Time to Rehospitalization in Patients With Schizophrenia Receiving Long-Acting Injectable Antipsychotics or Oral Antipsychotics.
Administration, Oral
Adult
Antipsychotic Agents
/ administration & dosage
Delayed-Action Preparations
/ administration & dosage
Drug Utilization
/ trends
Female
Follow-Up Studies
Hospitalization
/ statistics & numerical data
Humans
Injections, Intramuscular
Male
Schizophrenia
/ drug therapy
Time Factors
long-acting injectable antipsychotics
oral antipsychotics
rehospitalization
schizophrenia
second-generation antipsychotics
Journal
The international journal of neuropsychopharmacology
ISSN: 1469-5111
Titre abrégé: Int J Neuropsychopharmacol
Pays: England
ID NLM: 9815893
Informations de publication
Date de publication:
01 09 2019
01 09 2019
Historique:
received:
26
03
2019
revised:
31
05
2019
accepted:
29
06
2019
pubmed:
2
7
2019
medline:
12
5
2020
entrez:
2
7
2019
Statut:
ppublish
Résumé
This study aimed to investigate and compare time to rehospitalization in patients with schizophrenia receiving long-acting injectable antipsychotics (LAIs) after discharge with those receiving oral antipsychotics. Additionally, the trend of LAIs prescription rates was investigated. Patients with schizophrenia (n = 13 087), who were discharged from the study hospital from 2006 to 2017, were followed-up under naturalistic conditions in the year after discharge. The primary outcome was time to rehospitalization. Survival analysis was used in the comparisons between LAIs and oral antipsychotics and between FGA-LAIs and SGA-LAIs. Simple linear regression and Cochrane-Armitage trend test were used to test whether a time trend existed for LAIs prescription rates. In the 1 year following discharge, patients in the LAIs group had a significantly lower rehospitalization rate and a significantly lengthened time to rehospitalization than those in the oral antipsychotics group. Rehospitalization rate and time to rehospitalization were not significantly different in patients receiving FGA-LAIs or SGA-LAIs. A significantly higher percentage of patients treated with FGA-LAIs received anticholinergic agents than those treated with SGA-LAIs. The LAIs prescription rate grew significantly from 2006 to 2017 by an average of 0.5% per year. LAIs were significantly superior to oral antipsychotics in reducing rehospitalization risk, whereas SGA-LAIs were comparable with FGA-LAIs in reducing rehospitalization risk. However, use of concomitant anticholinergic agents was less frequent in the SGA-LAIs group than in the FGA-LAIs group. Increase in LAIs prescription rate may be due to growing experiences and success among clinicians in treating patients with LAIs.
Sections du résumé
BACKGROUND
This study aimed to investigate and compare time to rehospitalization in patients with schizophrenia receiving long-acting injectable antipsychotics (LAIs) after discharge with those receiving oral antipsychotics. Additionally, the trend of LAIs prescription rates was investigated.
METHODS
Patients with schizophrenia (n = 13 087), who were discharged from the study hospital from 2006 to 2017, were followed-up under naturalistic conditions in the year after discharge. The primary outcome was time to rehospitalization. Survival analysis was used in the comparisons between LAIs and oral antipsychotics and between FGA-LAIs and SGA-LAIs. Simple linear regression and Cochrane-Armitage trend test were used to test whether a time trend existed for LAIs prescription rates.
RESULTS
In the 1 year following discharge, patients in the LAIs group had a significantly lower rehospitalization rate and a significantly lengthened time to rehospitalization than those in the oral antipsychotics group. Rehospitalization rate and time to rehospitalization were not significantly different in patients receiving FGA-LAIs or SGA-LAIs. A significantly higher percentage of patients treated with FGA-LAIs received anticholinergic agents than those treated with SGA-LAIs. The LAIs prescription rate grew significantly from 2006 to 2017 by an average of 0.5% per year.
CONCLUSIONS
LAIs were significantly superior to oral antipsychotics in reducing rehospitalization risk, whereas SGA-LAIs were comparable with FGA-LAIs in reducing rehospitalization risk. However, use of concomitant anticholinergic agents was less frequent in the SGA-LAIs group than in the FGA-LAIs group. Increase in LAIs prescription rate may be due to growing experiences and success among clinicians in treating patients with LAIs.
Identifiants
pubmed: 31260538
pii: 5526736
doi: 10.1093/ijnp/pyz035
pmc: PMC6754732
doi:
Substances chimiques
Antipsychotic Agents
0
Delayed-Action Preparations
0
Types de publication
Comparative Study
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
541-547Informations de copyright
© The Author(s) 2019. Published by Oxford University Press on behalf of CINP.
Références
J Manag Care Spec Pharm. 2015 Sep;21(9):754-68
pubmed: 26308223
J Nerv Ment Dis. 2001 Sep;189(9):583-92
pubmed: 11580001
Am J Psychiatry. 2011 Jun;168(6):603-9
pubmed: 21362741
Can J Psychiatry. 2011 Jun;56(6):367-76
pubmed: 21756451
Schizophr Bull. 2015 Mar;41(2):449-59
pubmed: 24870446
J Psychiatr Pract. 2010 Sep;16(5):306-24
pubmed: 20859108
Clin Pract Epidemiol Ment Health. 2006 May 30;2:11
pubmed: 16734909
Neuropsychiatr Dis Treat. 2018 Feb 01;14:429-433
pubmed: 29440904
N Engl J Med. 2005 Sep 22;353(12):1209-23
pubmed: 16172203
Aust N Z J Psychiatry. 2006 Jun-Jul;40(6-7):596-605
pubmed: 16756586
Aust N Z J Psychiatry. 2004 Apr;38(4):240-5
pubmed: 15038803
Schizophr Bull. 2015 May;41(3):627-36
pubmed: 25180312
J Psychopharmacol. 2003 Jun;17(2):223-9
pubmed: 12870571
J Clin Psychiatry. 2006 Oct;67(10):1542-50
pubmed: 17107245
Aust N Z J Psychiatry. 2000 Oct;34(5):801-8
pubmed: 11037366
J Psychopharmacol. 2010 Jan;24(1):91-8
pubmed: 18801830
PLoS One. 2017 Oct 26;12(10):e0186768
pubmed: 29073180
J Clin Psychiatry. 2016;77(suppl 3):1-24
pubmed: 27732772
Schizophr Res. 2015 Dec;169(1-3):400-405
pubmed: 26395153
Schizophr Res. 2011 Apr;127(1-3):83-92
pubmed: 21257294
J Clin Psychiatry. 2010 Sep;71(9):1226-33
pubmed: 20441726
Am J Psychiatry. 2004 Feb;161(2 Suppl):1-56
pubmed: 15000267
Schizophr Bull. 2018 Oct 17;44(6):1381-1387
pubmed: 29272458
Ther Adv Psychopharmacol. 2014 Oct;4(5):198-219
pubmed: 25360245
Am J Psychiatry. 2004 Apr;161(4):692-9
pubmed: 15056516
Compr Psychiatry. 1989 Jan-Feb;30(1):13-7
pubmed: 2564330
J Clin Psychopharmacol. 2017 Feb;37(1):13-20
pubmed: 27977467
Int Clin Psychopharmacol. 2018 May;33(3):155-162
pubmed: 29324468