The effectiveness of long‐acting injectable antipsychotics versus oral antipsychotics in the maintenance treatment of outpatients with chronic schizophrenia

• Published in: Human psychopharmacology Vol. 35; no. 3; pp. e2729 - n/a
• Main Authors: Fang, Su‐Chen, Liao, Ding‐Lieh, Huang, Cheng‐Yi, Hsu, Chun‐Chi, Cheng, Shu‐Li, Shao, Yu‐Hsuan J.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.05.2020
• Subjects: Administration, Oral; Adolescent; Adult; Aged; Antipsychotic Agents - administration & dosage; Antipsychotic Agents - therapeutic use; Antipsychotics; Chronic Disease - drug therapy; Delayed-Action Preparations - therapeutic use; Emergency medical care; Emergency Medical Services - statistics & numerical data; Facilities and Services Utilization - statistics & numerical data; Female; Health services utilization; Hospitalization - statistics & numerical data; Humans; Injections, Intramuscular; Length of Stay - statistics & numerical data; long‐acting injectable antipsychotics; maintenance treatment; Male; Mental disorders; Mental Health Services - statistics & numerical data; Middle Aged; Outpatients; Psychotropic drugs; Regression analysis; Risk assessment; Schizophrenia; Schizophrenia - drug therapy; Young Adult; antipsychotics; long-acting injectable antipsychotics; schizophrenia; maintenance treatment
• ISSN: 0885-6222; 1099-1077; 1099-1077
• DOI: 10.1002/hup.2729

Objective To compare the psychiatric service utilization between patients who only received long‐acting injectable antipsychotics (LAIAs) and those who only received oral antipsychotics (OAPs) in the maintenance treatment of chronic schizophrenia. Methods We constructed a cohort of chronic schizophrenia patients who underwent maintenance treatment from the Taiwan National Health Insurance Research Database in 2011 and followed these patients for 12 months. We included patients who had been diagnosed with schizophrenia for at least 3 years, were not hospitalized in 2011, and had received 1 year of maintenance treatment. Inverse probability of treatment weighting logistic, linear, and negative binomial regression models were used to estimate associated psychiatric services utilization and adjust for covariate imbalances between the LAIAs and OAPs groups. Results Among 40,194 patients, 948 (2.36%) received only LAIAs and 39,246 (97.64%) received only OAPs. Compared with those who received only OAPs, the sole LAIAs users were associated with a lower percentage of psychiatric hospitalization (8.4% and 5.8%, respectively; odds ratio: 0.63, p < .01), shorter lengths of hospitalization days (82.8 and 65.9, respectively; coefficient [b]: −16.87, p = .03), and fewer emergency room visits (2.3 and 1.8, respectively; b: −0.24, p < .01) per patient. Conclusions Chronic schizophrenia patients who received only LAIs had a lower risk of disease relapse and a reduction in psychiatric service utilization than those receiving only OAPs.