M209. To Whom We Prescribe Long Acting Antpsychotics at Discharge From Hospital?

Abstract

Background Although the growing evidence show the advantages of long acting injectable (LAI)antipsychotics on treatment of psychotic disorders, characteristics of the patients with psychotic disorders using LAI is not studied enough. The aim of this retrospective study is to understand the clinical characteristics of the patients with psychotic disorders to whom any LAI was prescribed at discharge from hospital Methods We screened the files of 400 inpatients with psychosis spectrum disorders who were treated in inpatient units of Istanbul Faculty of Medicine, Department of Psychiatry between 01.01.2014-01.016.2019. We recorded the last admission if the patient had more than one hospitalization. We compared the variables including illness duration, diagnosis, presence of involuntary hospitalization, insight, substance/alcohol abuse, forensic problems between those who were prescribed LAI and others. We also applied logistic regression analysis to detect the independent predictors of LAI prescription. Results Thirty-nine percent of the patients were given LAI at discharge. Patients with schizophrenia and schizoaffective disorders were more common compared to psychotic disorder NOS/schizophreniform disorder in LAI group (p<0.001). Those who prescribed LAI were older and had longer duration of psychotic disorder. Poor insight at admission, past and present noncompliance, involuntary admission (64,5% vs 35,5%, p=0.003) and history of forensi problems (63% vs 37%, p=0.01)were more common in LAI group. Past ECT treatment, antipsychotic polypharmacy and LAI treatment in past were more common in LAI group. Lack of insight at admission, history of LAI treatment before and noncompliance to medications before hospitalization were appeared as predictors of LAI prescription at discharge in logistic regression. We found no relationship between LAI prescription and drug abuse, treatment resistance and psychiatric comorbidity. Discussion Our findings suggest that LAIs were prescribed to chronic and older inpatients with lack of insight, and compliance at admission. The patients who were prescribed LAI also had indirect indicators of poor outcome, like previous ECT and polypharmacy. Contrary to previous reports, we found no difference in alcohol/substance abuse between those who were prescribed LAI and others.