Time to Treatment Discontinuation in German Patients with Schizophrenia: Long-Acting Injectables versus Oral Antipsychotics
| Autor: | Claus Wolff-Menzler, Antonie Wimmer, Kerstin Olbrich, Jörg Mahlich, Adrian Wilk |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adolescent medicine.medical_treatment Administration Oral 030204 cardiovascular system & hematology Lower risk 030226 pharmacology & pharmacy Injections Medication Adherence Cohort Studies 03 medical and health sciences Young Adult 0302 clinical medicine Internal medicine Germany medicine Humans Pharmacology (medical) Original Research Article Antipsychotic Aged Proportional Hazards Models Retrospective Studies Proportional hazards model business.industry Hazard ratio General Medicine Middle Aged Confidence interval Discontinuation Regimen Delayed-Action Preparations Cohort Schizophrenia Female business Antipsychotic Agents |
| Zdroj: | Clinical Drug Investigation |
| ISSN: | 1179-1918 |
| Popis: | Background and Objective Long-acting injectable antipsychotics (LAIs) are associated with better treatment adherence and persistence than oral antipsychotics (OAPs) in patients with schizophrenia. However, real-world evidence assessing the impact of treatment with LAIs in Germany is limited. To fill this gap, we compared antipsychotic medication adherence and risk of treatment discontinuation (TD) among schizophrenia patients newly initiated on LAI or who switched their OAP regimen (overall cohort; OC). Methods Claims data of German schizophrenia patients who initiated LAIs or switched their OAP during 2012–2016 (index date) were retrospectively analyzed. Treatment switch was defined as add-on medication to existing prescription or terminating the existing prescription and initiating another OAP. Adherence and time to treatment discontinuation (TTD) were estimated. Determinants of treatment discontinuation were analyzed using two Cox regression models. Model 1 controlled for age, sex, and Charlson Comorbidity Index (CCI); model 2 also included insurance status, and medication, visit, and psychiatric inpatient stay costs. Sensitivity analysis on patients who terminated existing prescriptions and initiated new OAPs (complete switch cohort; CSC) was performed. Results In OC (n = 2650), LAI users had better adherence (35.4% vs. 11.6%), persistence (no 60-day gap; 40.7% vs. 19.8%), and longer TTD (median [95% confidence interval (CI)] 216 [193–249] vs. 50 [46–56] days) than OAP users. OAP usage (hazard ratio [HR] 1.89, 95% CI 1.73–2.06; p |
| Databáze: | OpenAIRE |
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