Assessment of oral overlap with antipsychotic long-acting injectables initiated in an inpatient setting
Introduction Long-acting injectable (LAI) antipsychotics are a promising solution to combating issues related to nonadherence to oral antipsychotics. Oral overlap is utilized when an LAI is initiated to achieve therapeutic concentrations. The place in therapy in which additional overlap is warranted...
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| Format: | Article |
| Language: | English |
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American Association of Psychiatric Pharmacists
2023-06-01
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| Series: | Mental Health Clinician |
| Subjects: | |
| Online Access: | https://theijpt.org/doi/pdf/10.9740/mhc.2023.06.147 |
| _version_ | 1797383316368785408 |
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| author | Tran Jennifer T. PharmD Binger Katie J. PharmD, BCPP Miles Talia M. PharmD, BCPS, BCPP |
| author_facet | Tran Jennifer T. PharmD Binger Katie J. PharmD, BCPP Miles Talia M. PharmD, BCPS, BCPP |
| author_sort | Tran Jennifer T. PharmD |
| collection | DOAJ |
| description | Introduction
Long-acting injectable (LAI) antipsychotics are a promising solution to combating issues related to nonadherence to oral antipsychotics. Oral overlap is utilized when an LAI is initiated to achieve therapeutic concentrations. The place in therapy in which additional overlap is warranted is often mistaken, and providers may prescribe additional overlap based on the presentation of the patient or misunderstanding of appropriate overlap.
Methods
This retrospective chart review assesses patients who were initiated on an LAI while admitted to the acute inpatient psychiatric unit from January 1, 2016, to December 31, 2019. The primary outcome assesses the appropriateness of oral overlap with LAIs. Secondary outcomes include adherence to oral overlap, discontinuation of an LAI within 4 months, and reason for discontinuation of LAI.
Results
A total of 62 patients were included: 40 (65%) had appropriate overlap, and 22 (35%) had inappropriate overlap. The most common LAI was paliperidone (n = 50, 81%). Patients were adherent to oral overlap in 67% (n = 6) of the appropriate overlap group and 85% (n = 17) of the inappropriate overlap group. Discontinuation of an LAI in 4 months occurred in 62.5% (n = 25) of the appropriate group and 40.9% (n = 9) of the inappropriate group. There were no significant differences in secondary outcomes when comparing adherence to oral overlap (p = .26), discontinuation of LAI within 4 months (p = .62), and reason for discontinuation (p = .69).
Discussion
This study identified that a majority of patients had appropriate prescribing of oral antipsychotic overlap. |
| first_indexed | 2024-03-08T21:18:16Z |
| format | Article |
| id | doaj.art-4ea0db63b6bc4cf193b4e396d887104e |
| institution | Directory Open Access Journal |
| issn | 2168-9709 |
| language | English |
| last_indexed | 2024-03-08T21:18:16Z |
| publishDate | 2023-06-01 |
| publisher | American Association of Psychiatric Pharmacists |
| record_format | Article |
| series | Mental Health Clinician |
| spelling | doaj.art-4ea0db63b6bc4cf193b4e396d887104e2023-12-21T12:17:09ZengAmerican Association of Psychiatric PharmacistsMental Health Clinician2168-97092023-06-0113314715110.9740/mhc.2023.06.147i2168-9709-13-3-147Assessment of oral overlap with antipsychotic long-acting injectables initiated in an inpatient settingTran Jennifer T. PharmD0https://orcid.org/0000-0001-7421-7219Binger Katie J. PharmD, BCPP1https://orcid.org/0000-0002-2031-5646Miles Talia M. PharmD, BCPS, BCPP2https://orcid.org/0000-0003-0022-05911 PGY2 Psychiatric Pharmacy Resident, Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana2 Clinical Pharmacy Specialist – Mental Health, Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana3 Clinical Pharmacy Specialist – Mental Health, Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, IndianaIntroduction Long-acting injectable (LAI) antipsychotics are a promising solution to combating issues related to nonadherence to oral antipsychotics. Oral overlap is utilized when an LAI is initiated to achieve therapeutic concentrations. The place in therapy in which additional overlap is warranted is often mistaken, and providers may prescribe additional overlap based on the presentation of the patient or misunderstanding of appropriate overlap. Methods This retrospective chart review assesses patients who were initiated on an LAI while admitted to the acute inpatient psychiatric unit from January 1, 2016, to December 31, 2019. The primary outcome assesses the appropriateness of oral overlap with LAIs. Secondary outcomes include adherence to oral overlap, discontinuation of an LAI within 4 months, and reason for discontinuation of LAI. Results A total of 62 patients were included: 40 (65%) had appropriate overlap, and 22 (35%) had inappropriate overlap. The most common LAI was paliperidone (n = 50, 81%). Patients were adherent to oral overlap in 67% (n = 6) of the appropriate overlap group and 85% (n = 17) of the inappropriate overlap group. Discontinuation of an LAI in 4 months occurred in 62.5% (n = 25) of the appropriate group and 40.9% (n = 9) of the inappropriate group. There were no significant differences in secondary outcomes when comparing adherence to oral overlap (p = .26), discontinuation of LAI within 4 months (p = .62), and reason for discontinuation (p = .69). Discussion This study identified that a majority of patients had appropriate prescribing of oral antipsychotic overlap.https://theijpt.org/doi/pdf/10.9740/mhc.2023.06.147veteranstransitions of carelong-acting injectableoral overlap |
| spellingShingle | Tran Jennifer T. PharmD Binger Katie J. PharmD, BCPP Miles Talia M. PharmD, BCPS, BCPP Assessment of oral overlap with antipsychotic long-acting injectables initiated in an inpatient setting Mental Health Clinician veterans transitions of care long-acting injectable oral overlap |
| title | Assessment of oral overlap with antipsychotic long-acting injectables initiated in an inpatient setting |
| title_full | Assessment of oral overlap with antipsychotic long-acting injectables initiated in an inpatient setting |
| title_fullStr | Assessment of oral overlap with antipsychotic long-acting injectables initiated in an inpatient setting |
| title_full_unstemmed | Assessment of oral overlap with antipsychotic long-acting injectables initiated in an inpatient setting |
| title_short | Assessment of oral overlap with antipsychotic long-acting injectables initiated in an inpatient setting |
| title_sort | assessment of oral overlap with antipsychotic long acting injectables initiated in an inpatient setting |
| topic | veterans transitions of care long-acting injectable oral overlap |
| url | https://theijpt.org/doi/pdf/10.9740/mhc.2023.06.147 |
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