Initiating long-acting injectable antipsychotics during acute admission for patients with schizophrenia – A 3-year follow-up.

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Initiating long-acting injectable antipsychotics during acute admission for patients with schizophrenia - A 3-year follow-up.

J Formos Med Assoc. 2015 Jun;114(6):539-45

Authors: Liu CC, Shan JC, Chiang CL, Hsieh MH, Liu CM, Chien YL, Chen SC, Hwang TJ

Abstract
BACKGROUND/PURPOSE: The debate on whether long-acting injectable antipsychotic (LAIA) medication is superior to oral medication, in preventing rehospitalization of patients with schizophrenia, remains inconclusive. We compared rehospitalization rates over 3 years following discharge from an acute admission, in which patients either began using LAIAs regularly for the first time, or continued to use oral antipsychotics.
METHODS: A retrospective observational study of 92 inpatients with schizophrenia from a university-based medical center during 2004-2008. The primary outcome measure is the rehospitalization rates between groups, as estimated by Kaplan-Meier survival analysis.
RESULTS: Eighteen of 47 (38.3%) LAIA patients, and 16 of 45 (35.6%) oral medication patients were rehospitalized (average time to rehospitalization, 378 ± 262 vs. 378 ± 340 days; p = 0.997). The estimated cumulative rates of rehospitalization were similar between groups. The overall odds comparing the LAIA to the oral medication group were 1.085 ± 0.373 (95% confidence interval: 0.553-2.13, p = 0.813). Compared to the oral medication group, the LAIA group had fewer coded with sufficient previous treatment response (32% vs. 69%, p < 0.001), more poorly compliant (91% vs. 56%, p < 0.001), and a slightly longer length of stay at index admission (32.7 ± 11.3vs. 27.6 ± 12.1, p = 0.04).
CONCLUSION: Initiating LAIAs during admission for an acute psychotic episode, to a group of patients with an inadequate previous treatment response and poorer compliance, might keep their rehospitalization rates to the level of their oral antipsychotic medication treated counterparts.

PMID: 26062967 [PubMed - in process]