Individuals with schizophrenia who began treatment with clozapine significantly increased their use of community-based services and decreased their use of psychiatric inpatient services over the next six months, according to a report in Psychiatric Services in Advance.
“Entering community-based care is a major goal in the recovery and optimization of longitudinal outcomes of individuals with schizophrenia,” wrote Deepak Sarpal, M.D., of the University of Pittsburgh and colleagues. “Our results suggest that clozapine treatment shifts resources from costly inpatient care to services focused on community-based care and long-term recovery, regardless of the patient’s age, gender, or race.”
Sarpal and colleagues examined data from the Allegheny County Data Warehouse of Southwestern Pennsylvania, which includes information on the utilization of more than 20 Medicaid- and county-funded behavioral public benefit programs; these programs include treatment for mental substance use disorders, community services such as residential housing programs, and forensic services such as involuntary commitment. The researchers identified 163 adults (aged 18 to 65) with schizophrenia or schizoaffective disorder who received their first clozapine prescription between 2009 and 2016 and took the medication regularly for six months.
Among these individuals, only 20 required inpatient hospitalization over six months of treatment, compared with 92 who required hospitalization in the six months prior to starting clozapine. Meanwhile, 79 of the 163 adults made use of community-based services following clozapine initiation, compared with just 35 who used these services in the previous six months. The researchers found no significant differences in the use of outpatient psychiatric care or need for forensic services before or after clozapine initiation.
“From the standpoint of high-value care, we believe our findings support the expansion of efforts by Medicaid managed care organizations to promote clozapine utilization for optimal and efficient long-term care,” Sarpal and colleagues concluded.
To read more on this topic, see the Psychiatric News article “Real-World Data Show Patients With Schizophrenia Adhere Better to Clozapine and LAIs.”
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