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长效注射抗精神病药在减少精神病患者 90 天和年度再入院方面的真实世界效果:来自州立精神病医院的见解。

Real-world effectiveness of long-acting injectable antipsychotics to reduce 90-day and annual readmission in psychotic disorders: insights from a state psychiatric hospital.

机构信息

Department of Psychiatry, Griffin Memorial Hospital, Norman, Oklahoma, USA.

Department of Psychiatry and Behavioral Science, Oklahoma State University, Tulsa, Oklahoma, USA.

出版信息

CNS Spectr. 2022 Oct;27(5):626-633. doi: 10.1017/S109285292100050X. Epub 2021 May 3.

DOI:10.1017/S109285292100050X
PMID:33938426
Abstract

BACKGROUND

To evaluate the effectiveness of long-acting injectable antipsychotics (LAI-a) in reducing the 90-day and annual readmission rates in schizophrenia inpatients.

METHODS

We conducted a cross-sectional study and included 180 adult patients with psychotic disorders discharged from 2018 to 2019 at a state psychiatric hospital. Descriptive statistics were used to measure the differences between the readmit and nonreadmit cohorts. Logistic regression model was used to measure the odds ratio (OR) for 90-day and annual readmission and was controlled for potential readmission risk factors.

RESULTS

A lower proportion of patients receiving LAI-a were readmitted within 90-day (28.6%) and 1-year (32.4%) periods. Patients receiving LAI-a had lower odds of association for 90-day (OR 0.36, 95% confidence intervals [CI] 0.139-0.921) and annual (OR 0.35, 95% CI 0.131-0.954) readmissions compared to those discharged on oral antipsychotics. A higher proportion of inpatients who received fluphenazine LAI had 90-day (25%) and annual (18.2%) readmissions compared to other LAI-a.

CONCLUSION

Utilization of LAI-a in patients with psychotic disorders can decrease both 90-day and annual psychiatric readmissions by 64% to 65%. Physicians should prefer LAI-a to reduce the readmission rate and improve the quality of life, and decrease the healthcare-related financial burden.

摘要

背景

评估长效注射抗精神病药(LAI-a)在降低精神分裂症住院患者 90 天和年度再入院率方面的有效性。

方法

我们进行了一项横断面研究,纳入了 2018 年至 2019 年期间在一家州立精神病院出院的 180 名患有精神障碍的成年患者。使用描述性统计来衡量再入院和非再入院队列之间的差异。使用逻辑回归模型来衡量 90 天和年度再入院的比值比(OR),并控制潜在的再入院风险因素。

结果

接受 LAI-a 治疗的患者在 90 天(28.6%)和 1 年内(32.4%)再入院的比例较低。与接受口服抗精神病药物出院的患者相比,接受 LAI-a 治疗的患者 90 天(OR 0.36,95%置信区间 [CI] 0.139-0.921)和年度(OR 0.35,95% CI 0.131-0.954)再入院的可能性较低。接受氟奋乃静 LAI 的住院患者 90 天(25%)和年度(18.2%)再入院的比例较高。

结论

在患有精神障碍的患者中使用 LAI-a 可以将 90 天和年度精神科再入院率降低 64%至 65%。医生应优先使用 LAI-a 来降低再入院率,提高生活质量,并降低与医疗保健相关的经济负担。

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