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Prescriber- and Patient-Level Characteristics Associated with Patient Adherence to Any Antipsychotics Among Patients
Arthur Voegel1, Ronaldo R Naranjo2, Lilian Diaz3
1Analysis Group, Inc., New York, NY, USA.
Purpose:
Antipsychotic (AP) medication adherence is important for the management of schizophrenia. This study thus aimed to evaluate prescriber- and patient-level characteristics and long-acting injectable (LAI) treatment use among patients with schizophrenia to determine the association between these factors and AP adherence.
Patients And Methods:
Adult patients with schizophrenia in the United States were identified from Komodo Research Data (01/01/2016-06/30/2023). Patients were required to have been initiated on an oral or LAI AP (index date) during the intake period (07/01/2021-06/30/2022), by a provider who prescribed APs to ≥6 patients with schizophrenia over the intake period (index prescriber). Providers were characterized using quartiles of the proportion of LAIs over all APs prescribed during the intake period (non-LAI prescribers; Q1: low, ≤8.5% LAIs; Q2-3: intermediate, >8.5% and <27% LAIs; Q4: high, ≥27% LAIs). Adherence to any AP (proportion of days covered ≥80%) was reported over the fixed 12-month follow-up period, and factors associated with adherence were evaluated using multivariate logistic regression.
Results:
In total, 22,255 patients were included (mean age: 40.9; male: 66%; Medicaid: 76%). At index, 82% and 18% of patients were initiated on an oral AP or LAI, respectively, with 10%, 21%, 47%, and 22% of index APs prescribed by non-, low-, intermediate-, and high-LAI prescribers, respectively. Prescription of the index AP by an intermediate- or high- LAI prescriber was associated with 39% and 63% higher odds of adherence, respectively, relative to non-LAI prescribers (both p<0.001). Prescription of an LAI versus oral index AP was associated with 25% higher odds of adherence (p<0.001). Patients of all racial/ethnic minorities had lower odds of adherence relative to White patients (all p<0.050).
Conclusion:
Adherence was higher among patients treated by high-LAI prescribers, indicating that familiarity with LAI treatment and awareness of adherence challenges may improve adherence rates among patients with schizophrenia.
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