Off-label long acting injectable antipsychotics in real-world clinical practice: a cross-sectional analysis of prescriptive patterns from the STAR Network DEPOT study.
Bipolar disorder
Long-acting injectable antipsychotics
Off-label
Personality disorder
Schizophrenia
Journal
BMC psychiatry
ISSN: 1471-244X
Titre abrégé: BMC Psychiatry
Pays: England
ID NLM: 100968559
Informations de publication
Date de publication:
30 06 2022
30 06 2022
Historique:
received:
07
10
2021
accepted:
03
06
2022
entrez:
30
6
2022
pubmed:
1
7
2022
medline:
6
7
2022
Statut:
epublish
Résumé
Information on the off-label use of Long-Acting Injectable (LAI) antipsychotics in the real world is lacking. In this study, we aimed to identify the sociodemographic and clinical features of patients treated with on- vs off-label LAIs and predictors of off-label First- or Second-Generation Antipsychotic (FGA vs. SGA) LAI choice in everyday clinical practice. In a naturalistic national cohort of 449 patients who initiated LAI treatment in the STAR Network Depot Study, two groups were identified based on off- or on-label prescriptions. A multivariate logistic regression analysis was used to test several clinically relevant variables and identify those associated with the choice of FGA vs SGA prescription in the off-label group. SGA LAIs were more commonly prescribed in everyday practice, without significant differences in their on- and off-label use. Approximately 1 in 4 patients received an off-label prescription. In the off-label group, the most frequent diagnoses were bipolar disorder (67.5%) or any personality disorder (23.7%). FGA vs SGA LAI choice was significantly associated with BPRS thought disorder (OR = 1.22, CI95% 1.04 to 1.43, p = 0.015) and hostility/suspiciousness (OR = 0.83, CI95% 0.71 to 0.97, p = 0.017) dimensions. The likelihood of receiving an SGA LAI grew steadily with the increase of the BPRS thought disturbance score. Conversely, a preference towards prescribing an FGA was observed with higher scores at the BPRS hostility/suspiciousness subscale. Our study is the first to identify predictors of FGA vs SGA choice in patients treated with off-label LAI antipsychotics. Demographic characteristics, i.e. age, sex, and substance/alcohol use co-morbidities did not appear to influence the choice towards FGAs or SGAs. Despite a lack of evidence, clinicians tend to favour FGA over SGA LAIs in bipolar or personality disorder patients with relevant hostility. Further research is needed to evaluate treatment adherence and clinical effectiveness of these prescriptive patterns.
Identifiants
pubmed: 35773631
doi: 10.1186/s12888-022-04071-2
pii: 10.1186/s12888-022-04071-2
pmc: PMC9245273
doi:
Substances chimiques
Antipsychotic Agents
0
Delayed-Action Preparations
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
442Investigateurs
Corrado Barbui
(C)
Michela Nosè
(M)
Marianna Purgato
(M)
Giulia Turrini
(G)
Giovanni Ostuzzi
(G)
Maria Angela Mazzi
(MA)
Davide Papola
(D)
Chiara Gastaldon
(C)
Samira Terlizzi
(S)
Federico Bertolini
(F)
Alberto Piccoli
(A)
Mirella Ruggeri
(M)
Pasquale De Fazio
(P)
Fabio Magliocco
(F)
Mariarita Caroleo
(M)
Gaetano Raffaele
(G)
Armando D'Agostino
(A)
Edoardo Giuseppe Ostinelli
(EG)
Margherita Chirico
(M)
Simone Cavallotti
(S)
Emilio Bergamelli
(E)
Caroline Zangani
(C)
Claudio Lucii
(C)
Simone Bolognesi
(S)
Sara Debolini
(S)
Elisa Pierantozzi
(E)
Francesco Fargnoli
(F)
Maria Del Zanna
(M)
Alessandra Giannini
(A)
Livia Luccarelli
(L)
Alberto De Capua
(A)
Pasqua Maria Annese
(PM)
Massimiliano Cerretini
(M)
Fiorella Tozzi
(F)
Nadia Magnani
(N)
Giuseppe Cardamone
(G)
Francesco Bardicchia
(F)
Edvige Facchi
(E)
Federica Soscia
(F)
Spyridon Zotos
(S)
Bruno Biancosino
(B)
Filippo Zonta
(F)
Francesco Pompei
(F)
Camilla Callegari
(C)
Daniele Zizolfi
(D)
Nicola Poloni
(N)
Marta Ielmini
(M)
Ivano Caselli
(I)
Edoardo Giana
(E)
Aldo Buzzi
(A)
Marcello Diurni
(M)
Anna Milano
(A)
Emanuele Sani
(E)
Roberta Calzolari
(R)
Paola Bortolaso
(P)
Marco Piccinelli
(M)
Sara Cazzamalli
(S)
Gabrio Alberini
(G)
Silvia Piantanida
(S)
Chiara Costantini
(C)
Chiara Paronelli
(C)
Angela Di Caro
(A)
Valentina Moretti
(V)
Mauro Gozzi
(M)
Chiara D'Ippolito
(C)
Silva Veronica Barbanti
(SV)
Papalini Alessandro
(P)
Mariangela Corbo
(M)
Giovanni Martinotti
(G)
Ornella Campese
(O)
Federica Fiori
(F)
Marco Lorusso
(M)
Lucia Di Capro
(L)
Daniela Viceconte
(D)
Valerio Mancini
(V)
Francesco Suraniti
(F)
Maria Salvina Signorelli
(MS)
Eugenio Rossi
(E)
Pasqualino Lupoli
(P)
Marco Menchetti
(M)
Laura Terzi
(L)
Marianna Boso
(M)
Paolo Risaro
(P)
Giuseppe De Paoli
(G)
Cristina Catania
(C)
Ilaria Tarricone
(I)
Valentina Caretto
(V)
Viviana Storbini
(V)
Roberta Emiliani
(R)
Beatrice Balzarro
(B)
Giuseppe Carrà
(G)
Francesco Bartoli
(F)
Tommaso Tabacchi
(T)
Roberto Nava
(R)
Adele Bono
(A)
Milena Provenzi
(M)
Giulia Brambilla
(G)
Flora Aspesi
(F)
Giulia Trotta
(G)
Martina Tremolada
(M)
Gloria Castagna
(G)
Mattia Bava
(M)
Enrica Verrengia
(E)
Sara Lucchi
(S)
Maria Ginevra Oriani
(MG)
Michela Barchiesi
(M)
Monica Pacetti
(M)
Andrea Aguglia
(A)
Andrea Amerio
(A)
Mario Amore
(M)
Gianluca Serafini
(G)
Laura Rosa Magni
(LR)
Giuseppe Rossi
(G)
Rossella Beneduce
(R)
Giovanni Battista Tura
(GB)
Laura Laffranchini
(L)
Daniele Mastromo
(D)
Farida Ferrato
(F)
Francesco Restaino
(F)
Emiliano Monzani
(E)
Matteo Porcellana
(M)
Ivan Limosani
(I)
Lucio Ghio
(L)
Maurizio Ferro
(M)
Vincenzo Fricchione Parise
(VF)
Giovanni Balletta
(G)
Lelio Addeo
(L)
Elisa De Vivo
(E)
Rossella Di Benedetto
(R)
Federica Pinna
(F)
Bernardo Carpiniello
(B)
Mariangela Spano
(M)
Marzio Giacomin
(M)
Damiano Pecile
(D)
Chiara Mattei
(C)
Elisabetta Pascolo Fabrici
(EP)
Sofia Panarello
(S)
Giulia Peresson
(G)
Claudio Vitucci
(C)
Tommaso Bonavigo
(T)
Monica Pacetti
(M)
Giovanni Perini
(G)
Filippo Boschello
(F)
Stefania Strizzolo
(S)
Francesco Gardellin
(F)
Massimo di Giannantonio
(M)
Daniele Moretti
(D)
Carlo Fizzotti
(C)
Edoardo Cossetta
(E)
Luana Di Gregorio
(L)
Francesca Sozzi
(F)
Giancarlo Boncompagni
(G)
Daniele La Barbera
(D)
Giuseppe Colli
(G)
Sabrina Laurenzi
(S)
Carmela Calandra
(C)
Maria Luca
(M)
Informations de copyright
© 2022. The Author(s).
Références
Psychol Assess. 2005 Sep;17(3):324-35
pubmed: 16262458
Eur Arch Psychiatry Clin Neurosci. 2021 Dec;271(8):1411-1413
pubmed: 34586466
Epidemiol Psychiatr Sci. 2018 Dec;27(6):546-551
pubmed: 30208981
Schizophr Bull. 2015 May;41(3):627-36
pubmed: 25180312
Int Clin Psychopharmacol. 2020 Jul;35(4):214-220
pubmed: 32371833
Bipolar Disord. 2018 Nov;20 Suppl 2:25-36
pubmed: 30328222
Psychiatry Res. 2013 Dec 15;210(2):626-33
pubmed: 23890713
Int J Psychiatry Clin Pract. 2017 Mar;21(1):75-79
pubmed: 27669762
CNS Drugs. 2019 May;33(5):431-456
pubmed: 30963507
Psychiatr Serv. 2016 Aug 1;67(8):898-903
pubmed: 27079991
Int J Clin Pract. 2017 Sep;71(9):
pubmed: 28869705
Br J Psychiatry. 2005 Oct;187:366-71
pubmed: 16199797
Ther Adv Psychopharmacol. 2013 Apr;3(2):89-99
pubmed: 24167680
Epidemiol Psichiatr Soc. 2001 Apr-Jun;10(2):107-14
pubmed: 11526792
J Pers Disord. 2021 Jun;35(3):321-335
pubmed: 31609189
J Psychiatr Pract. 2019 Jul;25(4):318-327
pubmed: 31291215
JAMA. 2014 May 21;311(19):1978-87
pubmed: 24846035
Psychol Med. 2018 Jul;48(10):1616-1623
pubmed: 29039277
J Manag Care Pharm. 2012 Jun;18(5 Suppl B):S1-20
pubmed: 22784311
Lancet Psychiatry. 2017 Jan;4(1):8-9
pubmed: 27856397
Int J Neuropsychopharmacol. 2015 May 25;18(11):pyv060
pubmed: 26012350
J Affect Disord. 2017 Apr 15;213:138-150
pubmed: 28222360
Int Rev Psychiatry. 2019 Aug - Sep;31(5-6):441-459
pubmed: 31225767
J Clin Psychiatry. 2020 Jun 16;81(4):
pubmed: 32558403
Lancet Psychiatry. 2019 Dec;6(12):1068-1080
pubmed: 31630984
Addict Biol. 2010 Apr;15(2):217-26
pubmed: 20148781
PLoS One. 2018 Aug 2;13(8):e0201371
pubmed: 30071042
Lancet. 2019 Sep 14;394(10202):939-951
pubmed: 31303314
BMC Psychiatry. 2016 Jul 19;16:249
pubmed: 27435813
BMJ. 1996 Feb 10;312(7027):345-9
pubmed: 8611831
Ther Adv Psychopharmacol. 2018 Sep 25;8(12):333-336
pubmed: 30524701