The impact of paliperidone palmitate long-acting injection on hospital admissions in a mental health setting

Abstract

We screened 216 patients in a retrospective observational investigator-initiated study, of whom 45.37% patients (n=98) were retained after the inclusion criteria were applied. These patients had been prescribed paliperidone palmitate long-acting injection (PPLAI) with diagnoses of schizophrenia, schizoaffective disorder and bipolar affective disorder. We investigated whether PPLAI has an effect on the frequency and length of admissions to mental health inpatient units, the number of contacts with Crisis Resolution Home Treatment Teams (CRHTT) and frequency of home visits by the CRHTT per patient, over 6 years, split using a 'mirror image' method. In total, 85% of patients continued PPLAI for 1 year, 60% for 2 years and 47% for 3 years. In the sample of patients who continued with PPLAI for 3 years (n=48), the mean number of hospital admissions decreased from 1.03 to 0.35 per patient (P=0.001). The mean number of bed days decreased significantly from 53 to 24 bed days (P=0.0001). The median values showed similar significant differences. There were numerical differences but nonsignificant results between CRHTT's number of contacts and length of episodes across the study period. Our results indicate that PPLAI has been shown to be effective in the reduction of hospital admissions, relapse rates and length of inpatient stay.

Haloperidol decanoate long-acting injection (HDLAI): Results of a 1-year mirror-image study

“…Interestingly, lower rates of discontinuation have been reported with paliperidone palmitate at 1 year in a similar population to those in our study. 15 , 16 However, both these studies included patients who were outpatients stabilized on medication, as well as inpatients. A higher discontinuation rate may have been expected in our study, which included only patients admitted to an inpatient unit following a relapse in their mental state.…”

Discontinuation rates during long‐term, second‐generation antipsychotic long‐acting injection treatment: A systematic review

“…In a recent study the rate of dropouts increased dramatically during the 3‐year follow‐up period. The main reasons for discontinuation were the onset of adverse effects and patient perceived ineffectiveness.…”

“…47,[49][50][51]53,55 The only study reporting the advantage of PP1M on oral antipsychotics showed several limitations, the main being a suboptimal statistical power due to the small sample size and the inclusion in the study cohort of both new and old PP1M users. 54 The main causes of drug discontinuation before the planned study end were adverse events 45,46,61,62,65 and ineffectiveness. 47,51,59,62,65,66 The two available long-term studies on PPM3 showed a rate of premature discontinuation similar to that shown by the active comparator (PP1M).…”

“…54 The main causes of drug discontinuation before the planned study end were adverse events 45,46,61,62,65 and ineffectiveness. 47,51,59,62,65,66 The two available long-term studies on PPM3 showed a rate of premature discontinuation similar to that shown by the active comparator (PP1M). 68,69 However, only one 68 reported the reasons of premature withdrawal (the most frequent being the occurrence of adverse events).…”

Meeting the unmet: from traditional to cutting-edge techniques for poly lactide and poly lactide-co-glycolide microparticle manufacturing

“…In particular, LAI products show a higher cost/effectiveness compared to oral antipsychotic treatment (Yang et al 2009) with reduced hospital admissions, relapse rates and length of inpatient stay, especially for patients who may be at risk of non-adherence with oral antipsychotics (Peng et al 2011;Nikolić et al 2017).…”