COMPARISONS OF RE-HOSPITALIZATION RATES IN PATIENTS WITH BIPOLAR DISORDER RECEIVING LONG-ACTING INJECTABLE ANTIPSYCHOTICS DURING HOSPITALIZATION

Author(s)

Greene M1, Yan T2, Stellhorn RA3, Touya M4, 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 LLC, Deerfield, IL, USA

OBJECTIVES:  To examine hospital readmission rates in patients with bipolar disorder (BD) 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 bipolar disorder 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 60-, 90-, and 180-day re-hospitalization rates were calculated across different LAIs. Logistic regression models controlling for patient demographic and clinical characteristics were conducted to estimate associations between different LAIs and hospital readmissions. RESULTS:  Of the hospitalized BD patients, 2,414 were treated with LAIs: aripiprazole (76), fluphenazine (261), haloperidol (839), paliperidone (538), or risperidone (700). Compared with those in other LAI cohorts, patients in the aripiprazole cohort were younger (mean (SD) age: 38.7 (15.3)). The 60-, 90-, and 180-day readmission rates were lowest in the aripiprazole cohort (all-cause 14.5% (60-day), 17.1% (90-day), 23.7% (180-day); psychiatric-related 14.5%, 17.1%, 22.4%), followed by fluphenazine (16.5%, 20.3%, 26.1%; 14.9%, 18.8%, 23.8%), risperidone (17.4%, 20.6%, 28.1%; 16.4%, 19.3%, 26.6%)), paliperidone (17.4%, 21.4%, 27.5%; 16.2%, 19.9%, 25.3%), and haloperidol (18.5%, 20.5%, 25.5%; 18.0%, 19.9%, 24.4%). However, none of these differences were 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 60-, 90-, and 180-day readmission rates among hospitalized BD patients treated with different LAIs. Only a small number of patients received aripiprazole LAI. While there were no statistically significant differences across the various LAIs, the aripiprazole cohort showed lower hospital readmission rates compared to the other cohorts.

Conference/Value in Health Info

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

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

Code

PMH57

Topic

Health Service Delivery & Process of Care

Topic Subcategory

Prescribing Behavior

Disease

Mental Health

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