Mental health care utilisation by patients before and after receiving paliperidone palmitate treatment: mirror-image analyses

Giouliana Kadra-Scalzo, Deborah Ahn, Alexander Bird, Mathew T. M. Broadbent, Chin Kuo Chang, Megan Pritchard, Hitesh Shetty, David Taylor, Richard Hayes, Robert Stewart

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Objectives To compare mental healthcare use and healthcare professional (HCP) contacts for patients before and after initiation of paliperidone palmitate.

Setting The South London and Maudsley NHS Foundation Trust (SLAM) Biomedical Research Centre Clinical Record Interactive Search.

Participants We identified all adults with a diagnosis of schizophrenia (International Classification of Diseases 10th Revision: F20.x), who had received paliperidone palmitate prescription for at least 365 days and had at least 1 year of recorded treatment from SLAM, prior to the first recorded receipt of paliperidone palmitate.

Primary and secondary outcome measures Inpatient and community mental healthcare service use, such as inpatient bed days, number of active days in the service, face-to-face and telephone HCP use in the 12 months before and after paliperidone palmitate initiation.

Results We identified 664 patients initiated on paliperidone palmitate. Following initiation, inpatient bed days were lower, although patients remained active on the service case load longer for both mirror approach 1 (mean difference of inpatient bed days −10.48 (95% CI −15.75 to −5.22); days active 40.67 (95% CI 33.39 to 47.95)) and mirror approach 2 (mean difference of inpatient bed days −23.96 (95% CI −30.01 to −17.92); mean difference of days active 40.69 (95% CI 33.39 to 47.94)). The postinitiation period was further characterised by fewer face-to-face and telephone contacts with medical and social work HCPs, and an increased contact with clinical psychologists.

Conclusions Our findings indicate a change in the profile of HCP use, consistent with a transition from treatment to possible rehabilitation.
Original languageEnglish
Article numbere051567
Pages (from-to)e051567
JournalBMJ Open
Issue number4
Publication statusPublished - 6 Apr 2022


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