Effect of 3-monthly paliperidone palmitate on hospitalisation in a naturalistic schizophrenia cohort – A five-year mirror image study

TY - JOUR

T1 - Effect of 3-monthly paliperidone palmitate on hospitalisation in a naturalistic schizophrenia cohort – A five-year mirror image study

AU - Wallman, Phoebe

AU - Clark, Ivana

AU - Taylor, David

N1 - Funding Information: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: DT has received speaker honoraria and research funding from Janssen, Recordati and Sunovion and is currently receiving a grant (#1126389) from Janssen UK. For PW and IC none were declared. Publisher Copyright: © 2022

PY - 2022/4

Y1 - 2022/4

N2 - Purpose/Background: Currently the longest-acting antipsychotic formulation widespread clinical use is paliperidone 3-monthly injection (PP3M). While its efficacy has been shown in rigorous trials, there are few data relating to its effect on hospitalisation in normal clinical practice. Methods/Procedures: This was a mirror-image study (3 years before; 2 years after) of hospitalisations before and after beginning paliperidone 1-monthly (PP1M) and switching to 3-monthly within 18 months. All consecutive patients prescribed paliperidone long-acting injections with its licence (F20 schizophrenia diagnosis; 18–65 years) were included. The setting was an urban, specialist mental health organisation In London, UK. Findings/Results: In total 378 patients were initiated on PP3M during the study period. After applying inclusion criteria, 76 patients were retained and followed-up for 2 years. Mean duration of PP1M use before starting 3-monthly injections was 6 months (range 3–18 months). Of the 76 patients initiated, 13 patients discontinued PP3M within 2 years of starting PP1M or were lost to follow-up. Mean hospitalisations per patient per year fell from 0.55 (SD 0.46) before paliperidone to 0.05 (SD 0.19) after initiation (p < 0.001). Only 5 of 76 PP1M/PP3M participants were hospitalised during the 2-year follow up. The mean number of bed days per year before paliperidone initiation was 32.2 (SD 44.3) and after paliperidone initiation it was 23.0 (SD 53.2) (p = 0.004). Almost all of the bed days after initiation were associated with the index admission during which PP1M was started. Implications/Conclusions: In patients stabilised on PP1M and switched to PP3M in normal clinical practice, rehospitalisation is very uncommon and much reduced compared with previous treatments.

AB - Purpose/Background: Currently the longest-acting antipsychotic formulation widespread clinical use is paliperidone 3-monthly injection (PP3M). While its efficacy has been shown in rigorous trials, there are few data relating to its effect on hospitalisation in normal clinical practice. Methods/Procedures: This was a mirror-image study (3 years before; 2 years after) of hospitalisations before and after beginning paliperidone 1-monthly (PP1M) and switching to 3-monthly within 18 months. All consecutive patients prescribed paliperidone long-acting injections with its licence (F20 schizophrenia diagnosis; 18–65 years) were included. The setting was an urban, specialist mental health organisation In London, UK. Findings/Results: In total 378 patients were initiated on PP3M during the study period. After applying inclusion criteria, 76 patients were retained and followed-up for 2 years. Mean duration of PP1M use before starting 3-monthly injections was 6 months (range 3–18 months). Of the 76 patients initiated, 13 patients discontinued PP3M within 2 years of starting PP1M or were lost to follow-up. Mean hospitalisations per patient per year fell from 0.55 (SD 0.46) before paliperidone to 0.05 (SD 0.19) after initiation (p < 0.001). Only 5 of 76 PP1M/PP3M participants were hospitalised during the 2-year follow up. The mean number of bed days per year before paliperidone initiation was 32.2 (SD 44.3) and after paliperidone initiation it was 23.0 (SD 53.2) (p = 0.004). Almost all of the bed days after initiation were associated with the index admission during which PP1M was started. Implications/Conclusions: In patients stabilised on PP1M and switched to PP3M in normal clinical practice, rehospitalisation is very uncommon and much reduced compared with previous treatments.

KW - Bed days

KW - Mirror-image

KW - Paliperidone 3-monthly

KW - Schizophrenia

UR - https://www.scopus.com/pages/publications/85123838678

U2 - 10.1016/j.jpsychires.2022.01.044

DO - 10.1016/j.jpsychires.2022.01.044

M3 - Review article

AN - SCOPUS:85123838678

SN - 0022-3956

VL - 148

SP - 131

EP - 136

JO - Journal of psychiatric research

JF - Journal of psychiatric research

ER -