Mobile Mental Health Unit of Heraklion, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, Voutes, Heraklion, Crete 71003, Greece; Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, Voutes, Heraklion, Crete 71003, Greece; Sleep Research and Treatment Center Department of Psychiatry, Pennsylvania State University College of Medicine, Hershey, PA 17033, USA.
Mobile Mental Health Unit of Heraklion, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, Voutes, Heraklion, Crete 71003, Greece.
Psychiatry Res. 2024 Feb;332:115676. doi: 10.1016/j.psychres.2023.115676. Epub 2023 Dec 24.
Relapse associated with multiple hospital readmissions of patients with chronic and severe mental disorders, such as psychosis and bipolar disorder, is frequently associated with non-adherence to treatment. The primary aim of the study was to compare the effectiveness of long-acting injectable (LAI) treatment, vs. oral medication in reducing readmissions of patients with psychotic or bipolar disorder in a community sample of 164 patients with psychosis and 29 patients with bipolar disorder (n = 193), with poor adherence to oral medication. The mean follow up period was 5.6 years and the number of readmissions were compared for an equal-length period of oral treatment preceding the onset of LAI administration. We observed a significant decrease of 45.2 % in total hospital readmissions after receiving LAIs treatment. The effect was significant both for patients with a pre-LAI treatment history of predominantly voluntary hospitalizations and with predominantly involuntary admissions. In addition, we observed equal effectiveness of first- vs. second-generation LAIs in reducing total hospital readmissions regardless of type of pre-treatment admission history (voluntary vs. involuntary). LAIs appear to be effective in reducing both voluntary and involuntary hospital readmissions in patients with psychosis and bipolar disorder with a history of poor adherence to treatment.
慢性和重度精神障碍（如精神病和双相情感障碍）患者多次住院与复发相关，通常与治疗不依从有关。该研究的主要目的是比较长效注射（LAI）治疗与口服药物治疗在减少社区样本中 164 名精神病患者和 29 名双相情感障碍患者（n=193）中，对口服药物依从性差的精神病或双相情感障碍患者再入院的效果。平均随访时间为 5.6 年，比较了在开始使用 LAI 治疗之前，口服治疗相同长度时间内的再入院次数。我们观察到接受 LAI 治疗后，总住院再入院率显著下降了 45.2%。这种效果对于 LAI 治疗前主要为自愿住院和主要为非自愿入院的患者均有显著意义。此外，我们观察到，无论治疗前入院史（自愿入院与非自愿入院）如何，第一代与第二代 LAI 在减少总住院再入院方面同样有效。对于治疗依从性差的精神病和双相情感障碍患者，LAI 似乎能有效减少自愿和非自愿的住院再入院。
