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      Readmission Rates of Patients with Schizophrenia Treated with Depot Antipsychotics versus Oral Antipsychotics in a Community Hospital

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      Author(s): 1 , , 2 , 2 , 2
      Editor(s): ,
      Publication date (Electronic, pub):
      Publication date (Electronic, collection):
      Journal: Cureus
      Publisher: Cureus
      Keywords: schizophrenia, readmission rates, depot antipsychotics

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          Abstract

          This is a pilot study comparing the 30 and 60 day relapse rates for schizophrenic patients treated with long-acting injectable antipsychotics versus traditional oral antipsychotics in a community hospital setting. This is a retrospective cohort study and medical records were reviewed to gather data involving readmission rates. We analyzed the data using relative risk (RR) for the 30 days and 60 days after patient discharge from the behavioral health unit of a community hospital.

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          A nationwide cohort study of oral and depot antipsychotics after first hospitalization for schizophrenia.

          Jari Tiihonen, Jari Haukka, Mark Z. Taylor … (2011)
          Data on the effectiveness of antipsychotics in the early phase of schizophrenia are limited. The authors examined the risk of rehospitalization and drug discontinuation in a nationwide cohort of 2,588 consecutive patients hospitalized for the first time with a diagnosis of schizophrenia between 2000 and 2007 in Finland. The authors linked national databases of hospitalization, mortality, and antipsychotic prescriptions and computed hazard ratios, adjusting for the effects of sociodemographic and clinical variables, the temporal sequence of the antipsychotics used, and the choice of the initial antipsychotic for each patient. Of 2,588 patients, 1,507 (58.2%) collected a prescription for an antipsychotic during the first 30 days after hospital discharge, and 1,182 (45.7%, 95% confidence interval [CI]=43.7-47.6) continued their initial treatment for 30 days or longer. In a pairwise comparison between depot injections and their equivalent oral formulations, the risk of rehospitalization for patients receiving depot medications was about one-third of that for patients receiving oral medications (adjusted hazard ratio=0.36, 95% CI=0.17-0.75). Compared with oral risperidone, clozapine (adjusted hazard ratio=0.48, 95% CI=0.31-0.76) and olanzapine (adjusted hazard ratio=0.54, 95% CI=0.40-0.73) were each associated with a significantly lower rehospitalization risk. Use of any antipsychotic compared with no antipsychotic was associated with lower mortality (adjusted hazard ratio=0.45, 95% CI=0.31-0.67). In Finland, only a minority of patients adhere to their initial antipsychotic during the first 60 days after discharge from their first hospitalization for schizophrenia. Use of depot antipsychotics was associated with a significantly lower risk of rehospitalization than use of oral formulations of the same compounds. Among oral antipsychotics, clozapine and olanzapine were associated with more favorable outcomes. Use of any antipsychotic was associated with lower mortality.
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            Long-acting injectable vs oral antipsychotics for relapse prevention in schizophrenia: a meta-analysis of randomized trials.

            Taishiro Kishimoto, Alfred Robenzadeh, Claudia Leucht … (2014)
            While long-acting injectable antipsychotics (LAIs) are hoped to reduce high relapse rates in schizophrenia, recent randomized controlled trials (RCTs) challenged the benefits of LAIs over oral antipsychotics (OAPs).
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              Hospital readmission as an accountability measure.

              R. Axon, Mark Williams (2011)
              Article 0 comments Cited 71 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cureus
                Journal ID (iso-abbrev): Cureus
                Journal ID (issn): 2168-8184
                Title: Cureus
                Publisher: Cureus (Palo Alto (CA) )
                ISSN (Electronic): 2168-8184
                Publication date (Electronic, pub): 24 December 2018
                Publication date (Electronic, collection): December 2018
                Volume: 10
                Issue: 12
                Electronic Location Identifier: e3775
                Affiliations
                [1 ] Psychiatry, Frederick Memorial Hospital, Frederick, USA
                [2 ] Osteopathy, West Virginia School of Osteopathic Medicine, Lewisburg, USA
                Author notes
                Eduardo D. Espiridion edjen19meg@ 123456gmail.com
                Article
                DOI: 10.7759/cureus.3775
                PMC ID: 6389030
                SO-VID: cc917d2a-b7d7-41f4-bb34-27777f7c54a9
                Copyright © Copyright © 2018, Espiridion et al.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 28 November 2018
                Date accepted : 24 December 2018
                Categories
                Subject: Psychiatry

                Keywords: schizophrenia,readmission rates,depot antipsychotics
                Data availability:
                Keywords: schizophrenia, readmission rates, depot antipsychotics

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