Key result
Long-acting injectable antipsychotics linked to ~77% fewer 30-day psychiatric readmissions versus oral antipsychotics.
Why the study?
Decreasing hospital readmissions is a priority in schizophrenia care, making it important to assess methods to prevent readmissions such as improving access to long-acting injectable antipsychotics.
Do long-acting injectable antipsychotics reduce 30-day psychiatric readmission rates in patients with schizophrenia or schizoaffective disorder compared to oral antipsychotics?
Observational
No
Do long-acting injectable antipsychotics reduce 30-day psychiatric readmission rates in patients with schizophrenia or schizoaffective disorder compared to oral antipsychotics?
Absolute Event Rate: 1.9% vs 8.3%
p-value: p=0.03
Long-acting injectable antipsychotics significantly reduced 30-day psychiatric rehospitalizations compared to oral antipsychotics in patients with schizophrenia or schizoaffective disorder.
May support LAI use to reduce early readmissions in schizophrenia; hypothesis-generating and requires RCTs before practice change.
PURPOSE/BACKGROUND: Schizophrenia is a chronic, debilitating mental illness that incurs a large economic burden. Decreasing hospital readmissions is a priority in health care to improve patient quality of life and decrease health care costs. Determining ways to prevent readmissions such as improving access to long-acting injectable (LAI) antipsychotics is important to assess. METHODS/PROCEDURES: A single-center retrospective review was conducted comparing readmission rates of patients diagnosed with schizophrenia or schizoaffective disorder discharged on LAI or oral antipsychotics between August 1, 2019, and June 30, 2022. The primary outcome was the 30-day psychiatric readmission rate. Secondary outcomes included chlorpromazine equivalent doses and use of anticholinergic medications. FINDINGS/RESULTS: The 30-day readmission rate was 1.9% for the LAI antipsychotic group and 8.3% for the oral antipsychotic group ( P = 0.03; 95% confidence interval, 1.05-20.02). The average chlorpromazine equivalent antipsychotic dose of patients discharged on LAI versus oral antipsychotic medications was 477.3 and 278.6 mg/d, respectively ( P < 0.001). In addition, the prevalence of medications used to treat extrapyramidal symptom was 22.3% (n = 23) for the LAI antipsychotic group and 30.8% (n = 74) for the oral antipsychotic group ( P = 0.12). Sixty-four percent of LAI antipsychotics utilized were obtained from pharmaceutical company hospital inpatient free trial programs. IMPLICATIONS/CONCLUSIONS: Long-acting injectable antipsychotics showed a statistically significant reduction in 30-day rehospitalizations as compared with oral antipsychotics and hospital inpatient free trial programs aided in LAI antipsychotic acquisition.
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Thaman et al. (2024) conducted an observational in Schizophrenia or schizoaffective disorder. Long-acting injectable (LAI) antipsychotics vs. Oral antipsychotics was evaluated on 30-day psychiatric readmission rate (95% CI 1.05-20.02, p=0.03). Long-acting injectable antipsychotics significantly reduced the 30-day psychiatric readmission rate compared with oral antipsychotics (1.9% vs 8.3%; P=0.03).
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