Rehospitalization rates of patients with schizophrenia discharged on haloperidol, risperidone or clozapine

Abstract

Rehospitalization rates of patients with schizophrenia discharged on haloperidol, risperidone or clozapine Taxas de re-hospitalização de pacientes após alta hospitalar em uso de haloperidol, risperidona ou clozapina A b s t r a c t Objective: The purpose of this study was to evaluate the rehospitalization rates of patients discharged from the Institute of Psychiatry of the Clinical Hospital of the Medical School of the Universidade de São Paulo while being treated with haloperidol, risperidone or clozapine. Method: This is a naturalistic study designed to monitor rehospitalization rates for patients discharged on haloperidol (n = 43), risperidone (n = 22) or clozapine (n = 31). Time to readmission over the course of three years was measured by the product-limit (Kaplan-Meier) method. Risk factors associated with rehospitalizations were examined. Results: At 36 months, remained in the community 74% of the haloperidol-treated patients, 59% of the risperidone-treated patients and 84% of the clozapine-treated patients. The haloperidol group showed a higher proportion of women, a later age of onset and shorter length of illness than the other groups, whereas the opposite was observed in the clozapine group. Conclusions: This study suggests that the rehospitalization rates of patients taking clozapine are lower than the rate for patients treated with haloperidol or risperidone. However, confounding variables such as gender distribution and age of onset represent limitations that should be taken into account for the interpretation of the results.Descriptors: Schizophrenia; Patient readmission; Relapse/prevention and control; Antipsychotic agents/second generation; Haloperidol Resumo Objetivo: O propósito deste estudo foi observar as taxas de re-hospitalização de pacientes com esquizofrenia que receberam alta do Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo em uso de haloperidol, risperidona ou clozapina. Método: Este foi um estudo naturalístico conduzido de forma a observar as taxas de re-hospitalizações dos pacientes que receberam alta em uso de haloperidol (n = 43), risperidona (n = 22) ou clozapina (n = 31). O tempo de rehospitalização foi analisado de acordo com a fórmula produto-limite (Kaplan-Meier) por três anos. Fatores de risco associados a internação foram examinados. Resultados: Aos 36 meses, permaneceram em seguimento extra-hospitalar 74% dos pacientes em uso de haloperidol, 59% em uso de risperidona e 84% em uso de clozapina. O grupo tratado com haloperidol apresentou predomínio do gênero feminino, idade de início mais tardia e menor tempo de doença que os demais grupos, enquanto o oposto ocorreu em relação ao grupo com clozapina. Conclusões: Pacientes em uso de clozapina apresentaram taxas de re-hospitalização menores que aqueles em uso de haloperidol e risperidona. No entanto, variáveis tais como distribuição de gênero e idade de início da doença podem representar limitações importantes que devem ser levadas em consideração na interpretação dos re...

The frequency of rehospitalization and associated factors in Colombian psychiatric patients: a cohort study

“…In agreement with other studies, this variable may affect the frequency of rehospitalization. It has been suggested that clozapine may provide a protective effect against rehospitalization among patients with schizophrenia [23,24]. …”

Electroconvulsive Therapy and Clozapine in Adolescents With Schizophrenia Spectrum Disorders

“…3,4 Clozapine is an antipsychotic used in treatment-resistant cases of SSD, and it has been reported to be the most efficacious pharmacological treatment for these patients. 11,13,14 Studies have also suggested that clozapine can improve catatonic symptoms. 7 Hospitalization rate has been used in some observational studies as an outcome measure to evaluate the effectiveness of antipsychotics in adults, 8Y12 and some studies have shown reduced rehospitalization in adult patients with SSDs treated with clozapine.…”

Risk Factors Associated With Readmissions of Hospitalized Mentally Ill Patients

“…A better understanding of the factors related to readmissions needed to help better management and early intervention. Understanding these factors will decrease the number of readmissions and hospital costs [7]. It seems that those in-patients who are seeking re-hospitalization tend to repeat some of these treatment-seeking behaviors and may assist nurses in planning care.…”