Long-term outcomes in patients with schizophrenia treated with risperidone long-acting injection or oral antipsychotics in Spain: Results from the electronic Schizophrenia Treatment Adherence Registry (e-STAR)

• Published in: European psychiatry Vol. 24; no. 5; pp. 287 - 296
• Main Authors: Olivares, J.M, Rodriguez-Morales, A, Diels, J, Povey, M, Jacobs, A, Zhao, Z, Lam, A
• Format: Journal Article
• Language: English
• Published: Paris Elsevier SAS 01.06.2009; Elsevier
• Subjects: Administration, Oral; Adult; Antipsychotic Agents - administration & dosage; Antipsychotic Agents - adverse effects; Antipsychotic medication; Benzodiazepines - administration & dosage; Benzodiazepines - adverse effects; Biological and medical sciences; Delayed-Action Preparations; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Injections, Intramuscular; Internal Medicine; Long-Term Care; Male; Medical sciences; Medication Adherence; Middle Aged; Neuropharmacology; Observational study; Olanzapine; Patient Readmission - statistics & numerical data; Pharmacology. Drug treatments; Prospective Studies; Psychiatric Status Rating Scales; Psychiatry; Psycholeptics: tranquillizer, neuroleptic; Psychology. Psychoanalysis. Psychiatry; Psychopharmacology; Registries; Risperidone - administration & dosage; Risperidone - adverse effects; Risperidone long-acting injection; Schizophrenia; Schizophrenia - drug therapy; Schizophrenic Psychology; Treatment retention; Europe; Spain; Risperidone long-acting injection; Schizophrenia; Observational study; Treatment retention; Antipsychotic medication; Social environment; Atypical antipsychotic; Intravenous administration; Neuroleptic; Psychotropic; Mental health; Pharmacotherapy; Serotonine receptor; Psychosis; Evolution; Treatment compliance; Risperidone; Benzisoxazole derivatives; Public health; Human; Controlled release form; Dopamine antagonist; Serotonin antagonist; Treatment efficiency; Oral administration; Long term; D2 Dopamine receptor; Treatment; Follow up study; Dosage form
• ISSN: 0924-9338; 1778-3585
• DOI: 10.1016/j.eurpsy.2008.12.002

Abstract Background The electronic Schizophrenia Treatment Adherence Registry (e-STAR) is a prospective, observational study of patients with schizophrenia designed to evaluate long-term treatment outcomes in routine clinical practice. Methods Parameters were assessed at baseline and at 3 month intervals for 2 years in patients initiated on risperidone long-acting injection (RLAI) ( n = 1345) or a new oral antipsychotic (AP) ( n = 277; 35.7% and 36.5% on risperidone and olanzapine, respectively) in Spain. Hospitalization prior to therapy was assessed by a retrospective chart review. Results At 24 months, treatment retention (81.8% for RLAI versus 63.4% for oral APs, p < 0.0001) and reduction in Clinical Global Impression Severity scores (−1.14 for RLAI versus −0.94 for APs, p = 0.0165) were significantly higher with RLAI. Compared to the pre-switch period, RLAI patients had greater reductions in the number (reduction of 0.37 stays per patient versus 0.2, p < 0.05) and days (18.74 versus 13.02, p < 0.01) of hospitalizations at 24 months than oral AP patients. Conclusions This 2 year, prospective, observational study showed that, compared to oral antipsychotics, RLAI was associated with better treatment retention, greater improvement in clinical symptoms and functioning, and greater reduction in hospital stays and days in hospital in patients with schizophrenia. Improved treatment adherence, increased efficacy and reduced hospitalization with RLAI offer the opportunity of substantial therapeutic improvement in schizophrenia.