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Current Reviews in Clinical and Experimental Pharmacology

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ISSN (Print): 2772-4328
ISSN (Online): 2772-4336

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Research Article

Long-acting Injectable vs. Oral Antipsychotics: Adherence, Persistence and Switching over three Years of Real-life Analysis

Author(s): Alessia Romagnoli*, Fiorenzo Santoleri and Alberto Costantini

Volume 16, Issue 1, 2021

Published on: 09 March, 2020

Page: [109 - 116] Pages: 8

DOI: 10.2174/1574884715666200309121932

Abstract

Background: Persistence and adherence to treatment are considered efficacy outcomes in psychiatric disorders. One of the best ways to improve these values in patients with psychiatric disorders is to prefer Long-Acting Injectable (LAI) drugs to oral AP.

Objective: The objective of this study is to evaluate adherence, persistence and switching of antipsychotics and compare in real life long-acting with oral formulations.

Materials and Methods: This pharmacological, observational, retrospective and non-interventional study involved all patients of the ASL of Pescara treated in the front-line with AP in the period between January 2011 and February 2019. Adherence was measured using the ratio between the received daily dose and prescribed daily dose. Persistence to treatment with antipsychotics was calculated as the daily difference between the beginning and end of treatment.

Results: We examined 840 patients treated with aripiprazole, 130 patients treated with paliperidone and 925 patients treated with risperidone. Adherence was significantly better in long-acting formulations with values of 0.89 (aripiprazole) and 0.82 (paliperidone and risperidone) than in oral formulations with values of 0.78, 0.70 and 0.58, respectively (p> 0.999, p= 0.0091, p=< 0.0001). Threeyear persistence curves relating to three study drugs did not show a statistically significant difference (p = 0.3314). Persistence curves based on formulation have not shown a statistically significant difference (p= 0, 4658, p=0, 4794, p=0, 2199 for ariprazolo, paliperidone and risperidone, respectively). 7% of patients were treated with aripiprazole, 12% of patients were treated with risperidone and 28% of patients were treated with paliperidone switched therapy.

Conclusion: In all the drugs of present study, adherence values were better in LAI than in OA, whereas no statistically significant difference was found in persistence values.

Keywords: Antipsychotics, adherence, persistence, real life, long-acting injectable drugs, oral antipsychotics.

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[1]
Dilsaver SC. An estimate of the minimum economic burden of bipolar I and II disorders in the United States: 2009. J Affect Disord 2011; 129(1-3): 79-83.
[http://dx.doi.org/10.1016/j.jad.2010.08.030] [PMID: 20888048]
[2]
Cloutier M, Aigbogun MS, Guerin A, et al. The economic burden of schizophrenia in the United States in 2013. J Clin Psychiatry 2016; 77(6): 764-71.
[http://dx.doi.org/10.4088/JCP.15m10278] [PMID: 27135986]
[3]
Rascati KL, Richards KM, Ott CA, et al. Adherence, persistence of use, and costs associated with second-generation antipsychotics for bipolar disorder. Psychiatr Serv 2011; 62(9): 1032-40.
[http://dx.doi.org/10.1176/ps.62.9.pss6209_1032] [PMID: 21885581]
[4]
Llorca PM, Abbar M, Courtet P, Guillaume S, Lancrenon S, Samalin L. Guidelines for the use and management of long-acting injectable antipsychotics in serious mental illness. BMC Psychiatry 2013; 13: 340.
[http://dx.doi.org/10.1186/1471-244X-13-340] [PMID: 24359031]
[5]
Markowitz M, Fu DJ, Levitan B, Gopal S, Turkoz I, Alphs L. Long-acting injectable paliperidone palmitate versus oral paliperidone extended release: A comparative analysis from two placebo-controlled relapse prevention studies. Ann Gen Psychiatry 2013; 12(1): 22.
[http://dx.doi.org/10.1186/1744-859X-12-22] [PMID: 23845018]
[6]
Li P, Snyder GL, Vanover KE. Dopamine targeting drugs for the treatment of schizophrenia: Past, present and future. Curr Top Med Chem 2016; 16(29): 3385-403.
[http://dx.doi.org/10.2174/1568026616666160608084834] [PMID: 27291902]
[7]
Ascher-Svanum H, Zhu B, Faries D, Landbloom R, Swartz M, Swanson J. Time to discontinuation of atypical versus typical antipsychotics in the naturalistic treatment of schizophrenia. BMC Psychiatry 2006; 6: 8.
[http://dx.doi.org/10.1186/1471-244X-6-8] [PMID: 16504026]
[8]
Olivares JM, Sermon J, Hemels M, Schreiner A. Definitions and drivers of relapse in patients with schizophrenia: A systematic literature review. Ann Gen Psychiatry 2013; 12(1): 32.
[http://dx.doi.org/10.1186/1744-859X-12-32] [PMID: 24148707]
[9]
Lehman AF, Lieberman JA, Dixon LB, et al. Practice guideline for the treatment of patients with schizophreniaIn: The American journal of psychiatry. 2004; 161: pp. (pp. (2 Suppl))1-56.
[10]
Berk L, Hallam KT, Colom F, et al. Enhancing medication adherence in patients with bipolar disorder. Hum Psychopharmacol 2010; 25(1): 1-16.
[http://dx.doi.org/10.1002/hup.1081] [PMID: 20041478]
[11]
Heres S, Lambert M, Vauth R. Treatment of early episode in patients with schizophrenia: the role of long acting antipsychotics. European psychiatry: The journal of the Association of European Psychiatrists 2014; 29((Suppl 2)): 1409-13.
[http://dx.doi.org/10.1016/S0924-9338(14)70001-X]
[12]
Brissos S, Veguilla MR, Taylor D, Balanzá-Martinez V. The role of long-acting injectable antipsychotics in schizophrenia: A critical appraisal. Ther Adv Psychopharmacol 2014; 4(5): 198-219.
[http://dx.doi.org/10.1177/2045125314540297] [PMID: 25360245]
[13]
Samalin L, Garnier M, Auclair C, Llorca PM. Clinical decision-making in the treatment of schizophrenia: Focus on long-acting Injectable antipsychotics. Int J Mol Sci 2016; 17(11)E1935
[http://dx.doi.org/10.3390/ijms17111935]] [PMID: 27869767]
[14]
Nasrallah HA, Duchesne I, Mehnert A, Janagap C, Eerdekens M. Health-related quality of life in patients with schizophrenia during treatment with long-acting, injectable risperidone. J Clin Psychiatry 2004; 65(4): 531-6.
[http://dx.doi.org/10.4088/JCP.v65n0412] [PMID: 15119916]
[15]
Macfadden W, DeSouza C, Crivera C, et al. Assessment of effectiveness measures in patients with schizophrenia initiated on risperidone long-acting therapy: The SOURCE study results. BMC Psychiatry 2011; 11: 167.
[http://dx.doi.org/10.1186/1471-244X-11-167] [PMID: 21999346]
[16]
Santoleri F, Sorice P, Lasala R, Rizzo RC, Costantini A. Patient adherence and persistence with Imatinib, Nilotinib, Dasatinib in clinical practice. PLoS One 2013; 8(2)e56813
[http://dx.doi.org/10.1371/journal.pone.0056813]] [PMID: 23437249]
[17]
DiMatteo MR. Variations in patients’ adherence to medical recommendations: A quantitative review of 50 years of research. Med Care 2004; 42(3): 200-9.
[http://dx.doi.org/10.1097/01.mlr.0000114908.90348.f9] [PMID: 15076819]
[18]
Kaplan G, Casoy J, Zummo J. Impact of long-acting injectable antipsychotics on medication adherence and clinical, functional, and economic outcomes of schizophrenia. Patient Prefer Adherence 2013; 7: 1171-80.
[http://dx.doi.org/10.2147/PPA.S53795] [PMID: 24265549]
[19]
Hasan A, Falkai P, Wobrock T, et al. World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for biological treatment of schizophrenia, part 1: Update 2012 on the acute treatment of schizophrenia and the management of treatment resistance. The world journal of biological psychiatry: The official journal of the World Federation of Societies of Biological Psychiatry 2012; 13(5): 318-78.
[20]
Hasan A, Falkai P, Wobrock T, et al. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia, part 2: Update 2012 on the long-term treatment of schizophrenia and management of antipsychotic-induced side effects. World J Biol Psychiatry 2013; 14(1): 2-44.
[21]
Weiden P, Rapkin B, Zygmunt A, Mott T, Goldman D, Frances A. Postdischarge medication compliance of inpatients converted from an oral to a depot neuroleptic regimen. Psychiatr Serv 1995; 46(10): 1049-54.
[http://dx.doi.org/10.1176/ps.46.10.1049] [PMID: 8829787]
[22]
Coldham EL, Addington J, Addington D. Medication adherence of individuals with a first episode of psychosis. Acta Psychiatr Scand 2002; 106(4): 286-90.
[http://dx.doi.org/10.1034/j.1600-0447.2002.02437.x] [PMID: 12225495]
[23]
Hill M, Crumlish N, Whitty P, et al. Nonadherence to medication four years after a first episode of psychosis and associated risk factors. Psychiatr Serv 2010; 61(2): 189-92.
[http://dx.doi.org/10.1176/ps.2010.61.2.189] [PMID: 20123826]
[24]
Tiihonen J, Haukka J, Taylor M, Haddad PM, Patel MX, Korhonen P. A nationwide cohort study of oral and depot antipsychotics after first hospitalization for schizophrenia. Am J Psychiatry 2011; 168(6): 603-9.
[http://dx.doi.org/10.1176/appi.ajp.2011.10081224]] [PMID: 21362741]
[25]
Ascher-Svanum H, Zhu B, Faries DE, Furiak NM, Montgomery W. Medication adherence levels and differential use of mental-health services in the treatment of schizophrenia. BMC Res Notes 2009; 2: 6.
[http://dx.doi.org/10.1186/1756-0500-2-6]] [PMID: 19138402]
[26]
De Berardis D, Marini S, Carano A, et al. Efficacy and safety of long acting injectable atypical antipsychotics: A review. Curr Clin Pharmacol 2013; 8(3): 256-64.
[http://dx.doi.org/10.2174/15748847113089990056] [PMID: 23343445]
[27]
Orsolini L, Tomasetti C, Valchera A, et al. An update of safety of clinically used atypical antipsychotics. Expert Opin Drug Saf 2016; 15(10): 1329-47.
[http://dx.doi.org/10.1080/14740338.2016.1201475] [PMID: 27347638]
[28]
Lambert TJ. Practical management of schizophrenia: The role of long-acting Antipsychotics. Int Clin Psychopharmacol 2013.
[http://dx.doi.org/10.1097/YIC.0b013e32835ab399] [PMID: 23680996]
[29]
Greene M, Yan T, Chang E, Hartry A, Touya M, Broder MS. Medication adherence and discontinuation of long-acting injectable versus oral antipsychotics in patients with schizophrenia or bipolar disorder. J Med Econ 2018; 21(2): 127-34.
[http://dx.doi.org/10.1080/13696998.2017.1379412] [PMID: 28895758]
[30]
Patel MX, Haddad PM, Chaudhry IB, McLoughlin S, Husain N, David AS. Psychiatrists’ use, knowledge and attitudes to first- and second-generation antipsychotic long-acting injections: comparisons over 5 years. J Psychopharmacol (Oxford) 2010; 24(10): 1473-82.
[http://dx.doi.org/10.1177/0269881109104882] [PMID: 19477883]
[31]
Bitter I, Katona L, Zambori J, et al. Comparative effectiveness of depot and oral second generation antipsychotic drugs in schizophrenia: A nationwide study in Hungary. Eur Neuropsychopharmacol 2013; 23(11): 1383-90.
[http://dx.doi.org/10.1016/j.euroneuro.2013.02.003]
[32]
Pilon D, Alcusky M, Xiao Y, et al. Adherence, persistence, and inpatient utilization among adult schizophrenia patients using once-monthly versus twice-monthly long-acting atypical antipsychotics. J Med Econ 2018; 21(2): 135-43.
[http://dx.doi.org/10.1080/13696998.2017.1379413] [PMID: 28895766]
[33]
Song X, El Khoury AC, Brouillette M, Smith D, Joshi K. Treatment discontinuation of long-acting injectables or oral atypical antipsychotics among Medicaid recipients with schizophrenia. J Med Econ 2019; 22(11): 1105-12.
[http://dx.doi.org/10.1080/13696998.2019.1615927] [PMID: 31062998]
[34]
Zhu B, Ascher-Svanum H, Shi L, Faries D, Montgomery W, Marder SR. Time to discontinuation of depot and oral first-generation antipsychotics in the usual care of schizophrenia. Psychiatr Serv 2008; 59(3): 315-7.
[http://dx.doi.org/10.1176/ps.2008.59.3.315] [PMID: 18308914]
[35]
Patel MX, Taylor M, David AS. Antipsychotic long-acting injections: mind the gap. Br J Psychiatry Suppl 2009; 52: S1-4.
[http://dx.doi.org/10.1192/bjp.195.52.s1] [PMID: 19880911]
[36]
Robinson DG, Gallego JA, John M, et al. A Randomized comparison of aripiprazole and risperidone for the acute treatment of first-episode schizophrenia and related disorders: 3-month outcomes. Schizophr Bull 2015; 41(6): 1227-36.
[http://dx.doi.org/10.1093/schbul/sbv125] [PMID: 26338693]
[37]
Pozzi M, Pisano S, Bertella S, et al. Persistence in therapy with risperidone and aripiprazole in pediatric outpatients: A 2-year naturalistic comparison. J Clin Psychiatry 2016; 77(12): e1601-9.
[http://dx.doi.org/10.4088/JCP.15m10247] [PMID: 27780333]
[38]
Roussidis A, Kalkavoura C, Dimelis D, et al. Reasons and clinical outcomes of antipsychotic treatment switch in outpatients with schizophrenia in real-life clinical settings: the ETOS observational study. Ann Gen Psychiatry 2013; 12(1): 42.
[http://dx.doi.org/10.1186/1744-859X-12-42] [PMID: 24359635]
[39]
Fagiolini A, Brugnoli R, Di Sciascio G, De Filippis S, Maina G. Switching antipsychotic medication to aripiprazole: Position paper by a panel of Italian psychiatrists. Expert Opin Pharmacother 2015; 16(5): 727-37.
[http://dx.doi.org/10.1517/14656566.2015.1013029]] [PMID: 25672664]

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