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Treatment compliance in veterans administration schizophrenia spectrum patients treated with risperidone long-acting injectable

Duncan, Erica J.a,b; Woolson, Sandra L.c; Hamer, Robert M.c

International Clinical Psychopharmacology: September 2012 - Volume 27 - Issue 5 - p 283–290
doi: 10.1097/YIC.0b013e328354b534
Original Articles

Risperidone is the first of the second-generation antipsychotics available in a long-acting injectable form (RLAI). This form of delivery has proven efficacy and safety in the treatment of schizophrenia. However, outcome studies in ‘real-world’ clinical samples are lacking. We carried out a retrospective study using a computerized repository of clinical data from eight Veterans Affairs Medical Centers. Compliance with outpatient medication and metabolic monitoring frequency was evaluated in schizophrenia spectrum patients during treatment with oral risperidone (RispPO) and after switch to RLAI. Propensity scores were computed during baseline when both groups were on RispPO, and the two groups were matched on propensity scores. Matching on propensity score was successful: 132 RispPO patients were well matchedto 132 RLAI patients during the RispPO Baseline Period. Days until medication discontinuation were longer in the RLAI group (679.2±499.3) than the RispPO group (403.7±365.1, P<0.0001). Days late for receiving medication were significantly shorter during the RLAI treatment (5.6±6.2) than the RispPO treatment (8.2±8.6, P<0.004). Metabolic monitoring frequency was significantly greater for patients switched to RLAI for patients maintained on RispPO treatment. Outpatient medication compliance is enhanced during treatment with RLAI compared with treatment with RispPO, as is the rate of monitoring for metabolic measures.

aMental Health Service, Atlanta Veterans Affairs Medical Center, Decatur

bDepartment of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia

cUniversity of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA

Correspondence to Erica J. Duncan, MD, Mental Health/116A, Atlanta Veterans Administration Medical Center, 1670 Clairmont Road, Decatur, GA 30033, USA Tel: +1 404 321 6111 x7532; fax: +1 404 417 2911; e-mail: erica.duncan@va.gov

Received February 18, 2011

Accepted April 11, 2012

© 2012 Lippincott Williams & Wilkins, Inc.