COMPARISONS OF 30-DAY RE-HOSPITALIZATION RATES IN PATIENTS WITH SCHIZOPHRENIA RECEIVING LONG-ACTING INJECTABLE ANTIPSYCHOTICS DURING HOSPITALIZATION

Author(s)

Greene M1, Yan T2, Stellhorn RA3, Hartry A4, Broder MS2
1Otsuka Pharmaceutical Development & Commercialization Inc., Princeton, NJ, USA, 2Partnership for Health Analytic Research, LLC, Beverly Hills, CA, USA, 3Otsuka Pharmaceutical Development & Commercialization, Inc., Princeton, NJ, USA, 4Lundbeck Pharmaceuticals Services, LLC, Deerfield, IL, USA

OBJECTIVES:  To examine 30-day hospital readmission rates in patients with schizophrenia treated with different long-acting injectable antipsychotics (LAIs) during their index hospitalization. METHODS:  Inpatient claims from Premier Perspective Database™ were used to identify adult patients (age ≥ 18 years) hospitalized with a primary diagnosis of schizophrenia (ICD-9-CM diagnosis code 295.XX) between 01/01/2013 and 06/30/2015 who received an LAI and were discharged home or to a home care program during the first (index) hospitalization. Five mutually exclusive LAI cohorts were included: aripiprazole, fluphenazine, haloperidol, paliperidone, or risperidone. All-cause and psychiatric-related 30-day re-hospitalization rates were calculated across different LAIs. Logistic regression models controlling for patient demographic and clinical characteristics were constructed to estimate associations between different LAIs and 30-day hospital readmissions. RESULTS:  Of the 73,222 hospitalized adult patients with schizophrenia, 15,286 (20.9%) were treated with LAIs: aripiprazole (206), fluphenazine (2,052), haloperidol (7,088), paliperidone (2,767), or risperidone (3,173). Compared with those in other LAI cohorts, patients in the aripiprazole cohort were younger (mean (SD) age: 37.3 (14.4)); a higher percentage of them were white (48.1%) and married (11.2%). The aripiprazole cohort had the lowest Charlson comorbidity score (mean (SD): 0.35 (0.68)), but the highest percentages of depression (12.1%) and anxiety (18.5%). The 30-day readmission rates were lowest in the aripiprazole cohort (all-cause: 9.7%; psychiatric-related: 8.7%), followed by haloperidol (10.0%; 9.5%), paliperidone (10.8%; 10.2%), risperidone (10.9%; 10.5%), and fluphenazine (11.0%; 10.4%). However, the differences were not statistically significant with and without adjusting for patient demographic and clinical characteristics. CONCLUSIONS:  This real-world study is, to our knowledge, the first to examine 30-day re-hospitalization rates among schizophrenia patients treated with different LAIs. Our findings suggest that 30-day re-hospitalization rates were lowest in the aripiprazole cohort but relatively low across the different LAIs.

Conference/Value in Health Info

2017-05, ISPOR 2017, Boston, MA, USA

Value in Health, Vol. 20, No. 5 (May 2017)

Code

PMH56

Topic

Health Service Delivery & Process of Care

Topic Subcategory

Prescribing Behavior

Disease

Mental Health

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