Thaman Pragya, Kulig Caitlin E, Greer Daniel
From the Rutgers Pharmaceutical Fellowship Program.
Rutgers University Ernest Mario School of Pharmacy, Piscataway, NJ.
J Clin Psychopharmacol. 2024;44(2):96-99. doi: 10.1097/JCP.0000000000001810. Epub 2024 Jan 16.
PURPOSE/BACKGROUND: Schizophrenia is a chronic, debilitating mental illness that incurs a large economic burden. Decreasing hospital readmissions is a priority in health care to improve patient quality of life and decrease health care costs. Determining ways to prevent readmissions such as improving access to long-acting injectable (LAI) antipsychotics is important to assess.
METHODS/PROCEDURES: A single-center retrospective review was conducted comparing readmission rates of patients diagnosed with schizophrenia or schizoaffective disorder discharged on LAI or oral antipsychotics between August 1, 2019, and June 30, 2022. The primary outcome was the 30-day psychiatric readmission rate. Secondary outcomes included chlorpromazine equivalent doses and use of anticholinergic medications.
FINDINGS/RESULTS: The 30-day readmission rate was 1.9% for the LAI antipsychotic group and 8.3% for the oral antipsychotic group ( P = 0.03; 95% confidence interval, 1.05-20.02). The average chlorpromazine equivalent antipsychotic dose of patients discharged on LAI versus oral antipsychotic medications was 477.3 and 278.6 mg/d, respectively ( P < 0.001). In addition, the prevalence of medications used to treat extrapyramidal symptom was 22.3% (n = 23) for the LAI antipsychotic group and 30.8% (n = 74) for the oral antipsychotic group ( P = 0.12). Sixty-four percent of LAI antipsychotics utilized were obtained from pharmaceutical company hospital inpatient free trial programs.
IMPLICATIONS/CONCLUSIONS: Long-acting injectable antipsychotics showed a statistically significant reduction in 30-day rehospitalizations as compared with oral antipsychotics and hospital inpatient free trial programs aided in LAI antipsychotic acquisition.
目的/背景：精神分裂症是一种慢性、使人衰弱的精神疾病，会带来巨大的经济负担。减少医院再入院率是医疗保健的优先事项，以提高患者生活质量并降低医疗成本。确定预防再入院的方法，如改善长效注射用（LAI）抗精神病药物的可及性，对于评估至关重要。
方法/程序：进行了一项单中心回顾性研究，比较2019年8月1日至2022年6月30日期间使用LAI或口服抗精神病药物出院的精神分裂症或分裂情感性障碍患者的再入院率。主要结局是30天精神科再入院率。次要结局包括氯丙嗪等效剂量和抗胆碱能药物的使用。
发现/结果：LAI抗精神病药物组的30天再入院率为1.9%，口服抗精神病药物组为8.3%（P = 0.03；95%置信区间，1.05 - 20.02）。使用LAI与口服抗精神病药物出院患者的平均氯丙嗪等效抗精神病药物剂量分别为477.3和278.6毫克/天（P < 0.001）。此外，LAI抗精神病药物组用于治疗锥体外系症状的药物患病率为22.3%（n = 23），口服抗精神病药物组为30.8%（n = 74）（P = 0.12）。所使用的LAI抗精神病药物中有64%是从制药公司医院住院患者免费试用项目获得的。
启示/结论：与口服抗精神病药物相比，长效注射用抗精神病药物在30天再住院率方面显示出统计学上的显著降低，并且医院住院患者免费试用项目有助于获得LAI抗精神病药物。
