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精神分裂症谱系障碍患者中抗精神病药物给药途径转换的临床、生活质量及医疗保健利用结果:一项系统评价和荟萃分析

Clinical, Quality of Life, and Health Care Utilization Outcomes of Switching the Administration Route of Antipsychotic Medications Among People With Schizophrenia Spectrum Disorder: A Systematic Review and Meta-Analysis.

作者信息

Kappi Amani, Wang Tianyi, Abu Farsakh Bassema, Okoli Chizimuzo T C

机构信息

Amani Kappi, PhD, MSN, RN, BSN, Jazan University, Jazan, Saudi Arabia.

Tianyi Wang, MS, University of Kentucky, Lexington, KY, USA.

出版信息

J Am Psychiatr Nurses Assoc. 2025 Mar-Apr;31(2):138-164. doi: 10.1177/10783903241279605. Epub 2024 Oct 23.

DOI:10.1177/10783903241279605
PMID:39440868
Abstract

BACKGROUND

Using long-acting injectable (LAI) antipsychotic medications can improve the outcomes of patients with schizophrenia, such as reducing symptom severity and hospitalization risk. However, the outcomes of switching from oral to LAI antipsychotic medications are unclear.

AIMS

The purpose of this review is to provide a summary of the clinical, quality of life, and health care utilization outcomes of switching from oral to LAI antipsychotics among patients with Schizophrenia Spectrum Disorder.

METHODS

We thoroughly searched the PubMed, Scopus, PsycInfo, and CINAHL databases. To conduct the meta-analysis, we used the Comprehensive Meta-Analysis Program.

RESULTS

Forty-one articles met our inclusion criteria. After switching to LAIs, symptom severity, the number of rehospitalizations, emergency department visits, and overall health care costs were reduced. Also, social functioning significantly improved. However, no differences were observed in the frequency of outpatient visits. Pharmacy costs were increased between pre- and post-LAI initiation.

CONCLUSION

Our findings support evidence that changing the route of administration of antipsychotic medications from oral to long-acting intramuscular injections can improve the clinical, quality of life, and health care utilization outcomes in people with schizophrenia. Health care practitioners might consider encouraging LAI use earlier during treatment for schizophrenia for better clinical outcomes and to reduce health care utilization associated with treatment.

摘要

背景

使用长效注射用(LAI)抗精神病药物可改善精神分裂症患者的治疗效果,如减轻症状严重程度和降低住院风险。然而,从口服抗精神病药物转换为LAI药物的治疗效果尚不清楚。

目的

本综述的目的是总结精神分裂症谱系障碍患者从口服抗精神病药物转换为LAI抗精神病药物后的临床、生活质量和医疗保健利用结果。

方法

我们全面检索了PubMed、Scopus、PsycInfo和CINAHL数据库。为进行荟萃分析,我们使用了综合荟萃分析程序。

结果

41篇文章符合我们的纳入标准。转换为LAI药物后,症状严重程度、再次住院次数、急诊就诊次数和总体医疗保健成本均有所降低。此外,社会功能显著改善。然而,门诊就诊频率未观察到差异。LAI治疗开始前后的药房费用有所增加。

结论

我们的研究结果支持以下证据,即抗精神病药物的给药途径从口服改为长效肌肉注射可改善精神分裂症患者的临床、生活质量和医疗保健利用结果。医疗保健从业者可能会考虑在精神分裂症治疗早期鼓励使用LAI,以获得更好的临床结果并减少与治疗相关的医疗保健利用。

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Clinical, Quality of Life, and Health Care Utilization Outcomes of Switching the Administration Route of Antipsychotic Medications Among People With Schizophrenia Spectrum Disorder: A Systematic Review and Meta-Analysis.精神分裂症谱系障碍患者中抗精神病药物给药途径转换的临床、生活质量及医疗保健利用结果:一项系统评价和荟萃分析
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引用本文的文献

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