Effectiveness of injectable risperidone long-acting therapy for schizophrenia: data from the US, Spain, Australia, and Belgium
Open Access
- 4 April 2011
- journal article
- Published by Springer Science and Business Media LLC in Annals of General Psychiatry
- Vol. 10 (1), 10
- https://doi.org/10.1186/1744-859x-10-10
Abstract
Because wide variations in mental health care utilization exist throughout the world, determining long-term effectiveness of psychotropic medications in a real-world setting would be beneficial to physicians and patients. The purpose of this analysis was to describe the effectiveness of injectable risperidone long-acting therapy (RLAT) for schizophrenia across countries. This was a pragmatic analysis of data from two prospective observational studies conducted in the US (Schizophrenia Outcomes Utilization Relapse and Clinical Evaluation [SOURCE]; ClinicalTrials.gov registration number for the SOURCE study: NCT00246194) and Spain, Australia, and Belgium (electronic Schizophrenia Treatment Adherence Registry [eSTAR]). Two separate analyses were performed to assess clinical improvement during the study and estimate psychiatric hospitalization rates before and after RLAT initiation. Clinical improvement was evaluated using the Clinical Global Impressions-Severity (CGI-S) and Global Assessment of Functioning (GAF) scales, and change from baseline was evaluated using paired t tests. Psychiatric hospitalization rates were analyzed using incidence densities, and the bootstrap resampling method was used to examine differences between the pre-baseline and post-baseline periods. The initial sample comprised 3,069 patients (US, n = 532; Spain, n = 1,345; Australia, n = 784; and Belgium, n = 408). In all, 24 months of study participation, completed by 39.3% (n = 209), 62.7% (n = 843), 45.8% (n = 359), and 64.2% (n = 262) of patients from the US, Spain, Australia, and Belgium, respectively, were included in the clinical analysis. Improvements compared with baseline were observed on both clinical assessments across countries (P < 0.001 at all post-baseline visits). The mean improvement was approximately 1 point on the CGI-S and 15 points on the GAF. A total of 435 (81.8%), 1,339 (99.6%), 734 (93.6%), and 393 (96.3%) patients from the US, Spain, Australia, and Belgium, respectively, had ≥1 post-baseline visit and were included in the analysis of psychiatric hospitalization rates. Hospitalization rates decreased significantly in all countries regardless of hospitalization status at RLAT initiation (P < 0.0001) and decreased significantly in the US and Spain (P < 0.0001) when the analysis was limited to outpatients only. RLAT in patients with schizophrenia was associated with improvements in clinical and functional outcomes and decreased hospitalization rates in the US, Spain, Australia, and Belgium, despite differences in health care delivery systems.Keywords
This publication has 26 references indexed in Scilit:
- Costs of treating patients with schizophrenia who have illness-related crisis eventsBMC Psychiatry, 2008
- Switching to Long-Acting Injectable Risperidone is Beneficial with Regard to Clinical Outcomes, Regardless of Previous Conventional Medication in Patients with SchizophreniaPharmacopsychiatry, 2007
- Thirty‐five months experience of risperidone long‐acting injection in a UK psychiatric service including a mirror‐image analysis of in‐patient careActa Psychiatrica Scandinavica, 2007
- A prospective, multicenter, randomized, parallel-group, open-label study of aripiprazole in the management of patients with schizophrenia or schizoaffective disorder in general psychiatric practice: Broad Effectiveness Trial With Aripiprazole (BETA)Schizophrenia Research, 2006
- Efficacy and safety of direct transition to risperidone long-acting injectable in patients treated with various antipsychotic therapiesInternational Clinical Psychopharmacology, 2005
- Early Clinical Experience With Risperidone Long-Acting InjectionPublished by Physicians Postgraduate Press, Inc ,2004
- Partial Compliance and Risk of Rehospitalization Among California Medicaid Patients With SchizophreniaPsychiatric Services, 2004
- Adherence to Treatment With Antipsychotic Medication and Health Care Costs Among Medicaid Beneficiaries With SchizophreniaAmerican Journal of Psychiatry, 2004
- Treatment of Schizophrenia With Long-Acting Injectable RisperidonePublished by Physicians Postgraduate Press, Inc ,2003
- Prevalence of and Risk Factors for Medication Nonadherence in Patients With SchizophreniaBritish Journal of Psychology, 2002