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Effect of paliperidone palmitate on hospitalisation in a naturalistic cohort – a four-year mirror image study

Published online by Cambridge University Press:  23 March 2020

D.M. Taylor ,
A. Sparshatt ,
M. O’Hagan  and
O. Dzahini
D.M. Taylor*
Affiliation:
Maudsley Hospital, Pharmacy Department, Denmark Hill, LondonSE5 8AZ, UK Institute of Pharmaceutical Science, King’s College, 5th Floor, Franklin-Wilkins Building, 150 Stamford StreetLondonSE1 9NH, UK
A. Sparshatt
Affiliation:
Maudsley Hospital, Pharmacy Department, Denmark Hill, LondonSE5 8AZ, UK
M. O’Hagan
Affiliation:
Maudsley Hospital, Pharmacy Department, Denmark Hill, LondonSE5 8AZ, UK
O. Dzahini
Affiliation:
Maudsley Hospital, Pharmacy Department, Denmark Hill, LondonSE5 8AZ, UK
*
* Corresponding author. Maudsley Hospital, Pharmacy Department, Denmark Hill, London SE5 8AZ, UK. Tel.: +44 2032 285 040. E-mail address:david.taylor@slam.nhs.uk (D.M. Taylor).
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Abstract

Background

Clinical trial outcomes are heavily influenced by the non-naturalistic clinical trial process. Observations of outcomes in clinical practice are a valuable adjunct to clinical trial results.

Hypothesis

Our null hypothesis was that clinically indicated switching to paliperidone palmitate had no effect on hospital admissions or hospital bed days.

Method

This was a part-prospective mirror image study examining outcomes 2 years before starting paliperidone palmitate and 2 years after. Sensitivity analyses examined the effect of different placings of the mirror in the mirror image design.

Results

We prospectively followed-up 225 patients prescribed paliperidone palmitate in clinical practice. At 2 years, 41.8% of patients were still receiving paliperidone palmitate. In the primary analysis, the mean number of admissions fell from 1.80 in the two years before starting paliperidone palmitate to 0.81 in two years following the drug’s initiation (outpatients) or two years following hospital discharge (inpatients) (P < 0.001). More than half of patients were not admitted to hospital during two years follow-up. Mean total bed days was reduced from 79.6 in the two years before to 46.2 in the two years after paliperidone palmitate initiation or discharge (P < 0.001). Sensitivity analyses gave broadly similar outcomes. Continuers demonstrated better outcomes than discontinuers in sensitivity analyses but not in the primary analysis.

Conclusion

Paliperidone palmitate initiation is associated with a substantial reduction in hospital admissions and days spent in hospital. The reduction in costs associated with reduced use of health care facilities is likely to exceed the purchase and administration costs of the drug.

Keywords

AntipsychoticsLong-acting injectionsPaliperidoneHospital admission
Type
Original article
Information
European Psychiatry , Volume 37 , September 2016 , pp. 43 - 48
Copyright
Copyright © European Psychiatric Association 2016

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References

Taylor, DPsychopharmacology and adverse effects of antipsychotic long-acting injections: a review. Br J Psychiatry 2009; 195(52):S13–S19CrossRefGoogle Scholar
Adams, CEFenton, MKQuraishi, SDavid, ASSystematic meta-review of depot antipsychotic drugs for people with schizophrenia. Br J Psychiatry 2001; 179(4): 290–299CrossRefGoogle ScholarPubMed
Leucht, CHeres, SKane, JMKissling, WDavis, JMLeucht, SOral versus depot antipsychotic drugs for schizophrenia – a critical systematic review and meta-analysis of randomised long-term trials. Schizophr Res 2011; 127(1–3):83–92CrossRefGoogle ScholarPubMed
Zhu, Bscher-Svanum, HShi, LFaries, DMontgomery, WMarder, SRTime to discontinuation of depot and oral first-generation antipsychotics in the usual care of schizophrenia. Psychiatr Serv 2008; 59(3): 315–317CrossRefGoogle ScholarPubMed
Tiihonen, JHaukka, JTaylor, MHaddad, PMPatel, MXKorhonen, PA Nationwide cohort study of oral and depot antipsychotics after first hospitalization for schizophrenia. Am J Psychiatry 2011; 168(6): 603–609CrossRefGoogle Scholar
Denham, JAdamson, LThe contribution of fluphenazine enanthate and decanoate in the prevention of readmission of schizophrenic patients. Acta Psychiatr Scand 1971; 47(4): 420–430CrossRefGoogle ScholarPubMed
Johnson, DAFreeman, HDrug defaulting by patients on long-acting phenothiazines. Psychol Med 1973; 3(1): 115–119CrossRefGoogle ScholarPubMed
Barnes, TRCurson, DALong-term depot antipsychotics. A risk-benefit assessment. Drug Saf 1994; 10(6): 464–479CrossRefGoogle ScholarPubMed
Novick, DHaro, JMPerrin, ESuarez, DTexeira, JMTolerability of outpatient antipsychotic treatment: 36-month results from the European Schizophrenia Outpatient Health Outcomes (SOHO) study. Eur Neuropsychopharmacol 2009; 19(8): 542–550CrossRefGoogle ScholarPubMed
Alphs, LSchooler, NLauriello, JHow study designs influence comparative effectiveness outcomes: the case of oral versus long-acting injectable antipsychotic treatments for schizophrenia. Schizophr Res 2014; 156(2–3):228–232CrossRefGoogle Scholar
Bossie, CAAlphs, LDCorrell, CULong-acting injectable versus daily oral antipsychotic treatment trials in schizophrenia: pragmatic versus explanatory study designs. Int Clin Psychopharmacol 2015; 30(5): 272–281CrossRefGoogle ScholarPubMed
Lieberman, JAMcEvoy, JPSwartz, MSRosenheck, RAPerkins, DOKeefe, RSet al.Effectiveness of antipsychotic drugs in patients with chronic schizophrenia N Engl J Med 2005; 353: 1209–1223CrossRefGoogle ScholarPubMed
Leucht, SCorves, CArbter, DEngel, RRLi, CDavis, JMSecond-generation versus first-generation antipsychotic drugs for schizophrenia: a meta-analysis. Lancet 2009; 373(9657): 31–41CrossRefGoogle ScholarPubMed
Karow, ASchnedler, DNaber, DWhat would the patient choose? Subjective comparison of atypical and typical neuroleptics. Pharmacopsychiatry 2006; 39(2): 47–51CrossRefGoogle ScholarPubMed
Bleakley, SOlofinjana, OTaylor, DWhich antipsychotics would mental health professionals take themselves?. Psychiatr Bull 2007; 31(3): 94–96CrossRefGoogle Scholar
Steinert, TWhich neuroleptic would psychiatrists take for themselves or their relatives?. Eur Psychiatry 2003; 18(1): 40–41CrossRefGoogle ScholarPubMed
Naber, DLambert, MThe CATIE and CUtLASS studies in schizophrenia: results and implications for clinicians. CNS Drugs 2009; 23(8): 649–659Google ScholarPubMed
Jones, PBBarnes, TRDavies, LDunn, GLloyd, HHayhurst, KPet al.Randomized controlled trial of the effect on Quality of Life of second- vs first-generation antipsychotic drugs in schizophrenia: Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS 1) Arch Gen Psychiatry 2006; 63(10): 1079–1087CrossRefGoogle Scholar
Janssen-Cilag Ltd., Summary of Product Characteristics. Risperdal Consta 25 mg powder and solvent for prolonged-release suspension for intramuscular injection. 2015 https://www.medicines.org.uk/emc/medicine/9939Google Scholar
Young, CLTaylor, DMHealth resource utilization associated with switching to risperidone long-acting injection. Acta Psychiatr Scand 2006; 114: 14–20CrossRefGoogle ScholarPubMed
Taylor, DMFischetti, CSparshatt, AThomas, ABishara, DCornelius, VRisperidone long-acting injection: a prospective 3-year analysis of its use in clinical practice. J Clin Psychiatry 2009; 70(2): 196–200CrossRefGoogle ScholarPubMed
Janssen-Cilag Ltd., Summary of Product Characteristics. XEPLION 150 mg prolonged release suspension for injection 2015 https://www.medicines.org.uk/emc/medicine/305892015Google Scholar
Eli Lilly and Company Limited ZYPADHERA 210 mg, 300 mg, and 405 mg, powder and solvent for prolonged release suspension for injection 2015 https://www.medicines.org.uk/emc/medicine/213612015Google Scholar
Otsuka Pharmaceuticals (UK) Ltd Summary of Product Characteristics. Abilify Maintena 400 mg powder and solvent for prolonged-release suspension for injection. 2015 https://www.medicines.org.uk/emc/medicine/284942015Google Scholar
Attard, AOlofinjana, OCornelius, VCurtis, VTaylor, DPaliperidone palmitate long-acting injection – prospective year-long follow-up of use in clinical practice. Acta Psychiatr Scand 2014; 130(1): 46–51CrossRefGoogle ScholarPubMed
Owen, RTPaliperidone palmitate injection: its efficacy, safety and tolerability in schizophrenia. Drugs Today (Barc) 2010; 46(7): 463–471CrossRefGoogle Scholar
Harrison, TSGoa, KLLong-acting risperidone: a review of its use in schizophrenia. CNS Drugs 2004; 18(2): 113–132CrossRefGoogle Scholar
Taylor, DMYoung, CPatel, MXProspective 6-month follow-up of patients prescribed risperidone long-acting injection: factors predicting favourable outcome. Int J Neuropsychopharmacol 2006; 9: 685–694CrossRefGoogle ScholarPubMed
Mohamed, SRosenheck, RHarpaz-Rotem, ILeslie, DSernyak, MJDuration of pharmacotherapy with long-acting injectable risperidone in the treatment of schizophrenia. Psychiatr Q 2009; 80(4): 241–249CrossRefGoogle ScholarPubMed
Bowskill, SVHandley, SAFisher, DSFlanagan, RJPatel, MXRisperidone and total 9-hydroxyrisperidone in relation to prescribed dose and other factors: data from a therapeutic drug monitoring service, 2002–2010. Ther Drug Monit 2012; 34(3): 349–355CrossRefGoogle ScholarPubMed
Niaz, OSHaddad, PMThirty-five months experience of risperidone long-acting injection in a UK psychiatric service including a mirror-image analysis of in-patient care. Acta Psychiatr Scand 2007; 116(1): 36–46CrossRefGoogle Scholar
Taylor, DFischetti, CSparshatt, AThomas, ABishara, DCornelius, VRisperidone long-acting injection: a 6-year mirror-image study of healthcare resource use. Acta Psychiatr Scand 2009; 120(2): 97–101CrossRefGoogle ScholarPubMed
Xiao, YMuser, EFu, DJLafeuille, MHPilon, DEmond, Bet al.Comparison of Medicaid spending in schizoaffective patients treated with once-monthly paliperidone palmitate or oral atypical antipsychotics Curr Med Res Opin 2016; 32(4):759–769CrossRefGoogle ScholarPubMed
Xiao, YMuser, ELafeuille, MHPesa, JFastenau, JDuh, MSet al.Impact of paliperidone palmitate versus oral atypical antipsychotics on healthcare outcomes in schizophrenia patients J Comp Eff Res 2015; 4(6): 579–592CrossRefGoogle ScholarPubMed
Kozma, CMSlaton, TDirani, RFastenau, JGopal, SHough, DChanges in schizophrenia-related hospitalization and ER use among patients receiving paliperidone palmitate: results from a clinical trial with a 52-week open-label extension (OLE). Curr Med Res Opin 2011; 27(8): 1603–1611CrossRefGoogle Scholar
Alphs, LMao, LLynn Starr, HBenson, CA pragmatic analysis comparing once-monthly paliperidone palmitate versus daily oral antipsychotic treatment in patients with schizophrenia Schizophr Res 2015; 170(2-3):259–264CrossRefGoogle ScholarPubMed
Bressington, DStock, JHulbert, SMacInnes, DA retrospective observational study of the effectiveness of paliperidone palmitate on acute inpatient hospitalization rates. Int Clin Psychopharmacol 2015; 30(4): 230–236CrossRefGoogle ScholarPubMed
Enio, SKhan, AFoster, MLAI, paliperidone palmitate (pp) – 1 year mirror image study. Eur Psychiatry 2015; 30(Suppl. 1):382CrossRefGoogle Scholar
British Medical Association, Royal Pharmaceutical Society of Britian>British National Formulary 69th ed.London: BMJ Group and Pharmaceutical Press; 2015British+National+Formulary69th+ed.London:+BMJ+Group+and+Pharmaceutical+Press;+2015>Google Scholar
Personal Social Services Research, Unit Unit Costs of Health and Social Care. 2015 http://www.pssru.ac.uk/project-pages/unit-costs/Google Scholar
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