The impact on schizophrenia-related hospital utilization and costs of switching to long-acting risperidone injections in Sweden

Willis, Michael; Svensson, Marianne; Löthgren, Mickael; Eriksson, Bo; Berntsson, Anders; Persson, Ulf

doi:10.1007/s10198-009-0215-9

Cited by 32 publications

(26 citation statements)

References 4 publications

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“…The Penn CNB incorporates computer-based assessment to minimise observer bias. The cognitive domains included here were accuracy and speed indices for (1) abstraction and mental flexibility; (2) attention; (3) face memory; (4) spatial memory; (5) spatial processing; (6) working memory; (7) sensorimotor dexterity; and (8) emotion processing (31). Z scores for the cognitive domains were standardised using data from a separate group of Indian control participants (15,32).…”

Section: Methodsmentioning

confidence: 99%

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A randomised controlled trial of adjunctive yoga and adjunctive physical exercise training for cognitive dysfunction in schizophrenia

Bhatia

Mazumdar

Wood

et al. 2016

Acta Neuropsychiatr.

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Background Yoga and physical exercise have been used as adjunctive intervention for cognitive dysfunction in schizophrenia (SZ), but controlled comparisons are lacking. Aims A single-blind randomised controlled trial was designed to evaluate whether yoga training or physical exercise training enhance cognitive functions in SZ, based on a prior pilot study. Methods Consenting, clinically stable, adult outpatients with SZ (n = 286) completed baseline assessments and were randomised to treatment as usual (TAU), supervised yoga training with TAU (YT) or supervised physical exercise training with TAU (PE). Based on the pilot study, the primary outcome measure was speed index for the cognitive domain of ‘attention’ in the Penn computerised neurocognitive battery. Using mixed models and contrasts, cognitive functions at baseline, 21 days (end of training), 3 and 6 months post-training were evaluated with intention-to-treat paradigm. Results Speed index of attention domain in the YT group showed greater improvement than PE at 6 months follow-up (p < 0.036, effect size 0.51). In the PE group, ‘accuracy index of attention domain showed greater improvement than TAU alone at 6-month follow-up (p < 0.025, effect size 0.61). For several other cognitive domains, significant improvements were observed with YT or PE compared with TAU alone (p < 0.05, effect sizes 0.30–1.97). Conclusions Both YT and PE improved attention and additional cognitive domains well past the training period, supporting our prior reported beneficial effect of YT on speed index of attention domain. As adjuncts, YT or PE can benefit individuals with SZ.

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Section: Methodsmentioning

confidence: 99%

“…Cognitive dysfunction is correlated with functional outcome, and has economic and social ramifications (3,4). It increases stigma, adding to illness burden (5).…”

Section: Introductionmentioning

confidence: 99%

A randomised controlled trial of adjunctive yoga and adjunctive physical exercise training for cognitive dysfunction in schizophrenia

Bhatia

Mazumdar

Wood

et al. 2016

Acta Neuropsychiatr.

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“…Most of the costs can be attributed to the loss of working ability, since patients with schizophrenia face a higher likelihood of being unemployed. Hospitalization has been identified as another significant cost driver not only in Japan but also in the USA [4, 5] and Europe [6, 7]. Therefore, relapse prevention that helps reduce inpatient stays is an important element in the treatment of schizophrenia.…”

Section: Introductionmentioning

confidence: 99%

“…LAI therapy has been shown to significantly improve adherence, reduce symptoms, and reduce the risk of relapse and re-hospitalization [6, 21–25]. On the other hand, LAIs are less flexible in regard to dose adjustments [26], delayed disappearance of side effects, and the possibility that some patients might feel pain at the injection site as well as skin irritation and lesions [27].…”

Section: Introductionmentioning

confidence: 99%

Drug Utilization of Japanese Patients Diagnosed with Schizophrenia: An Administrative Database Analysis

et al. 2017

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Background and objectivePatient characteristics require consideration for optimal treatment in order to achieve clinical remission for an improved quality of life and social functioning. Prior evidence supports long-acting injectable antipsychotics (LAIs) in the relapse prevention of schizophrenia. This study aimed to characterize Japanese patients diagnosed with schizophrenia and to compare the outcomes of LAIs and oral antipsychotics (AP) in re-hospitalization or emergency room visit rates.MethodsDiagnostic Procedure Combination (DPC) designated hospital data in Japan with ICD-10 code F20x between July 2013 and June 2015 were obtained from the Medical Data Vision Co. Ltd. Patients were divided into sub-groups in order to filter co-diagnostic conditions. Differences across sub-groups were assessed using a Chi square test or ANOVA. The incidence rate ratio (IRR) was calculated to compare the re-hospitalization (30 days post discharge) or emergency room visit rates between pharmacotherapy groups of oral versus LAI or typical versus atypical within LAI patients. Adjusted estimates were provided by propensity scores that were assigned for age, gender, and Charlson co-morbidity index (CCI) scores.ResultsA quarter of the data sourced were attributed to co-diagnosis with dementia/delirium with antipsychotic prescriptions despite reported risks of antipsychotic use. After adjusting for age, gender, and co-morbidity, LAI reduced re-hospitalization and emergency (ER) visit rates more than oral APs (LAI vs. oral IRR = 0.38 (95% CI 0.17–0.74), IRR = 0.56 (95% CI 0.34–0.91), respectively).ConclusionThe study findings demonstrate usage of DPC hospital data in schizophrenia pharmacotherapy based on classification of co-diagnoses. In comparison with oral APs only, LAI utilization can provide an opportunity for reduced re-hospitalization and ER visit rates among patients with schizophrenia.

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“…19 La RILP ha mostrado su eficacia y tolerabilidad en diversos ensayos clínicos, [20][21][22][23] observándose además un menor número de hospitalizaciones y una mayor adherencia al tratamiento por parte de los pacientes. [24][25][26][27][28] La mayoría de los datos publicados en relación con la eficacia de los antipsicóticos proviene de ensayos clínicos controlados. La rigidez metodológica de estos estudios permite obtener evidencia rigurosa en torno al medicamento pero limita la aplicabilidad de estos resultados en la práctica clínica cotidiana.…”

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Registro Electrónico de Adherencia al Tratamiento de Esquizofrenia en Latinoamérica (e-STAR): Resultados clínicos del uso de risperidona inyectable de liberación prolongada a dos años de seguimiento

Apiquian¹,

Córdoba²,

Louzã³

et al. 2013

Salud Ment

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SUMMARYSchizophrenia is a chronic psychiatric disorder associated to high healthcare costs mainly driven by inpatient care. Lack of adherence to antipsychotic treatment is a common reason for relapse and rehospitalization leading to poor prognosis and global functional impairment of patients. Risperidone long-acting injection (RLAI) has demonstrated its efficacy in treating symptoms of schizophrenia and offers the potential to improve adherence to treatment. ObjectiveTo determine clinical and functional efficacy of RLAI and use of health resources (eg., hospitalizations) in a 2-year follow up study among patients with schizophrenia from Latin America. MethodThe electronic Schizophrenia Treatment Adherence Registry (e-STAR) is an observational study of patients who start treatment with RLAI. Data from patients recruited in Mexico, Colombia and Brazil were collected retrospectively for one year prior to baseline, at baseline and every three months for 24 months. Hospitalization rates and treatment regime were registered. Efficacy was assessed using the Clinical Global Impression of Illness-Severity Scale (CGI-S), while the Global Assessment of Functioning (GAF) and the Personal and Social Performance (PSP) were used for the evaluation of functioning. ResultsSeventy-three patients completed the two-year follow-up. The proportion of patients hospitalized declined from 16.4% before treatment to 4.1% after 2 years of treatment with RLAI. Only 2.7% discontinued the treatment due to lack of efficacy. Significant improvements were reported in illness severity as well as in global functioning assessed by the CGI-S, GAF and PSP scales, respectively. DiscussionOur results give further support of the efficacy of RLAI for the treatment of schizophrenia. Additional to symptom severity reduction and functional recovery, improved treatment adherence and reduced hospitalization rates were observed with the use of RLAI. In a real world clinical setting, RLAI offer an effective long-term treatment for patients with schizophrenia, with a lower use of healthcare resources.Key words: Risperidone long-acting injection, schizophrenia, Latin America, treatment adherence. RESUMENLa esquizofrenia genera elevados costos al sistema de salud. La falta de adherencia al tratamiento es una de las principales causas de recaídas y hospitalizaciones en la esquizofrenia. Lo anterior conduce a un pobre pronóstico y deterioro funcional de los pacientes. La risperidona inyectable de liberación prolongada (RILP) ha demostrado su eficacia en el tratamiento de la esquizofrenia, ofreciendo la posibilidad de que los pacientes tengan una mayor adherencia terapéutica. ObjetivoDeterminar la eficacia y efecto sobre la funcionalidad y el uso de recursos hospitalarios de la RILP en una muestra de pacientes con esquizofrenia de América Latina a dos años de seguimiento. MétodoEl Registro Electrónico de Adherencia al Tratamiento de Esquizofrenia en Latinoamérica (e-STAR) es un estudio observacional del uso de la RILP en la esquizofrenia. Se reclutaron pacientes de M...

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The impact on schizophrenia-related hospital utilization and costs of switching to long-acting risperidone injections in Sweden

Abstract: A naturalistic mirror-image study found that switching to long-acting injectable risperidone led to sizeable reductions in inpatient resource use. These results coincide with the findings of other international studies.

Cited by 32 publications

References 4 publications

A randomised controlled trial of adjunctive yoga and adjunctive physical exercise training for cognitive dysfunction in schizophrenia

A randomised controlled trial of adjunctive yoga and adjunctive physical exercise training for cognitive dysfunction in schizophrenia

Drug Utilization of Japanese Patients Diagnosed with Schizophrenia: An Administrative Database Analysis

Registro Electrónico de Adherencia al Tratamiento de Esquizofrenia en Latinoamérica (e-STAR): Resultados clínicos del uso de risperidona inyectable de liberación prolongada a dos años de seguimiento

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