Predictor of discontinuation with paliperidone palmitate in patients with schizophrenia

Abstract

Objective To explore the influence of demographic characteristics, psychiatric symptoms and medication on the adherence of long-acting injectable paliperidone palmitate (PP) treatment in schizophrenia patients. Methods In this one year, naturalistic longitudinal study, 156 consecutive patients with schizophrenia were initiated with PP from June 2012 to October 2013, discontinuation of PP was deemed as event during one year observational period. Cox's proportional hazards regression model (Cox regression) was used to identify independent predictors of treatment discontinuation and calculate the Hazard Ratio (HR) of main effect factors. Results Of 156 patients with schizophrenia, most patients (n= 100, 64.1%) continued with PP for one year, 49 patients discontinue PP and 7 patients were loss to follow up. Cox regression results showed that female (HR=2.639, P=0.002), high dose of the third injection (HR= 1.031, P<0.01), PANSS reduction in acute phase (HR=0.957, P=0.012) and propranolol (HR=0.180, P= 0.002) were the predictors of PP discontinuation. Conclusion Gender, the third injection dose, PANSS reduction in acute phase and akathisia may be the main factors to discontinuation of PP treatment. Key words: Schizophrenia; Medication adherence; Paliperidone palmitate; Long-acting injections; Antipsychotic discontinuation