Real-world effectiveness of long-acting injectable antipsychotics to reduce 90-day and annual readmission in psychotic disorders: insights from a state psychiatric hospital

Abstract

Background To evaluate the effectiveness of long-acting injectable antipsychotics (LAI-a) in reducing the 90-day and annual readmission rates in schizophrenia inpatients. Methods We conducted a cross-sectional study and included 180 adult patients with psychotic disorders discharged from 2018 to 2019 at a state psychiatric hospital. Descriptive statistics were used to measure the differences between the readmit and nonreadmit cohorts. Logistic regression model was used to measure the odds ratio (OR) for 90-day and annual readmission and was controlled for potential readmission risk factors. Results A lower proportion of patients receiving LAI-a were readmitted within 90-day (28.6%) and 1-year (32.4%) periods. Patients receiving LAI-a had lower odds of association for 90-day (OR 0.36, 95% confidence intervals [CI] 0.139-0.921) and annual (OR 0.35, 95% CI 0.131-0.954) readmissions compared to those discharged on oral antipsychotics. A higher proportion of inpatients who received fluphenazine LAI had 90-day (25%) and annual (18.2%) readmissions compared to other LAI-a. Conclusion Utilization of LAI-a in patients with psychotic disorders can decrease both 90-day and annual psychiatric readmissions by 64% to 65%. Physicians should prefer LAI-a to reduce the readmission rate and improve the quality of life, and decrease the healthcare-related financial burden.

Profile changes in admissions to a psychiatric hospitalisation unit over 15 years (2006–2021), considering the impact of the pandemic caused by SARS-CoV-2

“…In turn, the reduction in the rate of annual admissions during the DSM-5 period particularly stands out, which could perhaps be explained by considering the progressive generalisation of the use of extended-release antipsychotics ( Patel and Tankersley, 2021 ). The change to start using the DSM-5 would also explain the increase in the physical comorbidities (especially endocrine and cardiovascular) that are characteristic side effects of these drugs ( Grajales et al, 2019 ).…”

Effect of long-acting injectable antipsychotics on hospitalizations and global functioning in schizophrenia: a naturalistic mirror-image study

“…25 Second, possible confounders that may affect results or some other factors that can be related to readmission risks like cognitive deficits, adverse effects, and reasons for discontinuation and follow-up with outpatient were not included in our analysis. 58 Other factors that may affect the utilization of LAI like physician's choice, costs, and type of clinical settings were not included which may confound our study results. We, however, included comorbidities, which makes our results representative of real-world clinical settings.…”