PMH7 Impact of Long-Acting Injectable Versus Oral Antipsychotics on Rehospitalization Rates and Emergency Room Visits among Relapsed Schizophrenia Patients

Abstract

adjusting for baseline factors (age, sex, race, region, metropolitan statistical area, family income, and health insurance coverage) using regression model statistics (adjusted R2). RESULTS: The overall prevalence of pediatric ADHD was 2.47% (n ϭ 5.82 million). Most of the children were boys (68%), White (84%) and had private health insurance (62%). Overall mean annual expenditure was $ 4145.87. Adjusted R2 for the baseline model was 0.1130. When different comorbidity measures were added to the baseline model the adjusted R2 increased to: 0.1230 (CIS), 0.1566 (D'Hoore version of CCI), 0.1534 (MECI), and 0.1372 (CDS-1). Among different combinations, a model consisting of patient baseline characteristics, MECI, and CIS explained the most variation in healthcare expenditure (adjusted R2 ϭ 0.1618). CONCLUSIONS: Models that include comorbidity and functional status measures performs best in risk adjusting health care expenditure in pediatric ADHD. There is a greater need to evaluate the use of CIS as a potential risk adjustment tool in mental and behavioral problems. OBJECTIVES:To assess the association of second-generation antipsychotics prescriptions (SGAs) with changes in body mass index (BMI) among adolescents compared to a randomly selected age and gender matched untreated comparison group. METHODS: A retrospective cohort study was conducted using an ambulatory electronic medical record database between January 2004 and July 2009. Antipsychotic naïve (no evidence of SGAs during 540 days pre index period) monotherapy adolescents 12-19 years with at least one prescription for any SGA during 395 days follow-up period were eligible. The comparison group without antipsychotic prescription was matched (3:1) to the antipsychotic group based on age, gender, and month of SGA. A maximum follow-up BMI 90 days post index date was evaluated and percentage change from baseline BMI was calculated. Multivariate linear regression was conducted to assess the percent change in follow-up BMI from baseline among antipsychotic users compared to the comparison group controlling for covariates. RESULTS: The mean age (15.35 years, SD 2.27) and gender (males, 53%) distribution among the antipsychotic group (nϭ793) was similar (pϾ0.05) to the comparison group (nϭ2,373). The mean percentage increase in follow-up BMI from baseline for antipsychotic group was significantly higher than the comparison group (pϽ0.01) except for ziprasidone (pϾ0.05). After adjusting for covariates, adolescents on olanzapine had the highest percentage increase in follow-up BMI from baseline (5.84%, 95% Confidence Interval [CI], 4.07-7.61) followed by aripiprazole (4.36%; 95% CI, 3.08 -5.64), risperidone (3.65%; 95% CI, 2.61-4.68), and quetiapine (1.53%; 95% CI, 0.53-2.52) compared to the comparison group. Normal weight adolescents on antipsychotics had higher percentage increase in follow-up BMI from baseline compared to overweight or obese. CONCLUSIONS: Treatment with SGAs is associated with significant increase in BMI among adolescents relative to a matched comp...

Monitoring of the decision making competence and adherence of patients with schizophrenia and schizoaffective disorder on lai treatment

“…In the same vein, the electronic records of patients medicated with LAI SGAs were compared with oral APs over a 30-month period revealed that LAI SGAs were associated with significantly lower mean number of hospitalizations, emergency room visits and fewer hospitalization days compared with oral APs. 297 Mirror-image studies evaluate the effect before versus after initiation of LAI treatment, with patients serving as their own controls. Mirror image studies published in the early 1970s provided the first clinical evidence favoring LAIs versus oral APs in terms of frequency and duration of hospitalizations.…”