Thursday, August 15, 2019

LAIs May Lower Rehospitalization Risk in Older Patients With Schizophrenia


Older people with schizophrenia who are treated with long-acting injectable antipsychotics (LAIs) are less likely to be rehospitalized than their peers who are treated with oral antipsychotics, suggests a study in the American Journal of Geriatric Psychiatry.

Ching-Hua Lin, M.D., Ph.D., of the Kaohsiung Municipal Kai-Syuan Psychiatric Hospital in Taiwan and colleagues followed 1,168 patients aged 60 years or older who were discharged from the public psychiatric hospital between 2006 and 2017. The patients had either schizophrenia or schizoaffective disorder, 151 were discharged on LAIs, and 1,017 were discharged on oral antipsychotics. The researchers reviewed rehospitalizations that occurred within a year of discharge for both groups of patients, including those who had exhibited significant psychotic symptoms, dangerous or violent behavior, or a decline in functioning.

Eighty-one patients (53.6%) in the LAIs group and 672 (66.1%) in the oral antipsychotics group were rehospitalized within one year of discharge. Patients in the LAIs group had a significantly longer time to rehospitalization, a median of 257 days compared with a median of 115 days for those in the oral antipsychotics group. When reviewing the patients’ records, the researchers found that shorter hospitalizations and fewer hospitalizations prior to the study were also associated with a longer time between discharge and rehospitalization.

Lin and colleagues noted several limitations to their study, notably that the follow-up was only one year, and longer follow-up may reveal other differences between the two groups. Additionally, all patients were discharged from a single facility in Taiwan, so results may not be generalizable to other facilities and countries.

“In the future, further studies focusing on factors associated with risk of rehospitalization and effective interventions to prevent rehospitalization should be explored,” they wrote.

For related news, see the Psychiatric Services article “Comparison of Injectable and Oral Antipsychotics in Relapse Rates in a Pragmatic 30-Month Schizophrenia Relapse Prevention Study.”

(Image: iStock/Ca-ssis)