Abstract
Abstract
Background
The comparative effectiveness of antipsychotic long-acting injections (LAIs) and oral medication is not clear due to various methodological problems.
Methods
To compare the effectiveness of LAIs and oral antipsychotics in preventing readmission in patients with schizophrenia, we performed a within-subject analysis of data collected from 75,274 patients hospitalized with schizophrenia over a 10-year period (2008–2017). Readmission rates were compared according to medication status (non-medication, oral medication alone, and LAI medication). Each admission episodes were compared according to medication status before admission.
Results
Total 132,028 episodes of admission were analyzed. During 255,664 person-years of total observation, 101,589 outcome events occurred. Comparing LAI to only oral medication, IRR was 0.71 (0.64–0.78, P < 0.001). IRR of LAI to only oral medication of first index admission was 0.74 (0.65–0.86). As hospitalization was repeated, IRR of second, third, and fourth or more index admission decreased 0.65 (0.53–0.79), 0.56 (0.43–0.76), and 0.42 (0.31–0.56), respectively.
Conclusions
LAI treatment reduced the readmission rate by 29% compared with oral medication in real-world settings. Moreover, LAIs reduced the readmission rate by 58% in patients with repeated admissions. The more readmissions, the greater the effect of LAIs in reducing the risk of re-hospitalization compared with oral antipsychotics.
Publisher
Springer Science and Business Media LLC
Subject
Psychiatry and Mental health
Reference19 articles.
1. Robinson D, Woerner MG, Alvir JM, et al. Predictors of relapse following response from a first episode of schizophrenia or schizoaffective disorder. Arch Gen Psychiatry. 1999;56(3):241–7.
2. Zipursky RB, Menezes NM, Streiner DL. Risk of symptom recurrence with medication discontinuation in first-episode psychosis: a systematic review. Schizophr Res. 2014;152(2–3):408–14.
3. Harber L, Takeuchi H, Borlido C, Hamidian R, Remington G. Factors associated with drug attitude in patients with schizophrenia spectrum disorders. Schizophr Res. 2017;188:185–6.
4. Lieberman JA. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. J Clin Psychiatry. 2007;353:1209–23.
5. Lehman AF, Lieberman JA, Dixon LB, et al. Practice guideline for the treatment of partients with schizophrenia, 2nd ed. Am J Psychiatry. 2004;161(Suppl 2):1–56.
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