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Comparison of treatment discontinuation and hospitalization among nonadherent patients initiating depot or oral typical antipsychotic medications

Novick, Diegoa,f; Haro, Josep Mariag; Bertsch, Jordang; Anand, Hemantb; Jemiai, Nadiac; Haddad, Peter M.d,e

International Clinical Psychopharmacology: September 2012 - Volume 27 - Issue 5 - p 275–282
doi: 10.1097/YIC.0b013e328354db12
Original Articles

This analysis compared the effectiveness (treatment discontinuation and hospitalization) of depot and oral typical antipsychotics in nonadherent outpatients with schizophrenia. Data from the 3-year, prospective, observational Schizophrenia Outpatient Health Outcome study were used. Time to treatment discontinuation, percentage of patients hospitalized and the mean numbers of hospitalizations were compared for previously nonadherent patients initiating depot typical or oral typical monotherapy. Cox proportional hazards, linear and logistic regression models were used to adjust for differences between the treatment groups at the index visit. Of 1642 nonadherent patients, 431 (26%) started an oral typical (n=169) or depot typical (n=262) antipsychotic and were included in the analysis. After adjusting for index variables, treatment discontinuation was significantly lower in the depot typical cohort (hazard ratio: 0.72, 95% confidence interval: 0.54–0.97, P<0.05). Younger age and more severe positive symptoms were also associated with higher discontinuation. The frequency of hospitalization and the mean number of hospitalizations were both significantly lower for the depot typical cohort at 6 months (P<0.05) compared with oral typicals. In the usual care of outpatients with schizophrenia, treatment continuation among nonadherent patients is longer for depot typicals compared with oral typicals and is accompanied by less hospitalization in the short term.

aEli Lilly and Company, Windlesham

bLilly ACE Neuroscience Medical Affairs, Windlesham

cHealth economist, Independent consultant, London

dUniversity of Manchester, Manchester

eGreater Manchester West Mental Health NHS Foundation Trust, Manchester, UK

fUniversitat Autonoma de Barcelona, Barcelona

gParc Santari San Joan de Deu, CIBER en Salud Mental (CIBERSAM), Universitat de Barcelona, Barcelona, Spain

Nadia Jemiai: Formerly at Eli Lilly and Company, European Outcomes Research Windlesham, UK

Correspondence to Diego Novick, Eli Lilly and Company Limited, Lilly Research Centre, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey GU20 6PH, UK Tel: +44 127 648 3832; fax: +44 127 648 3192; e-mail: novick_diego@lilly.com

Received January 30, 2012

Accepted March 19, 2012

© 2012 Lippincott Williams & Wilkins, Inc.