Abstract

Purpose

The aim of this study was to compare the consumption of antipsychotic drugs in Denmark and Greenland between 2014 and 2019. We also investigated the use of antipsychotic medication for schizophrenic and non-affective psychotic patients in both countries.

Methods

This study was performed as a register study using data from the medical register in Denmark and Greenland. A cross-sectional study on the prescription of antipsychotic drugs for psychotic patients (F 20–29) in Greenland in September 2020 was also conducted.

Results

The prevalence of antipsychotic drug consumption between 2014 and 2019 was higher in Greenland (average 16.9 DDD/1000/day) compared to Denmark (average 9.3 DDD/1000/day) and the consumption increased in Greenland remarkably. Olanzapine was the most widely used drug in both countries and Clozapine consumption was twice as high in Greenland as in Denmark (1.3 versus 0.6 DDD/1000/day). The mean dose of antipsychotics in schizophrenic and non-affective psychotic patients was higher in Greenland than in Denmark and this difference was greatest among institutional residents. In Greenland, 59% of institutional residents received 2 or 3 DDD/day while only 43% in Denmark received it. Polypharmacy was common in both countries.

Conclusion

The total consumption and the main dose of antipsychotics in schizophrenic patients was higher in Greenland than in Denmark. Factors contributing to the differences noted appear to be a combination of age and gender differences among patients in the two countries. Socio-economic differences, and differences in treatment options can contribute to the differences and must be investigated further.

Keywords:

• Consumption of antipsychotics
• psychotic disorders
• drug utilization
• Greenland
• Denmark

Acknowledgments

The authors thank Dr Inge Lynge for inspiration and Dr Nils Skovgaard and pharmacist Inge Mortensen for help in data search.

Disclosure statement

None of the authors, F. Alberdi, A. S. J. Lundell or J. Rasmussen have received financial support, funds, contracts, etc. for the preparation of the study. The authors have no financial or non-financial interests involved in the study.

Data availability statement

Contact corresponding author for further data.

Notes

1 OPUS (acronym for Outpatient treatment of young people with psychotic symptoms, in Danish). OPUS is a 2-year outpatient medicine and psychosocial treatment offered to young people under 35 with psychosis.

Additional information

Notes on contributors

Francisco Alberdi

Francisco Alberdi is MD, specialist in psychiatry and psychotherapy with special interest in transcultural psychiatry. In recent years, he has worked at Dronning Ingridip Napparsimavissua, Queen Ingrids hospital in Nuuk, Greenland.

Ane Storch Jakobsen

Ane Jakobsen is MD, psychiatrist and resident at Mental Health Center Copenhagen. She has been a resident doctor in the psychiatric department of Queen Ingrids Hospital in Nuuk, Greenland with several visits since 2016. She has a PhD in Psychiatry from University of Copenhagen on the topic “Cardiovascular health and life expectancy in people with severe mental illness”.

Johannes Rasmussen

Johannes Rasmussen is MD in training to become a specialist in psychiatry. He has worked most of the time in the field of psychiatry since he finished his medical degree in 2012. He has worked at Queen Ingrids Hospital, psychiatric department in Nuuk, Greenland from 2017 but is now back in Denmark finishing his specialist training.