Psychiatric hospitalisation before and after commencing long-acting injectable antipsychotic medication: a mirror-image study.

Abstract

Treatment adherence is an important predictor of outcomes in schizophrenia, related disorders and bipolar disorder, and may be improved by the use of long acting injectable (LAI) antipsychotic medication. Past research on the efficacy of LAIs is mixed with randomised controlled trials showing similar benefits to oral medication, and naturalistic studies showing advantages to LAIs. Psychiatric hospital bed-nights and admissions were compared before and after commencement of an LAI, using a retrospective cohort study with a mirror-image design. Total bed-nights and hospital admissions for each patient were compared for the same time period before and after commencing the LAI. Subgroup analyses were also conducted. Mean bed-nights decreased from 47.1 pre-LAI to 14.3 post-LAI, and median bed-nights from 24.5 to 0.0. Mean hospital admissions decreased from 1.7 pre-LAI to 0.7 post-LAI, and median admissions from 1.0 to 0.0. In our cohort, LAI treatment was associated with a significant reduction in bed-nights and total admissions to psychiatric hospitals. The findings of the current study are consistent with the results of previous naturalistic studies of LAI treatment for patients with psychotic disorders and bipolar disorder.