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Outcomes and costs of treatment with risperidone in adult and elderly patients: the Delta patient using risperidone
Anton J M Loonen1, Jacques C M Loos, Theodora H Van Zonneveld
1Delta Psychiatric Teaching Hospital, P.O. Box 800, NL-3170 DZ Poortugaal, The Netherlands. Anton.Loonen@wxs.nl
Purpose:
The primary aim of the present study (called DePUR: Delta patients using risperidone) was to compare patient characteristics, treatment outcome variables and medication costs of adult and elderly patients treated with risperidone.
Methods:
In a single-centre retrospective study, the following data were extracted from the medical records of 32 adult (< 65 years) and 32 elderly (> or = 65 years) inpatients to whom risperidone was prescribed shortly after admission: demographic data, diagnosis, medication and hospitalisation history, all drugs taken during admission, treatment effectiveness of risperidone, reported adverse events. These data were collected for the period from admission until discharge or until they had been hospitalised for 120 days.
Results:
Most patients (81% of adult patients and 91% of elderly patients) received risperidone for a psychiatric disease other than schizophrenia. In elderly patients, major depressive disorder with psychotic features was the most frequent diagnosis. Treatment with risperidone was in most cases effective (72% and 74%, respectively), but effectiveness was established sooner in the adult patients than in the elderly patients (7 versus 14 days). The length of stay in hospital was shorter in adults than in elderly (38.5 versus 92.7 days). The daily dose of risperidone was higher in adults than in elderly patients (3.6 versus 1.7 mg per day). Contrary to expectations, daily drug cost of risperidone and daily drug cost of all inpatient drugs were not cheaper in adult patients than in the elderly, mainly due to a higher dose of risperidone and a higher consumption of antipsychotic co-medication in adults.
Conclusion:
Risperidone is prescribed successfully for many other psychotic features than for schizophrenia. Treatment of elderly patients in our clinic does not require higher daily medication costs than for adult patients.
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