Improving the "real life" management of schizophrenia spectrum disorders by LAI antipsychotics: A one-year mirror-image retrospective study in community mental health services.

Valeria Latorre,Apostolos Papazacharias,Maria Lorusso,Paola Clemente,Domenico Semisa,Antonia Spinelli,Michele Gattullo,Gaetano Nappi,Giovanni Carrieri,Antonio Emmanuele Uva,Enrico D’Ambrosio,Kevin Lu

doi:10.1371/journal.pone.0230051

Valeria Latorre, Apostolos Papazacharias + Show 10 more

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https://doi.org/10.1371/journal.pone.0230051

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Abstract

Schizophrenia poses a significant economic burden on the healthcare system as well as it has a significant impact on society at large. Reasons for such a high economic burden of schizophrenia include the frequent relapses and hospitalizations occurring in this disorder. We analyze the effectiveness of long-acting injectable antipsychotics (LAIs) compared to oral medications, in terms of "clinical process management" in a sample of patients with a diagnosis of schizophrenia spectrum disorder treated in community mental health centers. An observational, retrospective, mirror-image study was carried out to evaluate the effectiveness of LAIs compared to oral medications in terms of number of hospitalizations, emergency visits and planned visits on a 10-year period (from July 2007 to June 2017). Differences between first and second generation LAIs were also explored. Our findings show that hospitalization and emergency visits are significantly decreased with the use of LAIs, while planned visits are increased in patients treated with LAIs. Our results suggest that LAIs, in particular, second generation ones, reduce hospitalization rates and emergency visits, improving the economic burden of schizophrenia. Therefore, LAIs should be considered a cost-effective treatment in the management of schizophrenia under routine conditions.

Highlights

Schizophrenia is a severe, chronic, often recurring mental disorder affecting 1% of the general population, and it is associated with a relevant long-term impact on patients’ social and occupational functioning
long-acting injectable antipsychotics (LAIs) generation seems to have an effect on hospitalization rates, emergency rates, and total number of emergency visits; it has a lower effect on total number of Characteristics Gender, n (%) Male Female Age, mean ±SD Years Educational level, mean ±SD Years of scholarization Diagnosis, n (%) Schizophrenia Schizoaffective disorder Other schizophrenia spectrum Illness duration, mean ±SD Years
We considered the number of hospitalizations, the number of emergency and planned visits one year before and after the change from oral to LAI antipsychotics

Summary

Introduction

Schizophrenia is a severe, chronic, often recurring mental disorder affecting 1% of the general population, and it is associated with a relevant long-term impact on patients’ social and occupational functioning. It is treated with a combination of medical, psychological and psychosocial interventions, with varying degrees of success. Improving the “real life” management of schizophrenia spectrum disorders by LAI antipsychotics

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