Treatment attitude and hospitalization: Comparison of oral therapy and long-acting injectable (LAI) antipsychotics in patients with schizophrenia

2017 ◽  
Vol 41 (S1) ◽  
pp. S369-S370
Author(s):  
L. Montemagno ◽  
M. Ludovico ◽  
A. Distefano ◽  
M. Marta Valentina ◽  
B. Mariacatena ◽  
...  
Keyword(s):  
Oral Drug ◽  
Global Functioning ◽  
Attitude Inventory ◽  
Oral Group ◽  
Schizophrenic Patients ◽  
Olanzapine Pamoate ◽  
Competing Interest ◽  
Oral Antipsychotic ◽  
Long Acting ◽  
Drug Attitude Inventory

BackgroundAdherence to prescribed antipsychotic drugs is a crucial factor in predicting medium- to long-term clinical outcome in schizophrenia. A helpful approach to promote adherence in schizophrenia is the use of long-acting injectable (LAI) antipsychotics.ObjectTo evaluate:– the global functioning and the hospitalization rate occurred in the year before and in the year following the switch from a low-efficacy oral antipsychotic to either a LAI once-monthly therapy (palmitate paliperidone or olanzapine pamoate) or the corresponding oral compound (paliperidone\risperidone or olanzapine) in schizophrenic patients;– the treatment attitude and the insight in patients treated with second-generation antipsychotic (SGA)-LAIs and with the corresponding oral compounds.MethodSixty adult schizophrenic outpatients: thirty were switched to LAIs and thirty to the corresponding oral antipsychotic. We used the following scales: Drug Attitude Inventory (DAI), Schedule for the Assessment of Insight (SAI), Life Skill Profile (LSP).ResultsNumber of hospitalizations per year decreased in both groups (LAIs: from 1.3 ± 0.5 to 0.3 ± 0.5; oral: from 1.3 ± 0.5 to 0.6 ± 0.5). We found a direct association between the “hospitalization event” and the oral drug compared to the corresponding LAI formulation (P = 0.049; OR: 3.05; 95% IC: 1.01–9.26). Patient receiving LAIs achieved a more significant improvement at the LSP score compared to the oral group (P < 0.001 vs. P = 0.0034) and higher DAI (5.9 ± 4.3 vs. −1.1 ± 4.3) and SAI (8.7 ± 2.9 vs. 5.6 ± 2.1).ConclusionsOur data suggest that SGA-LAIs, improving the adherence to the treatment, may sensitively reduce costs in mental health services.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Long acting antipsychotics treatment of schizophrenia: A 24-month prospective study on patient's attitude towards treatment

2017 ◽  
Vol 41 (S1) ◽  
pp. S188-S188
Author(s):  
E. Calderani ◽  
F. Pietrini ◽  
I. Burian ◽  
F. Chiarello ◽  
D. Dahlke ◽  
...  
Keyword(s):  
Rating Scale ◽  
Short Form ◽  
Concomitant Treatment ◽  
Young Mania ◽  
Attitude Inventory ◽  
Schizophrenic Patients ◽  
Competing Interest ◽  
One Year ◽  
Long Acting ◽  
The Impact

IntroductionLong-acting injectable (LAI) second-generation antipsychotics (SGAs) are considered an alternative to oral antipsychotics for schizophrenic patients with low adherence to therapy. However, it is still a matter of debate whether LAI-SGAs are able to significantly improve patient's attitudes towards treatment (ATT) [1].ObjectiveTo investigate the impact of LAI on ATT over 24 months.MethodsNineteen schizophrenic patients were switched from either oral olanzapine (11) or paliperidone (8) to the corresponding LAI. Patients were assessed at baseline (T0), after 6 (T1), 12 (T2) and 24 months (T3). Drug Attitude Inventory-10 (DAI-10) [2] was used to assess ATT. Young Mania Rating Scale (YMRS), Montgomery-Asberg Depression Rating Scale (MADRS), Positive and Negative Syndrome Scale (PANSS), and Short Form Health Survey (SF-36) were used for psychopathology evaluations.ResultsEleven patients reached T3. Eight patients were excluded (4 olanzapine, 4 paliperidone): 4 required a significant change in concomitant treatment, 4 a change of antipsychotic (metabolic comorbidity). No changes in psychopathology occurred between T2 and T3, some scales improved from baseline to T2. DAI-10 mean scores were improved after 12 months, thus not significantly, and were further improved at 24 months (P = .008 vs baseline).ConclusionsATT keeps improving after one year of LAI treatment, unrelated to clinical response.Disclosure of interestThe authors have not supplied their declaration of competing interest.

LAI versus oral antipsychotic treatment of schizophrenia: A 12-month prospective study on patient's attitude towards treatment and quality of life

2016 ◽  
Vol 33 (S1) ◽  
pp. S583-S584
Author(s):  
F. Pietrini ◽  
A. Ballerini ◽  
I. Burian ◽  
B. Campone ◽  
F. Chiarello ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Antipsychotic Treatment ◽  
Additional Advantage ◽  
First Semester ◽  
Schizophrenic Patients ◽  
Competing Interest ◽  
Oral Antipsychotic ◽  
Long Acting ◽  
The Impact

IntroductionIt is still a matter of debate whether LAI antipsychotics are able to significantly improve patient's attitude towards treatment.ObjectiveThe aim of this 12-month observational study was to investigate the impact of switching antipsychotic treatment from oral to LAI formulation on patient's attitude towards treatment and quality of life.MethodsA total of 41 schizophrenic patients (25 males, mean age 42.10 ± 11.88 years) were recruited. Patients were expected not to need significant changes in concomitant treatments. All patients were under a stabilized therapy with a single oral antipsychotic (either olanzapine or paliperidone) and were switched to the equivalent maintenance regimen with the long-acting formulation of the same antipsychotic (olanzapine pamoate or paliperidone palmitate). Patients were assessed before the switch (T0), and after 6 (T1) and 12 months (T2) of LAI antipsychotic treatment by means of the YMRS, MADRS, PANSS, DAI-10 and SF-36.ResultsOur data evidenced an overall significant improvement of psychopathology, adherence and quality of life over the 12-month period (T0 vs. T2). In particular, while all of the measures significantly improved in the first semester (T0 vs. T1), only YMRS, positive PANSS and DAI-10 improved both in the first and in the second semester (T1 vs. T2), indicating an additional advantage of a prolonged LAI treatment on these clinical dimensions.ConclusionsThe switch from oral to long-acting antipsychotic treatment may provide considerable advantages in improving patient's attitude towards (and therefore adherence to) treatment. Part of this improvement could be related with a better efficacy on psychopathology and quality of life.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Psychopathology and global functioning in schizophrenic patients on depot antypsychotics and long-acting injectable risperidone: A six month comparative study

2007 ◽  
Vol 22 ◽  
pp. S116
Author(s):  
A. Intxausti ◽  
A.L. Morera ◽  
C.C. González-Hernández ◽  
D. Alonso-Diaz ◽  
N. González-Brito ◽  
...  
Keyword(s):  
Comparative Study ◽  
Global Functioning ◽  
Schizophrenic Patients ◽  
Long Acting

Tolerability and safety of long-acting injectable aripiprazole

2016 ◽  
Vol 33 (S1) ◽  
pp. s260-s261
Author(s):  
A. Porras Segovia ◽  
P. Calvo Rivera ◽  
B. Girela Serrano ◽  
L. Gutierrez Rojas
Keyword(s):  
Patient Satisfaction ◽  
Side Effects ◽  
Current Treatment ◽  
Average Score ◽  
Satisfaction Scale ◽  
New Drug ◽  
Attitude Inventory ◽  
Competing Interest ◽  
New Treatment ◽  
Long Acting

IntroductionLong-acting injectable aripiprazole is the most recently introduced depot treatment in schizophrenia.ObjectivesThe objective of this study is to determine the tolerability and safety of this new treatment.AimsThe aim is to provide useful information regarding the use of this new drug.MethodsOur sample consists on 20 patients treated with a monthly dose of long-acting ariprazole. They were previously stabilized on oral aripiprazole before the first injection. The data on tolerability and safety were obtained by face-to-face interviews, using the Hogan Drug Attitude Inventory, the Patient Satisfaction with Medication Questionnaire and the UKU Side Effects Scale.ResultsOur sample consists of 20 patients, with a 50/50 gender distribution and a mean age of 39 years. The average score in the satisfaction scale Hogan was positive (an average of 7.25). In the Patient Satisfaction With Medication Questionnaire, 85% said they were satisfied with the new treatment, compared with 15% who showed some degree of dissatisfaction with the change. Overall, 90% of patients showed a preference for the current treatment compared to the previous. The patients showed good tolerance to medication, with a low score in the UKU scale (total score = 13.5). Side effects did not interfere with daily activity of the patient.ConclusionsLong acting injectable aripiprazole proved to be a safe treatment, with a good degree of acceptance among patients. These advantages makes of this new drug a useful addition to our kit tool.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Restraint or not restraint. Involuntary transport from home of schizophrenic patients

2017 ◽  
Vol 41 (S1) ◽  
pp. s836-s836
Author(s):  
B. Samso ◽  
S. Ramos ◽  
A. Malagón ◽  
A. Gonzalez ◽  
M. Bellsolà ◽  
...  
Keyword(s):  
Risk Factors ◽  
Substance Use ◽  
Demographic Data ◽  
Physical Restraint ◽  
Group Versus ◽  
Psychiatric Facility ◽  
Global Functioning ◽  
Related Factors ◽  
Schizophrenic Patients ◽  
Competing Interest

IntroductionAlthough physical restraint (PR) is a non-rarely practice on psychiatry there are few studies that focus the attention on the risk factors for this intervention. PR is a legitimacy practice when is needed and well applied but is not free from side effects. Knowing risk factors might be useful to improve the application of PR.ObjectivesStudy the risk factors involved with the use of PR at patient's home in individuals with schizophrenia before the involuntary transport (IT) to a psychiatric facility.MethodsIs a descriptive and observational study of 267 psychotic patients that were assisted by a psychiatric home care unit (EMSE) in Barcelona during their IT. The sample was divided in two groups, depending on the need of PR. Socio-demographic data were collected as well as positive and negative syndrome scale (PANSS), WHO disability assessment schedule (WHO/DAS), global assessment of functioning scale (GAF), Scale to assess unawareness of mental disorder (SUMD). Aggressiveness was assessed by PANSS-EC consisting of 5 items: excitement, tension, hostility, uncooperativeness and poor impulse.ResultsFrom the 267 psychotic patients 109 required PR. 154 were male and the average of age was 47. The results were significant in the PR group versus no PR for PANSS-EC (P = 0.000), as well as WHO/DAS (P = 0.017), GAF (P = 0.042), Positive PANSS (P = 0.000), age (P = 0.001) and substance use (P = 0.012). Were no significant for gender, insight or Negative PANSS.ConclusionsAggressiveness and violence were the most important PR related factors followed by positive symptoms, age, substance use and global functioning.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Time to relapse monotherapy and acquisition in a sample of schizophrenic patients over 3 years of follow-up

2016 ◽  
Vol 33 (S1) ◽  
pp. s261-s261
Author(s):  
P. González Rivera ◽  
A.J. Benito Ruiz ◽  
J. Prados Gomez ◽  
A. Hidalgo Borreguero ◽  
M. Soto Laguna ◽  
...  
Keyword(s):  
Concomitant Medication ◽  
Hospital Admissions ◽  
Clinical Sample ◽  
Psychiatric Patients ◽  
Clinical Relapse ◽  
Adherence To Treatment ◽  
Schizophrenic Patients ◽  
Competing Interest ◽  
Long Acting ◽  
Time To Relapse

IntroductionPoor adherence to treatment is one of the main problems in health care to psychiatric patients. The second-generation antipsychotics, and the subsequent emergence of the depot forms (long acting formulations) have facilitated this aspect, increasing the time to clinical relapse in patients with schizophrenia.GoalsDetermine the time to relapse in a clinical sample of patients diagnosed with schizophrenia treated with paliperidone palmitate over 3 years. Other objectives include the possible reduction in hospital admissions, as well as the possible reduction of psychiatric emergency visits, concomitant medication (benzodiazepines and Biperiden) and the possible increase in drug monotherapy.MethodologyThis is a study with a sample of 101 patients with schizophrenia who had started treatment with PP (consecutive sampling). Quantified variables in the 12 months prior to the change of PP treatment with variables at 6, 12, 24 and 36 months after initiation of treatment with PP were compared.Results and conclusionsAt the end of the tracking, 72.22% (73 patients) remained clinically stable, with adequate adherence to treatment and there have been no clinical relapses. It has obtained a statistically significant reduction in the use of concomitant medication, emergency room visits and the average duration of revenues, with no clinical relapse should occur in patients of the sample in the second and third year.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Remission and functioning after two years undergoing Long-Acting Injectable Risperidone (LAIR) in recent-onset schizophrenia

2011 ◽  
Vol 26 (S2) ◽  
pp. 1344-1344
Author(s):  
A. Batalla ◽  
A. Pons ◽  
A. Ortiz ◽  
I. Grande ◽  
J. Undurraga ◽  
...  
Keyword(s):  
Social Performance ◽  
Adherence Rate ◽  
Global Functioning ◽  
Recent Onset ◽  
Schizophrenic Patients ◽  
Remission Criteria ◽  
Improved Performance ◽  
Long Acting

IntroductionImproving adherence in the early stages of illness by means of long-acting antipsychotics can lead to reduced number of readmissions and enhanced remission rates, which could lead to improved performance in the medium-long term.ObjectivesAssessing clinical remission, number of admissions and personal and social performance in recent-onset schizophrenic patients undergoing LAIR.MethodsLongitudinal retrospective study of a cohort of thirty-one recent-onset schizophrenic patients ( ≤ 2 years) who started LAIR treatment between 2004–2008. Twenty-six (83.9%) were treated for two years. PANSS scale was assessed at baseline; PANSS, Personal and Social Performance scale (PSP) and remission criteria after two years.ResultsTwenty-six patients (83.9%), 61.5% male aged between 16–44 years old, completed two years of treatment. All patients met criteria for schizophrenia (DSM-IV) with an average duration of 0.8 year since diagnosis. The main reason to using LAIR was poor adherence (76.9%). The PANSS total and all its subscale scores improved significantly (p < 0.005) with 80.8% of patients showing a ≥ 50% improvement on the PANSS total. Seventeen patients (65.4%) achieved remission criteria. Five patients (19.2%) were admitted during the follow-up. The average on global functioning (PSP) was 72.4 (IC 95%, 66.4-78.4). LAIR doses at baseline were 25 mg (46.2%), 37.5 mg (30.8%) or 50 mg (23.1%); after two years, 25 mg (34.6%), 37.5 mg (34.6%), 50 mg (23.1%) or 75 mg (7.7%).ConclusionsDespite the limitation of retrospective observational studies, our data, including the good adherence rate (83.9%), suggest that LAIR could be effective in the treatment of recent-onset schizophrenia.

Long-acting injectable antipsychotics and global functioning in north western italian public health service

2017 ◽  
Vol 41 (S1) ◽  
pp. S605-S606
Author(s):  
M. Probo ◽  
V. Dalo’ ◽  
F. Facchini ◽  
M. Rudoni ◽  
V. Preziosi ◽  
...  
Keyword(s):  
Public Health ◽  
Health Service ◽  
Public Health Service ◽  
Anticholinergic Drug ◽  
Severity Of Illness ◽  
Global Functioning ◽  
Treatment Length ◽  
First Choice ◽  
Schizophrenic Patients ◽  
Long Acting

IntroductionLong-acting injectable antipsychotics (LAI-APs) should be the first choice therapy in the treatment of schizophrenia, however their use in outpatient's psychiatric services remains limited.ObjectiveObservational study in schizophrenic patients of the northwestern public health service.AimTo assess demographic and psychopathological features in patients treated with LAI haloperidol (H-LAI) and second-generation LAI antipsychotics (SG-LAI).MethodsWe recruited 105 schizophrenic patients upon LAI-APs treatment, and we assessed socio-demographic data, medical comorbidity, substances use, time from admission, treatment length, and per os augmentation therapies. All participants were assessed for global functioning and severity of illness by CGI-SCH and PSP, respectively.ResultsOf all patients, 52% were treated by H-LAI, 48% by SG-LAI. No statistical differences (P > 0.05) were found between the 2 groups for age, gender, other demographic variables, substances use, somatic comorbidities. Both groups were homogeneous for severity of illness (CGI-SCH score = 4.20 in H-LAI vs. 4.38 in SG-LAI) and global functioning (PSP score = 49.1 in H-LAI vs. 54.4 in SG-LAI). Compared with the H-LAI group, SG-LAI-treated patients were characterized by shorter time from admission (>10 yrs) and treatment length (>1 yr), and less frequent anticholinergic drug co-prescription. We counted only 6 LAI-APs treatments started in the last year.ConclusionsDespite of the literature support, LAI-APs treatment for schizophrenia is still limited in our service. Our data suggest that SG-LAI-APs are used as first choice of LAI-APs treatment, although maintained for short time, while H-LAI are reserved to long-standing patients and are burdened by side effects needing anticholinergic treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Therapeutic attitudes and clinical global impression: A 2-year follow-up study of 33 outpatients with a mental disorder in treatment with paliperidone palmitate

2016 ◽  
Vol 33 (S1) ◽  
pp. S616-S617
Author(s):  
M.D. Perez Lopez ◽  
M. Soto laguna ◽  
J. Prados Gomez ◽  
I. Zarranz Herrera Oria ◽  
R. Perez Asenjo ◽  
...  
Keyword(s):  
Mental Disorder ◽  
Clinical Global Impression ◽  
Paranoid Schizophrenia ◽  
Paliperidone Palmitate ◽  
Antipsychotic Therapy ◽  
Attitude Inventory ◽  
Axis I ◽  
Long Acting ◽  
Drug Attitude Inventory ◽  
Drug Attitude

IntroductionMaintaining antipsychotic therapy in mental disorder is important in preventing relapse, rehospitalization, and suicide. Lack of awareness of illness may be a leading cause for non-adherence. Long-acting depot can prevent non- adherence and thus potentially contribute to better patient outcomes.ObjectiveThe aim of this prospective, observational, non interventional 2-year-long study is to assess severity and post-intervention changes and attitudes toward medication of a group of patients treated paliperidone palmitate (PP).MethodsThirty-three outpatients stabilised with PP during the last 24 months. Inclusion criteria were: patients’ age (> 18 years), a diagnosis of schizophrenia, bipolar disorder, schizoaffective disorder stabilised during the last 12 months with PP, without a diagnostics from axis I or II (except for nicotine of caffeine) and able to sign the inform consent. Data collected: general sociodemographic and clinical data (age, sex, level of education, socioeconomic situation, family support, psychiatric diagnosis, years of evolution, use/abuse of substances, treatment, previous and later number of hospitalisations. Evaluations included disease severity (Clinical Global Impression-Severity (CGI-S) and Drug Attitude Inventory, (DAI)).ResultsThirty-threeoutpatients were followed during 24 months [mean dose 132,58 (44,4) mg], 75,8% were men, age 45,05 years old, 87,8% with a diagnoses of paranoid schizophrenia. Antipsychotic monotherapy increased over the time with PP. Significant improvements were observed on both Clinical Global Impression and Drug Attitude Inventory. The number of rehospitalizations and mean stays decreased from the beginning until the end of these 24 months.ConclusionsOur results suggest an improvement in the patient's clinical vision and attitude towards medication with long-acting depot.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Subjective response to neuroleptics and outcome in schizophrenia: a re-examination comparing two measures

1992 ◽  
Vol 22 (2) ◽  
pp. 347-352 ◽  
Author(s):  
T. P. Hogan ◽  
A. G. Awad
Keyword(s):  
Subjective Response ◽  
Strongly Correlated ◽  
Neuroleptic Treatment ◽  
Attitude Inventory ◽  
End Of Treatment ◽  
Schizophrenic Patients ◽  
High Concordance ◽  
Two Measures ◽  
Drug Attitude Inventory ◽  
Early Drug

SYNOPSISThe schizophrenic patient's early psychological response to neuroleptic treatment has been demonstrated to be a significant predictor of treatment response. The validity of the construct of subjective response is evaluated by comparison of two measures. Fifty-five recently admitted and unmedicated schizophrenic patients were randomly allocated to chlorpromazine or haloperidol. Subjective responses at 24 and 48 hours as assessed by two different scales, the Van Putten & May scale and the self-administered Drug Attitude Inventory, were strongly correlated with outcome at three weeks. Early emergence of extrapyramidal symptoms was not related to subjective response, but dysphoric patients had a greater incidence of EPS by the end of treatment than did non-dysphoric patients. The two measures showed high concordance in identification of early drug dysphoria.

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