A mirror image study of the utility of long acting aripiprazole

2016 ◽  
Vol 33 (S1) ◽  
pp. s252-s252
Author(s):  
R. Hodgson ◽  
C. Aladakatti ◽  
N. Kataria ◽  
T. Saravanappa ◽  
D. Brittany
Keyword(s):  
Mental Health ◽  
First Generation ◽  
Time Frame ◽  
Blood Parameters ◽  
Mirror Image ◽  
Image Study ◽  
Intention To Treat ◽  
Competing Interest ◽  
Long Acting ◽  
The Uk

Aims and backgroundAblify Maintena (AM) is a long acting injection of aripiprazole that received marketing authorisation in the UK in January 2014. It is costly compared to first generation antipsychotics (FGAs) LAIs and there are no robust trials comparing AM with FGAs. We examined the effectiveness and use of AM in a mental health trust.MethodsWe identified all patients prescribed AM in North Staffordshire (population: 470,000) since launch and examined records for demography, diagnosis, bed and medication use. We examined the effectiveness of AM using a mirror image design.ResultsThirty patients received AM in a time frame allowing a 1-year follow-up. Sixty-nine percent were male and the mean age was 39 years. Over half were detained under the 1983 Mental Health Act and 30% were inpatients on a psychiatric intensive care unit when AM was started. Twenty-eight patients had a psychotic diagnosis. There was a significant reduction in bed occupancy (63 v 6 days, P = 0.0001) and admissions (1.6 v 0.5, P = 0.0001). The median dose was 400 mg. Lack of effectiveness/poor adherence with prior treatments were the main reason for starting AM in 84%. Eighty-six percent of patients clinically improved on AM. Blood parameters were in the normal range.DiscussionWithin the limitations of the methodology, our results show a reduction in psychiatric bed use in the year following AM initiation on an intention to treat basis. The reduction in bed use equates to a minimum annual saving of £14,250 per patient. AM at the median study dose costs £2645 per year.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals A two-year mirror-image study of the effect of treatment with paliperidone and aripiprazole long-acting injections on need for inpatient care and home treatment intervention

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S280-S280
Author(s):  
Shay-Anne Pantall ◽  
Joseph Pilsbury ◽  
Le Gan ◽  
Lisa Brownell
Keyword(s):  
First Generation ◽  
Second Generation ◽  
Drug Acquisition ◽  
Mirror Image ◽  
Home Treatment ◽  
Image Study ◽  
Acquisition Costs ◽  
Bed Days ◽  
Long Acting ◽  
Depot Antipsychotics

AimsTo evaluate the effect of the use of aripiprazole and paliperidone long acting injections on healthcare resource useBackgroundLong acting injections of second-generation antipsychotics such as paliperidone and aripiprazole have become more commonly prescribed over the past decade. They have much higher acquisition costs when compared to first generation depot antipsychotics. It is therefore essential to demonstrate their tolerability and cost-effectiveness.MethodWe undertook an observational, retrospective two-year mirror study for all patients who started treatment with paliperidone long acting injection between January and June 2016 (n = 47) or aripiprazole long acting injection between April 2014 and July 2017 (n = 93). Clinical notes were examined to determine the number of admissions, inpatient days, home treatment episodes and number of home treatment days, in the 12 months preceding and following the commencement of the long acting injection.Result70% remained on paliperidone and 62% remained on aripiprazole at the end of the one-year period.There was a significant reduction in occupied bed days in those treated with paliperidone from 78.2 days in the year before this treatment was started to 25.4 days in the year after (p = 0.002). There was a significant reduction in occupied bed days in those treated with aripiprazole from 66.51 days to 32.7 days (p = 0.0006).There was no significant reduction in days spent under the care of home treatment teams for individuals treated with either of these medicines.ConclusionTreatment with either paliperidone or aripiprazole long-acting injection was associated with a reduction in admissions and occupied bed days of a magnitude that delivered an overall cost-saving despite the high drug acquisition costs. It remains to be determined how these reductions compare with other second-generation long-acting injections and first-generation depot antipsychotics.

One-year mirror-image study of the impact of olanzapine long-acting injection on healthcare resource utilization and costs in severe schizophrenia

2018 ◽  
Vol 270 ◽  
pp. 205-210 ◽  
Author(s):  
Mylène Fefeu ◽  
Pierre De Maricourt ◽  
Arnaud Cachia ◽  
Nicolas Hoertel ◽  
Marie-Noëlle Vacheron ◽  
...  
Keyword(s):  
Resource Utilization ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Mirror Image ◽  
Image Study ◽  
One Year ◽  
Long Acting ◽  
The Impact

scholarly journals Haloperidol decanoate long-acting injection (HDLAI): Results of a 1-year mirror-image study

2018 ◽  
Vol 8 (9) ◽  
pp. 241-249 ◽  
Author(s):  
Shubhra Mace ◽  
Olubanke Dzahini ◽  
Maria O’Hagan ◽  
David Taylor
Keyword(s):  
Relative Risk ◽  
Hospital Admissions ◽  
Mirror Image ◽  
Discontinuation Rate ◽  
Haloperidol Decanoate ◽  
Image Study ◽  
Duration Of Illness ◽  
Bed Days ◽  
Long Acting ◽  
High Treatment

Background: We sought to determine clinical outcomes of the prescribing of haloperidol decanoate long-acting injection (HDLAI) at 1 year. Method: A 1-year mirror-image study of 84 inpatients initiated on HDLAI. Admissions and bed days in the year preceding HDLAI were compared with the year after initiation. Predictors for discontinuation were evaluated. Results: At 1 year, 33% of patients remained on treatment. Patients starting HDLAI because of nonadherence were more likely to stop treatment [relative risk (RR) 1.72; 95% confidence interval (CI) 1.01, 2.91; p = 0.044] whilst patients with a longer duration of illness were more likely to remain on treatment (RR 0.88; 95% CI 0.78, 1.00; p = 0.050). In the bed days cohort overall, ( n = 65), there was a significant reduction in mean hospital admissions (1.4/patient/year to 0.6/patient/year; p = 0.0001) but not bed days (55.6/patient to 45.0/patient; p = 0.07) in the year following HDLAI initiation compared with the year before. Continuers had a significant reduction in mean bed days (53.1 to 4.0; p = 0.0002) and hospital admissions (1.5 to 0.2; p = 0.0001). Discontinuers demonstrated a significant reduction in hospital admissions (1.5 to 0.8; p = 0.0001) but not bed days (56.7 to 64.5; p = 0.83). Conclusion: HDLAI was associated with a high treatment discontinuation rate. Hospital admissions fell in the year after HDLAI but there was no change in bed days. Our study suggests that patients with a longer duration of illness and patients initiated on HDLAI for reasons other than poor adherence may benefit from HDLAI initiation.

Discontinuation, read missions and polytherapy with long-acting antipsychotics: An observational study

2016 ◽  
Vol 33 (S1) ◽  
pp. S540-S540
Author(s):  
I. García Cabeza ◽  
P. Pérez Marín ◽  
H. De Diego
Keyword(s):  
Observational Study ◽  
First Generation ◽  
Paliperidone Palmitate ◽  
Categorical Variables ◽  
Anticholinergic Drugs ◽  
Psychoactive Drugs ◽  
Oral Medications ◽  
Competing Interest ◽  
Long Acting

Introduction and aimLong-acting antipsychotics (LAIs) provide certain advantages over oral medications. The aim of our study is to determine whether there are differences between the various long-acting injectable antipsychotics available in our environment.MethodsA retrospective observational study with psychotic patients discharged with LAIs was designed. Data on discontinuation, relapses and associated drugs in the discharge and in a year follow-up were collected. Fifty-seven patients were included: 21 risperidone (RLAI), 20 paliperidone palmitate (PP) and 16 first-generation LAIs (FG). Odds ratio was used to compare discontinuation, χ2 test for categorical variables and Kruskal-Wallis test for independent samples.ResultsDiscontinuation was lower with PP: ORRLAI/PP = 2.74 and ORFGLAI/PP = 3.09. There were significant differences in readmissions: rehospitalizations (χ2 = 7.072, P = 0.029) and days of stay (χ2 = 8.251; P = 0.016), both lower in the PP group. We found less use of psychoactive drugs with PP, with significant differences in the discharge (χ2 = 11.518; P = 0.003) and in the follow-up (χ2 = 7.097; P = 0.029). There were also significant differences in the use of oral antipsychotics in the discharge (χ2 = 27.049, P = 0.000); anticholinergic drugs in the discharge (χ2 = 7.001, P = 0.03) and in the follow-up (χ2 = 11.699, P = 0.003) and benzodiazepines in the follow-up (χ2 = 8.493, P = 0.014), always lower in the group of patients treated with PP.ConclusionsTreatment with paliperidone palmitate may be more suitable than other long acting antipsychotics when it starts during the acute episode.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Paliperidone palmitate: Experience in a community mental health unit

2017 ◽  
Vol 41 (S1) ◽  
pp. s804-s805
Author(s):  
L. Carrión Expósito ◽  
G.M. Chauca Chauca ◽  
E.L. Guadalupe
Keyword(s):  
Mental Health ◽  
Retrospective Study ◽  
Maintenance Dose ◽  
Lower Number ◽  
Paliperidone Palmitate ◽  
Health Unit ◽  
Dose Number ◽  
Competing Interest ◽  
Long Acting ◽  
Mental Health Unit

IntroductionThere are many jobs that offer advantages of treatment with long-acting injectable in psychosis.ObjectiveTo know the changes in the different variables after the start of paliperidone palmitate (PP).Material and methodWe performed a descriptive and retrospective study. Were evaluated patients who received maintenance therapy with PP during 48 months.ResultsThe sample was composed of 29 patients: 72.4% men and 27.6% women. Average age of 46.21 years. In Figures 1, 2 and 3 show data obtained in relation to compliance with treatment, relapse, maintenance dose, number of admissions and visits to emergency departments respectively.ConclusionsThe administration of PP is associated with a higher level of compliance with treatment. The patients presented a lower number of relapses, hospitalizations and visits to the emergency room. The maintenance dose more used is 150 mg.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals TechCare: Mobile-assessment and therapy for psychosis: An intervention for clients within the early intervention service

2016 ◽  
Vol 33 (S1) ◽  
pp. S608-S608 ◽  
Author(s):  
N. Gire ◽  
I.B. Chaudhry ◽  
F. Naeem ◽  
J. Duxbury ◽  
M. Riley ◽  
...  
Keyword(s):  
Mental Health ◽  
Real Time ◽  
Learning Algorithm ◽  
Psychological Intervention ◽  
Feasibility Trial ◽  
Psychological Interventions ◽  
Intervention Service ◽  
Qualitative Work ◽  
Competing Interest ◽  
The Uk

IntroductionIn the UK, mental illness is a major source of disease burden costing in the region of £105 billion pounds. mHealth is a novel and emerging field in psychiatric and psychological care for the treatment of mental health difficulties such as psychosis.ObjectiveTo develop an intelligent real-time therapy (iRTT) mobile intervention (TechCare) which assesses participant's symptoms in real-time and responds with a personalised self-help based psychological intervention, with the aim of reducing participant's symptoms. The system will utilise intelligence at two levels:– intelligently increasing the frequency of assessment notifications if low mood/paranoia is detected;– an intelligent machine learning algorithm which provides interventions in real-time and also provides recommendations on the most popular selected interventions.AimThe aim of the current project is to develop a mobile phone intervention for people with psychosis, and to conduct a feasibility study of the TechCare App.MethodsThe study consists of both qualitative and quantitative components. The study will be run across three strands:– qualitative work;– test run and intervention refinement;– feasibility trial.ResultsPreliminary analysis of qualitative data from Strand 2 (test run and intervention refinement) in-depth interviews with service users (n = 2) and focus group with health professionals (n = 1), highlighted main themes around security of the device, multimedia and the acceptability of psychological interventions being delivered via the TechCare App.ConclusionsResearch in this area can be potentially helpful in addressing the demand on mental health services globally, particularly improving access to psychological interventions.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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