Tuesday, December 10, 2019

Older Schizophrenia Patients Found Less Likely to Be Rehospitalized With LAI Antipsychotics

Individuals over age 60 with schizophrenia who were prescribed long-acting injectable (LAI) antipsychotics after being discharged from a hospital were significantly less likely to be rehospitalized within a year than those receiving oral antipsychotics, according to a report in The American Journal of Geriatric Psychiatry. Also, patients who did need to be admitted again had a longer time to rehospitalization.

LAI antipsychotics have been shown to improve adherence to medication in younger populations, which in turn improves overall outcomes. Yet evidence in older populations is lacking.

Risk factors for nonadherence in elderly patients with schizophrenia include psychosis, limited insight, adverse reactions, and stigma, wrote Ching-Hua Lin, M.D., Ph.D., of the Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Taiwan, and colleagues. These may be compounded by age-related factors, such as cognitive deficits that make it difficult to follow dosing instructions, or other medical problems.

The researchers analyzed data on 1,168 patients over age 60 with schizophrenia or schizoaffective disorder who were discharged between January 1, 2006, and December 31, 2017. Of these, 151 (12.9%) received LAI antipsychotic medication, and 1,017 (87 percent) received oral antipsychotic medication.

Eighty-one patients (53.6%) in the LAI group were rehospitalized within one year of discharge compared with 672 (66.1%) in the oral antipsychotic group, a statistically significant difference. The median time to rehospitalization for LAI patients was 257 days compared with 115 days for patients receiving oral antipsychotics.

Despite the positive results for LAIs compared with oral antipsychotics, the 53.6% rehospitalization rate remains frustratingly high. “In the future, further studies focusing on factors associated with risk of rehospitalization and effective interventions to prevent rehospitalization should be explored,” the researchers wrote.

For related information, see the Psychiatric News article “Clozapine, LAI Antipsychotics Found Best at Preventing Relapse.”

(Image: SDI productions/istock.com)

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