People with schizophrenia who take long-acting injectable antipsychotics (LAIs) have a lower risk of disease relapse, health care use, and adverse events such as suicide attempts compared with those who take oral antipsychotics, a study in JAMA Network Open has found.
Yue Wei, M.P.H., of the University of Hong Kong and colleagues examined data from the electronic health records of 70,396 adults with schizophrenia who were prescribed at least one LAI and at least one oral antipsychotic between 2004 and 2019. They then compared the rates of different health outcomes during periods when patients were taking only LAIs with the periods when patients were taking only oral antipsychotics.
Compared with treatment with oral antipsychotics, treatment with LAIs was associated with 44% fewer suicide attempts, 37% fewer all-cause hospitalizations, and 48% fewer psychiatric hospitalizations for psychiatric disorders. LAIs were also associated with a 12% reduction in hospitalizations for cardiovascular diseases and a 14% reduction in extrapyramidal symptoms (such as an inability to sit still, involuntary muscle contraction, tremors, stiff muscles, and involuntary facial movements), suggesting LAIs were not associated with more adverse side effects than oral medications. There were no significant differences between LAIs and oral antipsychotics with respect to emergency department visits.
Wei and colleagues wrote that their results build upon those found in other studies.
“Our study adds further insights, as we investigated hospitalizations for different causes and safety outcomes, with findings that [LAIs] were associated with not only fewer disease relapses and less health care use, but also fewer adverse events,” they wrote. “It is worth investigating the medication preference and clinical outcomes of people treated with [LAIs] by performing multinational studies.”
For more information, see the American Journal of Psychiatry article “Maintenance Treatment With Long-Acting Injectable Antipsychotics for People With Nonaffective Psychoses: A Network Meta-Analysis.”
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Be Careful When Entering Arrangements With Purported Telemedicine Companies, HHS Warns
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) has issued a special alert warning physicians and other health care professionals of the fraud and abuse risks associated with arrangements with telemedicine companies.
“OIG has conducted dozens of investigations of fraud schemes involving companies that purported to provide telehealth, telemedicine, or telemarketing services,” according to the alert. In some cases, telemedicine companies paid kickbacks to physicians sometimes described as payment per review, audit, consult, or assessment of medical charts,” OIG wrote. “OIG is aware that many practitioners have appropriately used telehealth services during the current public health emergency to provide medically necessary care to their patients,” the alert continued. However, OIG encourages physicians and other health care professionals to use heighten scrutiny before entering into arrangements with telemedicine companies. The alert outlines seven “suspect characteristics” that could suggest an arrangement that presents a heightened risk of fraud and abuse.
The full alert from OIG is available here. For more information about telepsychiatry, check out APA’s Telepsychiatry Toolkit.