The Use of Long-Acting Injectable Antipsychotic Therapy for Schizophrenia
Introduction Antipsychotic medications form the cornerstone of schizophrenia treatment. However, only a minority of patients adhere to their initial antipsychotic regimen. It’s expected that Long-Acting Injectable (LAI) antipsychotics improves patient adherence to treatment, however previous researc...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Swansea University
2018-09-01
|
| Series: | International Journal of Population Data Science |
| Online Access: | https://ijpds.org/article/view/957 |
| _version_ | 1797428692643741696 |
|---|---|
| author | Jason Jiang Jeff Bakal Pierre Chue Mark Snaterse Liana Urichuk Serdar Dursun Christopher McCabe Finlay McAlister Deborah James Lawrence Richer |
| author_facet | Jason Jiang Jeff Bakal Pierre Chue Mark Snaterse Liana Urichuk Serdar Dursun Christopher McCabe Finlay McAlister Deborah James Lawrence Richer |
| author_sort | Jason Jiang |
| collection | DOAJ |
| description | Introduction
Antipsychotic medications form the cornerstone of schizophrenia treatment. However, only a minority of patients adhere to their initial antipsychotic regimen. It’s expected that Long-Acting Injectable (LAI) antipsychotics improves patient adherence to treatment, however previous research comparing the use of first generation LAI’s against oral antipsychotics reported results that were inconclusive.
Objectives and Approach
Explore the effectiveness of the use of LAI’s in the delivery of mental health services in Alberta.
Using linked data from AHS Analytics:
• Physician claims
• National Ambulatory Care Reporting System (NACRS),
• Discharge Abstract database (DAD)
• Pharmacy Information Network (PIN)
• Alberta Provincial Registry data
• Define a cohort of patients on antipsychotic medications.
• Explore and contrast outcomes related to the use of LAIs against other antipsychotic medication types. Specifically using linked data to define:
• Treatment Adherence
• Utilization of LAI vs. other medication
• Demographic differences
• Outcomes pre- and post-LAI treatment
Results
A patient cohort was established containing only cases from April 1, 2013 to March 31, 2015. Additional data was used to perform a two year washout and a one year follow-up.
Case and medication definitions were determined by a team of psychiatric clinicians. Patient comorbidity information was extracted using previously validated methods.
Overall, 6349 incident cases were identified.
Preliminary analysis indicate:
• Overall patient cohort is older than expected
• Use of additional medication types is correlated with greater health services utilization after diagnosis
• Patients on only oral medications appear to have lower treatment adherence
• Males seem to have higher treatment adherence than females
• No significant differences were found between patients with rural vs. urban postal codes
Conclusion/Implications
We faced significant challenges when defining cases, medication use and outcomes. However, the linkage of a large number of data sources gives us powerful and multi-faceted insight into the use of antipsychotic medication use in Alberta. Future work will include work on definition validations and deeper analysis of outcomes. |
| first_indexed | 2024-03-09T09:02:33Z |
| format | Article |
| id | doaj.art-cccde8d42bf04241bad68fe175d96ecf |
| institution | Directory Open Access Journal |
| issn | 2399-4908 |
| language | English |
| last_indexed | 2024-03-09T09:02:33Z |
| publishDate | 2018-09-01 |
| publisher | Swansea University |
| record_format | Article |
| series | International Journal of Population Data Science |
| spelling | doaj.art-cccde8d42bf04241bad68fe175d96ecf2023-12-02T11:17:03ZengSwansea UniversityInternational Journal of Population Data Science2399-49082018-09-013410.23889/ijpds.v3i4.957957The Use of Long-Acting Injectable Antipsychotic Therapy for SchizophreniaJason Jiang0Jeff Bakal1Pierre Chue2Mark Snaterse3Liana Urichuk4Serdar Dursun5Christopher McCabe6Finlay McAlister7Deborah James8Lawrence Richer9Alberta Health ServicesUniversity of Alberta / Alberta Health ServicesUniversity of AlbertaAlberta Health ServicesAlberta Health ServicesUniversity of AlbertaUniversity of AlbertaUniversity of AlbertaUniversity of AlbertaUniversity of AlbertaIntroduction Antipsychotic medications form the cornerstone of schizophrenia treatment. However, only a minority of patients adhere to their initial antipsychotic regimen. It’s expected that Long-Acting Injectable (LAI) antipsychotics improves patient adherence to treatment, however previous research comparing the use of first generation LAI’s against oral antipsychotics reported results that were inconclusive. Objectives and Approach Explore the effectiveness of the use of LAI’s in the delivery of mental health services in Alberta. Using linked data from AHS Analytics: • Physician claims • National Ambulatory Care Reporting System (NACRS), • Discharge Abstract database (DAD) • Pharmacy Information Network (PIN) • Alberta Provincial Registry data • Define a cohort of patients on antipsychotic medications. • Explore and contrast outcomes related to the use of LAIs against other antipsychotic medication types. Specifically using linked data to define: • Treatment Adherence • Utilization of LAI vs. other medication • Demographic differences • Outcomes pre- and post-LAI treatment Results A patient cohort was established containing only cases from April 1, 2013 to March 31, 2015. Additional data was used to perform a two year washout and a one year follow-up. Case and medication definitions were determined by a team of psychiatric clinicians. Patient comorbidity information was extracted using previously validated methods. Overall, 6349 incident cases were identified. Preliminary analysis indicate: • Overall patient cohort is older than expected • Use of additional medication types is correlated with greater health services utilization after diagnosis • Patients on only oral medications appear to have lower treatment adherence • Males seem to have higher treatment adherence than females • No significant differences were found between patients with rural vs. urban postal codes Conclusion/Implications We faced significant challenges when defining cases, medication use and outcomes. However, the linkage of a large number of data sources gives us powerful and multi-faceted insight into the use of antipsychotic medication use in Alberta. Future work will include work on definition validations and deeper analysis of outcomes.https://ijpds.org/article/view/957 |
| spellingShingle | Jason Jiang Jeff Bakal Pierre Chue Mark Snaterse Liana Urichuk Serdar Dursun Christopher McCabe Finlay McAlister Deborah James Lawrence Richer The Use of Long-Acting Injectable Antipsychotic Therapy for Schizophrenia International Journal of Population Data Science |
| title | The Use of Long-Acting Injectable Antipsychotic Therapy for Schizophrenia |
| title_full | The Use of Long-Acting Injectable Antipsychotic Therapy for Schizophrenia |
| title_fullStr | The Use of Long-Acting Injectable Antipsychotic Therapy for Schizophrenia |
| title_full_unstemmed | The Use of Long-Acting Injectable Antipsychotic Therapy for Schizophrenia |
| title_short | The Use of Long-Acting Injectable Antipsychotic Therapy for Schizophrenia |
| title_sort | use of long acting injectable antipsychotic therapy for schizophrenia |
| url | https://ijpds.org/article/view/957 |
| work_keys_str_mv | AT jasonjiang theuseoflongactinginjectableantipsychotictherapyforschizophrenia AT jeffbakal theuseoflongactinginjectableantipsychotictherapyforschizophrenia AT pierrechue theuseoflongactinginjectableantipsychotictherapyforschizophrenia AT marksnaterse theuseoflongactinginjectableantipsychotictherapyforschizophrenia AT lianaurichuk theuseoflongactinginjectableantipsychotictherapyforschizophrenia AT serdardursun theuseoflongactinginjectableantipsychotictherapyforschizophrenia AT christophermccabe theuseoflongactinginjectableantipsychotictherapyforschizophrenia AT finlaymcalister theuseoflongactinginjectableantipsychotictherapyforschizophrenia AT deborahjames theuseoflongactinginjectableantipsychotictherapyforschizophrenia AT lawrencericher theuseoflongactinginjectableantipsychotictherapyforschizophrenia AT jasonjiang useoflongactinginjectableantipsychotictherapyforschizophrenia AT jeffbakal useoflongactinginjectableantipsychotictherapyforschizophrenia AT pierrechue useoflongactinginjectableantipsychotictherapyforschizophrenia AT marksnaterse useoflongactinginjectableantipsychotictherapyforschizophrenia AT lianaurichuk useoflongactinginjectableantipsychotictherapyforschizophrenia AT serdardursun useoflongactinginjectableantipsychotictherapyforschizophrenia AT christophermccabe useoflongactinginjectableantipsychotictherapyforschizophrenia AT finlaymcalister useoflongactinginjectableantipsychotictherapyforschizophrenia AT deborahjames useoflongactinginjectableantipsychotictherapyforschizophrenia AT lawrencericher useoflongactinginjectableantipsychotictherapyforschizophrenia |