Verdoux Hélène, Pambrun Elodie, Tournier Marie, Bezin Julien, Pariente Antoine
Univ. Bordeaux, U1219, F-33000 Bordeaux, France; INSERM, U1219, F-33000 Bordeaux, France; Centre Hospitalier Charles Perrens, F-33000 Bordeaux, France.
Univ. Bordeaux, U1219, F-33000 Bordeaux, France; INSERM, U1219, F-33000 Bordeaux, France.
Schizophr Res. 2016 Dec;178(1-3):58-63. doi: 10.1016/j.schres.2016.09.014. Epub 2016 Sep 10.
To explore the impact of the introduction of newer antipsychotic long-acting injections (LAIs) on trends in LAI prescribing and characteristics associated with initiation of LAIs in naturalistic conditions.
The study was performed using reimbursement data from the French Insurance Healthcare system. Prescribing trends were investigated from 2007 to 2014 in 382,572 persons aged 18years and over. Characteristics associated with delay in transition from oral antipsychotic to LAIs were explored in a cohort of 6904 persons newly treated with an oral antipsychotic using multivariate survival analyses.
LAI prescribing rates slightly increased over the study period. The likelihood of being prescribed LAIs was stable for FGA LAIs (around 1.8 per 1000) (aOR=0.99, 95%CI 0.98-1.00) and increased for SGA LAIs from 0.5 to 1 per 1000 (aOR=1.11, 95%CI 1.08-1.14). In persons initiating an LAI (n=288), shorter transition from oral antipsychotic to LAI was independently predicted by male gender, younger age, dispensing of an oral SGA and a higher number of oral antipsychotics dispensed over the follow-up. Transition was longer in persons dispensed antidepressants or mood-stabilizers over the follow-up. Male gender, low income and higher number of antipsychotics were associated only with shorter transition to FGA LAIs, while initial prescription by a public practitioner, no mood-stabilizer dispensing and lack of somatic severe chronic condition were associated only with SGA LAIs dispensing.
It is of interest to explore whether similar prescribing trends are observed in other countries and to further assess the effectiveness of new LAIs in real-life conditions.
探讨新型抗精神病长效注射剂（LAIs）的引入对LAIs处方趋势以及在自然条件下启动LAIs相关特征的影响。
该研究使用了法国保险医疗系统的报销数据。对2007年至2014年期间382,572名18岁及以上人群的处方趋势进行了调查。使用多变量生存分析，在一组6904名新接受口服抗精神病药物治疗的人群中，探讨了从口服抗精神病药物转换为LAIs延迟相关的特征。
在研究期间，LAIs的处方率略有增加。第一代抗精神病长效注射剂（FGA LAIs）的处方可能性稳定（约每1000人中有1.8人）（调整后比值比[aOR]=0.99，95%置信区间[CI] 0.98 - 1.00），第二代抗精神病长效注射剂（SGA LAIs）的处方可能性从每1000人中有0.5人增加到1人（aOR = 1.11，95%CI 1.08 - 1.14）。在启动LAIs的人群（n = 288）中，男性、较年轻的年龄、口服SGA的配药以及随访期间口服抗精神病药物的配药数量较多，可独立预测从口服抗精神病药物到LAIs的转换时间较短。在随访期间接受抗抑郁药或心境稳定剂配药的人群中，转换时间较长。男性、低收入和抗精神病药物数量较多仅与向FGA LAIs的转换时间较短有关，而由公立执业医生首次处方、未配用心境稳定剂以及没有躯体严重慢性病仅与SGA LAIs的配药有关。
探索其他国家是否观察到类似的处方趋势，并进一步评估新型LAIs在实际生活条件下的有效性，是很有意义的。
