Joshi Kruti, Lafeuille Marie-Hélène, Brown Brianne, Wynant Willy, Emond Bruno, Lefebvre Patrick, Tandon Neeta
a Janssen Scientific Affairs LLC , Titusville , NJ , USA.
b Groupe d'analyse Ltée , Montréal , QC , Canada.
Curr Med Res Opin. 2017 Oct;33(10):1763-1772. doi: 10.1080/03007995.2017.1359516. Epub 2017 Aug 4.
Since May 2015, adult patients with schizophrenia adequately treated with once monthly paliperidone palmitate (PP1M) may be transitioned to once-every-three-months paliperidone palmitate (PP3M). This study aims to describe baseline characteristics and treatment patterns of patients with schizophrenia initiated on PP3M in a real-world setting.
Pharmacy and medical claims from May 2014 to September 2016 for adult patients with schizophrenia initiated on PP3M (index date) in the Symphony Health Solutions database were analyzed. The cohort consisting of all patients and the one restricted to those transitioning from PP1M as per prescribing guideline recommendations were considered. Baseline characteristics were assessed during the 12 month baseline period. PP1M treatment patterns, proportion of days covered (PDC) by mental-health-related medications, and healthcare resource utilization (HRU) patterns were evaluated for each baseline quarter. PP3M treatment patterns were assessed post-index.
Among the 1545 adult patients initiated on PP3M who formed the first cohort, 68.8% transitioned from PP1M based on prescribing guidelines and on an adaptation of the strict clinical trial protocol for PP1M to PP3M transition, forming the second cohort. In both cohorts, the proportion of patients with a PDC ≥80% for antipsychotics, antidepressants, anxiolytics, and mood stabilizers increased while the proportion of patients with ≥1 emergency room, inpatient, or outpatient visit decreased in baseline quarters closer to PP3M initiation. Among patients with ≥4 months of follow-up after the first dose, 85-88% had a second dose. Similarly, among those with ≥4 months of follow-up after the second dose, 87-90% received a third dose.
Patients initiated on PP3M demonstrated decreased HRU and increased adherence in quarters closer to PP3M initiation, and were persistent on their PP3M treatment.
自2015年5月起,接受每月一次棕榈酸帕利哌酮(PP1M)充分治疗的成年精神分裂症患者可转换为每三个月一次的棕榈酸帕利哌酮(PP3M)治疗。本研究旨在描述在真实世界中开始使用PP3M治疗的精神分裂症患者的基线特征和治疗模式。
分析了2014年5月至2016年9月在Symphony Health Solutions数据库中开始使用PP3M(索引日期)的成年精神分裂症患者的药房和医疗理赔数据。研究队列包括所有患者以及根据处方指南建议从PP1M转换而来的患者。在12个月的基线期内评估基线特征。对每个基线季度的PP1M治疗模式、心理健康相关药物的覆盖天数比例(PDC)以及医疗资源利用(HRU)模式进行评估。在索引日期后评估PP3M治疗模式。
在组成第一个队列的1545例开始使用PP3M的成年患者中,68.8%根据处方指南并通过对PP1M至PP3M转换的严格临床试验方案进行调整后从PP1M转换而来,形成第二个队列。在两个队列中,抗精神病药、抗抑郁药、抗焦虑药和心境稳定剂的PDC≥80%的患者比例增加,而在接近PP3M起始的基线季度中,≥1次急诊室、住院或门诊就诊的患者比例下降。在首剂后随访≥4个月的患者中,85 - 88%接受了第二剂。同样,在第二剂后随访≥4个月的患者中,87 - 90%接受了第三剂。
开始使用PP3M治疗的患者在接近PP3M起始的季度中显示出医疗资源利用减少和依从性增加,并且持续接受PP3M治疗。