Olayinka Olaniyi, Oyelakin Ayotomide, Cherukupally Karthik, Virk Inderpreet, Ojimba Chiedozie, Khadka Susmita, Maksymenko Alexander, Fouron Patrice, Khandaker Taher, Olupona Tolu, Hershberger Jason
Department of Psychiatry and Behavioral Sciences, Interfaith Medical Center, Brooklyn, NY, USA.
Psychiatry J. 2019 Jun 13;2019:8629030. doi: 10.1155/2019/8629030. eCollection 2019.
Individuals with Schizophrenia Spectrum Disorders (SSD) often experience significant impairment in educational, occupational, and psychosocial functioning. The clinical benefit of long-acting injectable antipsychotics (LAIs) in the management of patients with SSD is well established. SSD patients who are nonadherent to treatment have lower disease relapse and readmission rates when prescribed a LAI, compared to oral antipsychotics. Despite the reported advantages of LAIs, their prescription rates in clinical settings remain low. This pilot study aimed to determine the pattern of LAI prescription in psychiatric inpatients of a teaching community hospital in Brooklyn, New York.
A retrospective review of the charts of patients discharged from the psychiatric units of the hospital from September 1, 2017, through September 30, 2017, was conducted. Frequencies and proportions for demographic and disease-related characteristics were calculated. Pertinent continuous variables were recoded into categorical variables. Chi-square-tests or Fisher's exact tests were performed for categorical variables. The one-sample Shapiro-Wilk test (for sample size < 50) was used to check for the normality of distribution of continuous variables. Statistical significance was defined as p ≤ 0.05.
Forty-three (70%) of the patients discharged from the inpatient unit during the study period had SSD and were eligible for a LAI. Their ages ranged from 20 to 71 years (mean = 41 years), and more than two-thirds were male. Less than half of the eligible patients (n = 19; 44%) were prescribed a LAI, most of whom were male (n=16; 84%). An association between age group (patients aged 41 years or younger) and LAI use was observed (p < 0.05), while gender, employment status, living arrangement, length of hospital stay, recent hospitalization, and cooccurring substance use disorder were not.
LAI prescription rate at the inpatient psychiatric unit of the hospital was marginally higher than those reported in most studies. Age appears to influence LAI use during the study period. Initiatives that increase LAI prescription rate for all eligible patients admitted to inpatient psychiatric unit should be encouraged.
精神分裂症谱系障碍（SSD）患者在教育、职业和心理社会功能方面常常经历显著损害。长效注射用抗精神病药物（LAIs）在SSD患者管理中的临床益处已得到充分证实。与口服抗精神病药物相比，对治疗不依从的SSD患者在开具LAIs处方时疾病复发率和再入院率更低。尽管LAIs有上述报道的优势，但其在临床环境中的处方率仍然很低。这项试点研究旨在确定纽约布鲁克林一家教学社区医院精神科住院患者中LAIs的处方模式。
对2017年9月1日至2017年9月30日期间从该医院精神科病房出院的患者病历进行回顾性研究。计算人口统计学和疾病相关特征的频率及比例。将相关连续变量重新编码为分类变量。对分类变量进行卡方检验或费舍尔精确检验。使用单样本夏皮罗-威尔克检验（样本量<50时）检查连续变量分布的正态性。统计学显著性定义为p≤0.05。
在研究期间从住院部出院的患者中有43名（70%）患有SSD且符合使用LAIs的条件。他们的年龄在20至71岁之间（平均=41岁），超过三分之二为男性。不到一半的符合条件患者（n = 19；44%）开具了LAIs处方，其中大多数为男性（n = 16；84%）。观察到年龄组（41岁及以下患者）与LAIs使用之间存在关联（p < 0.05），而性别、就业状况、居住安排、住院时间、近期住院情况和并发物质使用障碍则无关联。
该医院精神科住院部的LAIs处方率略高于大多数研究报告的水平。在研究期间年龄似乎会影响LAIs的使用。应鼓励采取措施提高所有入住精神科住院部的符合条件患者的LAIs处方率。
