Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-10T06:25:55.179Z Has data issue: false hasContentIssue false
  • English
  • Français

Monitoring and improving antipsychotic adherence in outpatient forensic diversion programs

Published online by Cambridge University Press:  23 May 2019

Jonathan M. Meyer Open the ORCID record for Jonathan M. Meyer [Opens in a new window]
Jonathan M. Meyer*
Affiliation:
California Department of State Hospitals, Patton, CA, USA; Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
*
* Address correspondence to: Jonathan M. Meyer, California Department of State Hospitals; Department of Psychiatry, University of California, San Diego, 4225 Executive Square #600, La Jolla, CA 92037, USA. (Email: jmmeyer@ucsd.edu)
Get access Rights & Permissions [Opens in a new window]

Abstract

Outpatient diversion programs present an opportunity for severely mentally ill defendants to receive psychiatric treatment and have alleged offenses dismissed by the court. Moreover, the successful completion of pretrial diversion is associated with fewer post-program arrest and jail days. The target patient population for such programs is typically people with schizophrenia spectrum disorders, but the care of such patients in outpatient settings presents challenges for monitoring treatment fidelity, specifically antipsychotic adherence, as low adherence rates are associated with increased rates of recidivism. Presented here is a review of evidence-based strategies that must be employed to track antipsychotic adherence in outpatient diversion programs, including pill counts, use of long-acting injectable antipsychotics, and determination of plasma antipsychotic levels to assess adherence and the adequacy of antipsychotic treatment. Antipsychotic therapy remains the foundation of schizophrenia treatment, but only through the use of all available modalities can clinicians maximize the odds that schizophrenia patients in pretrial diversion maintain psychiatric stability and successfully complete mental health court mandates.

Keywords

Pretrial diversionrecidivismschizophreniaplasma levelmonitoringlong-acting injectable antipsychoticadherence
Type
Review
Information
CNS Spectrums , Volume 25 , Issue 2 , April 2020 , pp. 136 - 144
Copyright
© Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

References:

California Assembly Bill 1810. Pretrial Diversion, Section 15. 2018.Google Scholar
Case, B, Steadman, HJ, Dupuis, SA, et al. Who succeeds in jail diversion programs for persons with mental illness? A multi-site study. Behav Sci Law. 2009; 27(5): 661–674.10.1002/bsl.883CrossRefGoogle ScholarPubMed
Renner, M, Newark, C, Bartos, BJ, et al. Length of stay for 25, 791 California patients found incompetent to stand trial. J Forensic Leg Med. 2017; 51: 22–26.10.1016/j.jflm.2017.07.006CrossRefGoogle Scholar
Steadman, HJ, Redlich, A, Callahan, L, et al. Effect of mental health courts on arrests and jail days: a multisite study. Arch Gen Psychiatry. 2011; 68(2): 167–172.10.1001/archgenpsychiatry.2010.134CrossRefGoogle ScholarPubMed
Gill, KJ, Murphy, AA. Jail diversion for persons with serious mental illness coordinated by a Prosecutor’s Office. Biomed Res Int. 2017; 20177917616.Google ScholarPubMed
Comartin, E, Kubiak, SP, Ray, B, et al. Short- and long-term outcomes of mental Health court participants by psychiatric diagnosis. Psychiatr Serv. 2015; 66(9): 923–929.10.1176/appi.ps.201400230CrossRefGoogle Scholar
Oueslati, B, Fekih-Romdhane, F, Mrabet, A, et al. Correlates of offense recidivism in patients with schizophrenia. Int J Law Psychiatry. 2018; 58: 178–183.10.1016/j.ijlp.2018.05.001CrossRefGoogle ScholarPubMed
Rezansoff, SN, Moniruzzaman, A, Fazel, S, et al. Adherence to antipsychotic medication and criminal recidivism in a Canadian provincial offender population. Schizophr Bull. 2017; 43(5): 1002–1010.10.1093/schbul/sbx084CrossRefGoogle Scholar
Lamberti, JS. Understanding and preventing criminal recidivism among adults with psychotic disorders. Psychiatr Serv. 2007; 58(6): 773–781.10.1176/ps.2007.58.6.773CrossRefGoogle ScholarPubMed
Dufort, A, Zipursky, RB. Understanding and managing treatment adherence in schizophrenia. Clin Schizophr Relat Psychoses. 2019. Jan 3. doi: 10.3371/CSRP.ADRZ.121218. [Epub ahead of print]CrossRefGoogle Scholar
Brain, C, Sameby, B, Allerby, K, et al. Twelve months of electronic monitoring (MEMS) in the Swedish COAST-study: a comparison of methods for the measurement of adherence in schizophrenia. Eur Neuropsychopharmacol. 2014; 24(2): 215–222.10.1016/j.euroneuro.2013.11.013CrossRefGoogle Scholar
Remington, G, Teo, C, Mann, S, et al. Examining levels of antipsychotic adherence to better understand nonadherence. J Clin Psychopharmacol. 2013; 33(2): 261–263.10.1097/JCP.0b013e31828568bcCrossRefGoogle ScholarPubMed
Byerly, MJ, Thompson, A, Carmody, T, et al. Validity of electronically monitored medication adherence and conventional adherence measures in schizophrenia. Psychiatric Services. 2007; 58(6): 844–847.10.1176/ps.2007.58.6.844CrossRefGoogle Scholar
Velligan, DI, Wang, M, Diamond, P, et al. Relationships among subjective and objective measures of adherence to oral antipsychotic medications. Psychiatric Services. 2007; 58(9): 1187–1192.10.1176/ps.2007.58.9.1187CrossRefGoogle ScholarPubMed
McCutcheon, R, Beck, K, Bloomfield, MA, et al. Treatment resistant or resistant to treatment? Antipsychotic plasma levels in patients with poorly controlled psychotic symptoms. J Psychopharmacol. 2015; 29(8): 892–897.10.1177/0269881115576688CrossRefGoogle ScholarPubMed
Meyer, JM. Converting oral to long acting injectable antipsychotics: a guide for the perplexed. CNS Spectrums. 2017; 22(S1): 14–28.10.1017/S1092852917000840CrossRefGoogle Scholar
Velligan, DI, Lam, YW, Glahn, DC, et al. Defining and assessing adherence to oral antipsychotics: a review of the literature. Schizophr Bull. 2006; 32(4): 724–742.10.1093/schbul/sbj075CrossRefGoogle ScholarPubMed
Xu, DR, Gong, W, Gloyd, S, et al. Measuring adherence to antipsychotic medications for schizophrenia: concordance and validity among a community sample in rural China. Schizophr Res. 2018; 201307–201314.Google ScholarPubMed
Alphs, L, Mao, L, Rodriguez, SC, et al. Design and rationale of the Paliperidone Palmitate Research in Demonstrating Effectiveness (PRIDE) study: a novel comparative trial of once-monthly paliperidone palmitate versus daily oral antipsychotic treatment for delaying time to treatment failure in persons with schizophrenia. J Clin Psychiatry. 2014; 75(12): 1388–1393.10.4088/JCP.13m08965CrossRefGoogle ScholarPubMed
Alphs, L, Benson, C, Cheshire-Kinney, K, et al. Real-world outcomes of paliperidone palmitate compared to daily oral antipsychotic therapy in schizophrenia: a randomized, open-label, review board-blinded 15-month study. J Clin Psychiatry. 2015; 76(5): 554–561.10.4088/JCP.14m09584CrossRefGoogle ScholarPubMed
Kishimoto, T, Hagi, K, Nitta, M, et al. Effectiveness of long-acting injectable vs oral antipsychotics in patients with schizophrenia: a meta-analysis of prospective and retrospective cohort studies. Schizophr Bull. 2018; 44(3): 603–619.10.1093/schbul/sbx090CrossRefGoogle ScholarPubMed
Meyer, JM. Converting oral to long acting injectable antipsychotics: a guide for the perplexed. CNS Spectrums. 2018; 22(S1): 14–28.10.1017/S1092852917000840CrossRefGoogle Scholar
Alkermes Inc. Aristada Initio Package Insert. Walltham MA: Alkermes Inc.; 2018.Google Scholar
Indivior Inc. Perseris Package Insert. North Chesterfield, VA: Indivior Inc.; 2018.Google Scholar
Hard, ML, Mills, RJ, Sadler, BM, et al. Aripiprazole lauroxil: pharmacokinetic profile of this long-acting injectable antipsychotic in persons with schizophrenia. J Clin Psychopharmacol. 2017; 37(3): 289–295.10.1097/JCP.0000000000000691CrossRefGoogle ScholarPubMed
Hard, ML, Mills, RJ, Sadler, BM, et al. Pharmacokinetic profile of a 2-month dose regimen of aripiprazole lauroxil: a phase i study and a population pharmacokinetic model. CNS Drugs. 2017; 31(7): 617–624.10.1007/s40263-017-0447-7CrossRefGoogle Scholar
Meyer, JM. Understanding depot antipsychotics: an illustrated guide to kinetics. CNS Spectrums. 2013; 18(Suppl s1): 55–68.10.1017/S1092852913000783CrossRefGoogle ScholarPubMed
Leucht, S, Cipriani, A, Spineli, L, et al. Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis. The Lancet. 2013; 382(9896): 951–962.10.1016/S0140-6736(13)60733-3CrossRefGoogle ScholarPubMed
Meyer, JM, Rosenblatt, LC, Kim, E, et al. The moderating impact of ethnicity on metabolic outcomes during treatment with olanzapine and aripiprazole in patients with schizophrenia. Journal of Clinical Psychiatry. 2009; 70(3): 318–325.10.4088/JCP.08m04267CrossRefGoogle ScholarPubMed
McCutcheon, R, Beck, K, D’Ambrosio, E, et al. Antipsychotic plasma levels in the assessment of poor treatment response in schizophrenia. Acta Psychiatr Scand. 2017; 137(1): 39–46.10.1111/acps.12825CrossRefGoogle Scholar
Meyer, JM, Stahl, SM. The Clozapine Handbook. Cambridge, UK: Cambridge University Press; 2019.Google Scholar
Meyer, JM. A rational approach to employing high plasma levels of antipsychotics for violence associated with schizophrenia: case vignettes. CNS Spectrums. 2014; 19(5): 432–438.10.1017/S1092852914000236CrossRefGoogle ScholarPubMed
Iyo, M, Tadokoro, S, Kanahara, N, et al. Optimal extent of dopamine D2 receptor occupancy by antipsychotics for treatment of dopamine supersensitivity psychosis and late-onset psychosis. J Clin Psychopharmacol. 2013; 33(3): 398–404.10.1097/JCP.0b013e31828ea95cCrossRefGoogle ScholarPubMed
Linnet, K, Wiborg, O. Steady-state serum concentrations of the neuroleptic perphenazine in relation to CYP2D6 genetic polymorphism. Clin Pharmacol Ther. 1996; 60(1): 41–47.10.1016/S0009-9236(96)90165-4CrossRefGoogle ScholarPubMed
Sparshatt, A, Taylor, D, Patel, MX, et al. A systematic review of aripiprazole – dose, plasma concentration, receptor occupancy, and response: implications for therapeutic drug monitoring. Journal of Clinical Psychiatry. 2010; 71(11): 1447–1556.10.4088/JCP.09r05060greCrossRefGoogle ScholarPubMed
Rostami-Hodjegan, A, Amin, AM, Spencer, EP, et al. Influence of dose, cigarette smoking, age, sex, and metabolic activity on plasma clozapine concentrations: a predictive model and nomograms to aid clozapine dose adjustment and to assess compliance in individual patients. Journal of Clinical Psychopharmacology. 2004; 24(1): 70–78.10.1097/01.jcp.0000106221.36344.4dCrossRefGoogle ScholarPubMed
Wei, FC, Jann, MW, Lin, HN, et al. A practical loading dose method for converting schizophrenic patients from oral to depot haloperidol therapy. Journal of Clinical Psychiatry. 1996; 57(7): 298–302.Google ScholarPubMed
Ereshefsky, L, Jann, MW, Saklad, SR, et al. Effects of smoking on fluphenazine clearance in psychiatric inpatients. Biol Psychiatry. 1985; 20(3): 329–332.10.1016/0006-3223(85)90063-0CrossRefGoogle ScholarPubMed
Bishara, D, Olofinjana, O, Sparshatt, A, et al. Olanzapine: a systematic review and meta-regression of the relationships between dose, plasma concentration, receptor occupancy, and response. J Clin Psychopharmacol. 2013; 33(3): 329–335.10.1097/JCP.0b013e31828b28d5CrossRefGoogle ScholarPubMed
Haslemo, T, Eikeseth, PH, Tanum, L, et al. The effect of variable cigarette consumption on the interaction with clozapine and olanzapine. Eur J Clin Pharmacol. 2006; 62(12): 1049–1053.10.1007/s00228-006-0209-9CrossRefGoogle ScholarPubMed
Schoretsanitis, G, Spina, E, Hiemke, C, et al. A systematic review and combined analysis of therapeutic drug monitoring studies for oral paliperidone. Expert Rev Clin Pharmacol. 2018; 11(6): 625–639.10.1080/17512433.2018.1478727CrossRefGoogle ScholarPubMed
de Leon, J, Sandson, NB, Cozza, KL. A preliminary attempt to personalize risperidone dosing using drug–drug interactions and genetics: part II. Psychosomatics. 2008; 49(4): 347–361.10.1176/appi.psy.49.4.347CrossRefGoogle ScholarPubMed
de Leon, J, Wynn, G, Sandson, NB. The pharmacokinetics of paliperidone versus risperidone. Psychosomatics. 2010; 51(1): 80–88.10.1016/S0033-3182(10)70664-2CrossRefGoogle ScholarPubMed
Mallikaarjun, S, Kane, JM, Bricmont, P, et al. Pharmacokinetics, tolerability and safety of aripiprazole once-monthly in adult schizophrenia: an open-label, parallel-arm, multiple-dose study. Schizophr Res. 2013; 150(1): 281–288.10.1016/j.schres.2013.06.041CrossRefGoogle ScholarPubMed
Marder, SR, Midha, KK, Van Putten, T, et al. Plasma levels of fluphenazine in patients receiving fluphenazine decanoate. Relationship to clinical response. Br J Psychiatry. 1991; 158: 658–665.10.1192/bjp.158.5.658CrossRefGoogle ScholarPubMed
Jann, MW, Wei, FC, Lin, HN, et al. Haloperidol and reduced haloperidol plasma concentrations after a loading dose regimen with haloperidol decanoate. Prog Neuropsychopharmacol Biol Psychiatry. 1996; 20(1): 73–86.10.1016/0278-5846(95)00293-6CrossRefGoogle ScholarPubMed
Schoretsanitis, G, Spina, E, Hiemke, C, et al. A systematic review and combined analysis of therapeutic drug monitoring studies for long-acting paliperidone. Expert Rev Clin Pharmacol. 2018; 11(12): 1237–1253.10.1080/17512433.2018.1549489CrossRefGoogle ScholarPubMed
Fleischhacker, WW, Eerdekens, M, Karcher, K, et al. Treatment of schizophrenia with long-acting injectable risperidone: a 12-month open-label trial of the first long-acting second-generation antipsychotic. The Journal of Clinical Psychiatry. 2003; 64(10): 1250–1257.10.4088/JCP.v64n1017CrossRefGoogle ScholarPubMed
Ivaturi, V, Gopalakrishnan, M, Gobburu, JVS, et al. Exposure-response analysis after subcutaneous administration of RBP-7000, a once-a-month long-acting Atrigel formulation of risperidone. Br J Clin Pharmacol. 2017; 83(7): 1476–1498.10.1111/bcp.13246CrossRefGoogle ScholarPubMed
Ereshefsky, L, Mascarenas, CA. Comparison of the effects of different routes of antipsychotic administration on pharmacokinetics and pharmacodynamics. Journal of Clinical Psychiatry. 2003; 64(Suppl 16): 1618–1623.Google ScholarPubMed
Samara, MT, Leucht, C, Leeflang, MM, et al. Early improvement as a predictor of later response to antipsychotics in schizophrenia: a diagnostic test review. Am J Psychiatry. 2015; 172(7): 617–629.10.1176/appi.ajp.2015.14101329CrossRefGoogle ScholarPubMed
Midha, KK, Hubbard, JW, Marder, SR, et al. Impact of clinical pharmacokinetics on neuroleptic therapy in patients with schizophrenia. J Psychiatry Neurosci. 1994; 19(4): 254–264.Google ScholarPubMed
Nyberg, S, Dencker, SJ, Malm, U, et al. D(2)- and 5-HT(2) receptor occupancy in high-dose neuroleptic-treated patients. The International Journal Of Neuropsychopharmacology/Official Scientific Journal of the Collegium Internationale Neuropsychopharmacologicum (CINP). 1998; 1(2): 95–101.10.1017/S1461145798001229CrossRefGoogle ScholarPubMed