Treatment Duration With Long-Acting Injectable Antipsychotics After In-hospital Initiation: A Retrospective Cohort Study
| Autor: | Regina Werl, Jan Rosenleitner, Barbara Rittmannsberger, Hans Rittmannsberger, Kurosch Yazdi, Gertraud Malsiner-Walli |
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| Rok vydání: | 2017 |
| Předmět: |
Pediatrics
medicine.medical_specialty Multivariate analysis Time Factors Treatment duration Injections Medication Adherence Poor adherence 03 medical and health sciences 0302 clinical medicine Outcome Assessment Health Care medicine International Statistical Classification of Diseases and Related Health Problems Humans Pharmacology (medical) Retrospective Studies business.industry Proportional hazards model Retrospective cohort study 030227 psychiatry Discontinuation Psychiatry and Mental health Long acting Psychotic Disorders Delayed-Action Preparations business 030217 neurology & neurosurgery Antipsychotic Agents Follow-Up Studies |
| Zdroj: | Journal of clinical psychopharmacology. 37(2) |
| ISSN: | 1533-712X |
| Popis: | PURPOSE Long-acting injectable (LAI) antipsychotics are recommended especially for patients with multiple admissions and poor adherence. The empirical basis of this strategy is a matter of debate. METHODS In a retrospective cohort study extending over 6 years, all patients admitted for inpatient treatment with a diagnosis of psychotic disorders according to International Statistical Classification of Diseases and Related Health Problems, 10th Revision (F2) were screened for treatment episodes with a new start of an LAI. Indication for LAI treatment was based primarily on previous medication default. All-cause discontinuation was used as a measure of treatment efficiency. Patients with early dropout (termination of LAI treatment within 6 months) were compared with patients with longer treatment (treatment >6 months) for sociodemographic and treatment variables using bivariate and multivariate analyses. RESULTS A total of 194 treatment episodes with new start of LAIs were identified. Almost one half dropped out within 6 months (early dropout: n = 95 [49%]; mean duration, 2.2 months). Termination of treatment was mainly due to patients' refusal to continue. However, almost a third of patients (61; 31.4%) had a treatment duration of more than 2 years. In a multivariate Cox regression model, longer treatment duration was associated with older age (P = 0.05), not being single (P = 0.04), fewer admissions during the year preceding the index episode (P = 0.02), and better ratings for adherence at the index episode (P = 0.03). CONCLUSIONS There are both more patients than expected leaving the treatment early and more patients than expected staying for long periods, even among patients with a history of poor adherence. |
| Databáze: | OpenAIRE |
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