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Do Long-Acting Injectable Antipsychotics Prevent or Delay Hospital Readmission?
Thomas J Maestri1, Lisa M Mican1, Heather Rozea1
1Maestri, PharmD, BCPP, Clinical Assistant Professor, Xavier University of Louisiana College of Pharmacy, New Orleans LA. Mican, PharmD, BCPP, Assistant Director of Pharmacy, Austin State Hospital, Clinical Assistant Professor, UT-Austin College of Pharmacy, Austin TX. Rozea, PharmD, PGY-1 Pharmacy Practice Resident, Michael E. DeBakey VA Medical Center, Houston TX. Barner, PhD, Professor, UT-Austin College of Pharmacy, Austin TX.
Psychopharmacology Bulletin
|May 2, 2018
Summary
Long-acting injectable (LAI) antipsychotics may help patients with a history of non-adherence stay out of the hospital longer. LAIs with monthly or less frequent dosing showed the most promising results for preventing readmission.
Area of Science:
- Psychiatry
- Pharmacology
Background:
- Long-acting injectable (LAI) antipsychotics simplify medication regimens and improve adherence.
- Medication non-adherence is a significant challenge in managing severe mental illnesses.
Purpose of the Study:
- To evaluate if LAI antipsychotics prevent or delay hospital readmission in patients with a history of medication non-adherence.
Main Methods:
- Retrospective study of 240 patients (18-65 years) diagnosed with bipolar disorder, schizophrenia, or schizoaffective disorder.
- Patients received either LAI antipsychotics (fluphenazine, haloperidol, risperidone, paliperidone) or oral antipsychotics.
- Matched groups based on dose, diagnosis, prior admissions, and length of stay.
Main Results:
- Patients on LAIs had a longer mean survival time without readmission (278.0 days) compared to oral antipsychotics (243.6 days).
- No significant difference in one-year readmission frequency between LAI (43.1%) and oral (56.9%) groups.
- LAIs administered monthly or less frequently showed significantly longer survival times without readmission (307.9 days) versus shorter intervals (245.0 days).
Conclusions:
- LAI antipsychotics show promise in improving outcomes for patients with medication non-adherence.
- Longer administration intervals (monthly or less) of LAIs appear particularly effective in preventing hospital readmissions.
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