Comparing Compliance By Race and Ethnicity for Schizophrenia Patients on Oral or Long-Acting Injectable Antipsychotics

OBJECTIVES: The most common treatments for schizophrenia are oral antipsychotics (OAs) and long-acting injectable antipsychotics (LAIAs). Existing research has analyzed antipsychotic compliance and racial discrepancies in prescribing patterns but not racial discrepancies in compliance. The research presented in this abstract aims to analyze the compliance of OAs and LAIAs in schizophrenia patients, broken down by their race/ethnicity.

METHODS: Patients with at least 3 schizophrenia diagnoses between 1/1/2019-12/31/2022 and received OAs or LAIAs within 30 days after a schizophrenia diagnosis using the Komodo Research Dataset were included. Patients using both OAs and LAIAs were excluded. For continuously enrolled patients, adherence and persistence were calculated for 6 months, 1 year, 2 years, and 4 years after initial treatment. Adherence was defined as proportion of days covered (PDC) > 0.8 and persistence was defined as having no gaps greater than 90 days between prescription refills.

RESULTS: The study included 20,939 LAIA users and 194,678 OA users. For 1-year adherence, compared to the overall population (LAIAs/OAs: 51.9%/49.2%), higher adherence was seen in 'Non-Hispanic White' (54.8%/53.6%), 'Asian or Pacific Islander' (57.0%/55.3%), and 'Hispanic or Latino' (53.0%/49.7%), while lower adherence was observed in 'Black or African American' (49.7%/42.4%) and 'Others' (50.5%/47.2%). These trends held for persistence and adherence for other observation windows, except for 6-month persistence.

CONCLUSIONS: This research has shown that compliance to LAIAs and OAs varies by patients’ race and ethnicity, with ‘Non-Hispanic White’, ‘Asian or Pacific Islander’, and ‘Hispanic or Latino’ patients having mostly above-average outcomes and ‘Black or African American’ and ‘Other’ patients having mostly below-average outcomes. This suggests that there is a racial disparity in schizophrenia treatment that should be further studied in order to work towards improving health outcomes.