Impact of long-acting injectable antipsychotics vs. oral medication on relapses of patients with psychosis and bipolar disorder

Psychiatry Res. 2024 Feb:332:115676. doi: 10.1016/j.psychres.2023.115676. Epub 2023 Dec 24.

Abstract

Relapse associated with multiple hospital readmissions of patients with chronic and severe mental disorders, such as psychosis and bipolar disorder, is frequently associated with non-adherence to treatment. The primary aim of the study was to compare the effectiveness of long-acting injectable (LAI) treatment, vs. oral medication in reducing readmissions of patients with psychotic or bipolar disorder in a community sample of 164 patients with psychosis and 29 patients with bipolar disorder (n = 193), with poor adherence to oral medication. The mean follow up period was 5.6 years and the number of readmissions were compared for an equal-length period of oral treatment preceding the onset of LAI administration. We observed a significant decrease of 45.2 % in total hospital readmissions after receiving LAIs treatment. The effect was significant both for patients with a pre-LAI treatment history of predominantly voluntary hospitalizations and with predominantly involuntary admissions. In addition, we observed equal effectiveness of first- vs. second-generation LAIs in reducing total hospital readmissions regardless of type of pre-treatment admission history (voluntary vs. involuntary). LAIs appear to be effective in reducing both voluntary and involuntary hospital readmissions in patients with psychosis and bipolar disorder with a history of poor adherence to treatment.

Keywords: Adherence; First-generation LAIs; Hospital admissions; Involuntary admissions; Second-generation LAIs; Voluntary admissions.

MeSH terms

  • Administration, Oral
  • Antipsychotic Agents* / adverse effects
  • Bipolar Disorder* / chemically induced
  • Bipolar Disorder* / drug therapy
  • Delayed-Action Preparations / therapeutic use
  • Humans
  • Medication Adherence
  • Psychotic Disorders* / drug therapy
  • Recurrence
  • Schizophrenia* / drug therapy

Substances

  • Antipsychotic Agents
  • Delayed-Action Preparations