Comparison of hospitalization risk before and after changing from risperidone long-acting injection to another long-acting injection or oral antipsychotic in patients with schizophrenia: Mirror-image study

2016 ◽  
Vol 70 (8) ◽  
pp. 365-366 ◽  
Author(s):  
Hidenobu Suzuki ◽  
Hiroyuki Hibino ◽  
Yuichi Inoue ◽  
Atsuhiko Takaya
Keyword(s):  
Mirror Image ◽  
Image Study ◽  
Before And After ◽  
Oral Antipsychotic ◽  
Long Acting

scholarly journals Partial compliance with long-acting paliperidone palmitate and impact on hospitalization: a 6-year mirror-image study

2020 ◽  
Vol 10 ◽  
pp. 204512532092478 ◽  
Author(s):  
Sofia Pappa ◽  
Katy Mason
Keyword(s):  
Hospital Admissions ◽  
Mirror Image ◽  
Poor Compliance ◽  
Paliperidone Palmitate ◽  
Image Study ◽  
Partial Compliance ◽  
Before And After ◽  
The Mean ◽  
Oral Antipsychotic ◽  
Long Acting

Background: Previous studies showed a linear correlation between partial compliance with an oral antipsychotic medication and hospitalisation risk among patients with schizophrenia. Long-acting injections (LAIs) may significantly improve adherence and reduce relapse in patients with psychosis. The aim of this study was to evaluate the relationship between the level of compliance with 1-monthly paliperidone palmitate (PP1M) and hospitalisation rates. Methods: This was a naturalistic, mirror-image study examining retention, compliance and hospitalisation rates 3 years pre- and 3 years post-PP1M initiation. Compliance was divided in three groups: full (no missed dose/year), good (6–11injections/year), poor (<6 injections/year). Results: A total of 173 patients suffering from a severe mental illness (70% with a diagnosis of schizophrenia and 30% with other diagnoses) were included; 77% of patients continued PP1M for 1 year, 66% for 2 years and 55% for 3 years. Of the 95 patients who remained on PP1 throughout the 3 years of follow up, 81% showed full, 13% good, and only 6% poor compliance. In the patients who were fully compliant, the mean number of hospital admissions decreased from 1.34 to 0.43, and the mean number of bed days from 82 to 19 days per patient 3 years before and 3 years after PP1M initiation ( p < 0.001). It is noteworthy that the reductions in hospital stay were statistically significant for the group of patients with full compliance but not for the other two groups. In fact, patients with poor compliance demonstrated higher hospitalisation rates both before and after PPM1 initiation. These findings were similar in the subgroup of patients with schizophrenia who continued treatment for 3 years ( n = 68). Conclusion: There was a direct association between partial compliance and re-hospitalisation; fully compliant patients maintained the best outcomes in terms of reduced bed use following PPM1 initiation.

scholarly journals T201. EFFECTS OF PALIPERIDONE PALMITATE ON HEALTHCARE UTILIZATION AND COSTS FOR PATIENTS WITH SCHIZOPHRENIA: A CLAIM-BASED MIRROR-IMAGE STUDY IN SOUTH KOREA

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S308-S308
Author(s):  
Myung Hun Jung ◽  
Duk-In Jon ◽  
Jung-Seo Yi ◽  
Boung Chul Lee
Keyword(s):  
Healthcare Utilization ◽  
Mirror Image ◽  
Paliperidone Palmitate ◽  
Outpatient Services ◽  
Image Study ◽  
Asian Populations ◽  
Before And After ◽  
Icd 10 ◽  
Prescription Costs ◽  
Long Acting

Abstract Background Long-acting injectable (LAI) antipsychotics, such as paliperidone palmitate (PP), are known to improve treatment adherence in patients with schizophrenia, which can lead to reductions in relapse and hospitalization rates. However, relatively few studies have demonstrated the economic impact of LAIs, especially in Asian populations. Methods We conducted a claim-based mirror-image study to explore changes in healthcare utilization and associated costs, among 1,272 South Korean patients with schizophrenia (ICD-10-CM code F20), between the 1-year periods before and after the initiation of PP treatment. Results The results showed that patients accessed outpatient services more frequently after versus before starting PP treatment, with the number of prescription days increasing by 133.45 (p &lt; .0001) and the associated costs increasing by USD 1,497.15 (p &lt; .0001). In contrast, the number of admission days was reduced by 11.33 after starting PP treatment (p &lt; .0001) and the associated costs were reduced by USD 1,220.75 (p &lt; .0001). Discussion Although the high acquisition cost of PP has been regarded as an obstacle to its clinical use, our results imply that the high prescription costs for PP may be counterbalanced by the reduced admission costs associated with its use. Economic outcomes for patients treated with LAIs should be investigated further to help healthcare decision-makers and providers to determine the value of LAIs relative to other treatment medications.

scholarly journals Hospitalisation Utilisation and Costs in Schizophrenia Patients in Finland before and after Initiation of Risperidone Long-Acting Injection

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Christian Asseburg ◽  
Michael Willis ◽  
Mickael Löthgren ◽  
Niko Seppälä ◽  
Mika Hakala ◽  
...  
Keyword(s):  
Resource Use ◽  
Mirror Image ◽  
Base Case ◽  
Economic Modelling ◽  
Image Study ◽  
Start Date ◽  
Before And After ◽  
Bed Days ◽  
Long Acting ◽  
The Impact

Objectives. Quantify changes in hospital resource use in Finland following initiation of risperidone long-acting injection (RLAI).Materials and Methods. A retrospective multi-center chart review (naturalistic setting) was used to compare annual hospital bed-days and hospital episodes for 177 schizophrenia patients (mean age 47.1 years, 52% female, 72% hospitalized) before and after initiation of RLAI (between January 2004 and June 2005) using the within-patient “mirror-image” study design. The base case analytical approach allocated hospital episodes overlapping the start date entirely to the preinitiation period. In order to investigate the impact of inpatient care ongoing at baseline, the change in bed-days was also estimated using an alternative analytical approached related to economic modelling.Results. In the conventional analysis, the mean annual hospitalisation costs declined by €11,900 and the number of bed-days was reduced by 40%, corresponding to 0.19 fewer hospital episodes per year. The reductions in bed-days per patient-year were similar for patients switched to RLAI as inpatients and as outpatients. In the modelling-based analysis, an 8% reduction in bed-days per year was observed.Conclusion. Despite uncertainty in the choice of analytic approach for allocating inpatient episodes that overlapping this initiation, consistent reductions in resource use are associated with the initiation of RLAI in Finland.

Switching to paliperidone palmitate in an outpatient sample: Preliminary results of a 43-month follow-up

2017 ◽  
Vol 41 (S1) ◽  
pp. S368-S369
Author(s):  
R. Martín Gutierrez ◽  
R. Medina Blanco ◽  
D. Sierra Biddle ◽  
M.J. Cuesta Nuñez ◽  
P. Suárez Pinilla
Keyword(s):  
Psychotic Disorders ◽  
Mirror Image ◽  
Paliperidone Palmitate ◽  
Health Clinic ◽  
Image Study ◽  
Emergency Visits ◽  
Outpatient Mental Health ◽  
Before And After ◽  
Long Acting ◽  
Bipolar Patients

IntroductionPatients with psychosis are treated in outpatient community clinics during most of their lifetime. Antipsychotic treatments are commonly used in regular clinical practice. However, the non-adherence is one of the main causes of relapses. Long-acting injectables (LAIs) could be a safe option to guarantee the efficacy.Aim and objectivesOur purpose is to evaluate the efficacy of the switch to paliperidone palmitate from other oral or LAI antipsychotics, in terms of hospital and emergency admissions.MethodsWe performed a mirror-image study in an outpatient mental health clinic, comparing patients before and after paliperidone palmitate change over 43 months. Fifty-seven patients were included, most of them (n = 47) were diagnosed with psychotic disorders (82.5%) while 4 were bipolar patients (7%), and the remained patients (n = 6; 10.6%) were classified as behavioral disorders. The following variables were studied before and after the switching: number of admissions, days of stay and emergency visits.ResultsFrom those 57 patients, 44 were previously treated with other LAIs, whereas 13 were taking oral antipsychotics. The median age at switch was 49 years (SD = 12.31). The reasons for switching were: inefficacy (26.3%), non-adherence (19.3%), side effects (38.6%), and non-specified (15.8%). We found significant differences between the three main variables: number of admissions (t = 4.59; P ≤ 0.001), days of stay (t = 2.27; P = 0.027) and emergency visits (t = 3.74; P ≤ 0.001).ConclusionsPaliperidone palmitate seems to be an effective treatment in order to guarantee the adherence. Our preliminary data show that paliperidone palmitate might reduce the sanitary cost in outpatients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Short-acting antipsychotics or long-acting injectables? A treatment comparison in patients with schizophrenia

2020 ◽  
Vol 25 (03) ◽  
pp. 170-178 ◽  
Author(s):  
Helena Thiem ◽  
Here Folkerts ◽  
Lukas Völkel
Keyword(s):  
Length Of Stay ◽  
Average Length ◽  
Psychiatric Institute ◽  
Real World Data ◽  
Short Acting ◽  
Treatment Comparison ◽  
Average Length Of Stay ◽  
Before And After ◽  
Oral Antipsychotic ◽  
Long Acting

Abstract Aim This research aims to compare the efficacy and direct costs of short-acting oral antipsychotics and aripiprazole once-monthly (AOM) in the context of the treatment of patients with schizophrenia based on real-world data in Germany. Method Results are based on a single-armed, retrospective, non-interventional pre-post comparison study evaluating data from 132 patients with schizophrenia before and after switching from oral antipsychotics to AOM treatment (6 months each). Socio-demographics, as well as parameters of indication, efficacy and resource consumption were analyzed and statistically evaluated. Results The switch from an oral antipsychotic medication to AOM led to a distinct improvement in all clinically relevant parameters, including a reduction in hospitalization rates (55.1 % vs. 14.0 %), length of stay (43.5 d vs. 34.8 d) and percentage of patients with multiple hospitalizations (13.6 % vs. 3.8 %). There was also a reduction in schizophrenic episodes for patients with ≥ 1 episode (2.9 vs. 1.4) and of the percentage of patients with ≥ 1 (88.0 % vs. 29.3 %) as well as ≥ 2 (60.0 % vs. 8.1 %) schizophrenic episodes. The proportion of patients requiring a visit to day clinics or psychiatric institute outpatient clinics (PIA) decreased (39.5 % vs. 8.4 %) for patients with AOM treatment, as did the average length of stay in day clinics or PIAs (116.8 d vs. 86.4 d) for patients with ≥ 1 stay. The cost saving potential of AOM compared to the treatment with oral antipsychotics ranged between 1,729.32 € and 5,048.53 € per patient for a six-month observation period. Conclusion Our results suggest that AOM treatment of patients with schizophrenia is more effective (reduction in schizophrenic episodes, hospitalizations, stays in day clinics, psychiatrist visits, losses in productivity) and generates lower costs for the statutory health insurance (SHI) in Germany than treatment with oral antipsychotics and should therefore not be regarded as only a last-resort treatment option for schizophrenia.

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.

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