Thirty-five months experience of risperidone long-acting injection in a UK psychiatric service including a mirror-image analysis of in-patient care.
OBJECTIVE
To report the use of risperidone long-acting injection (RLAI) in a UK psychiatric service.


METHODS
Retrospective case note review of all patients prescribed RLAI over a 35-month period. In the mirror-image analysis patients initiated on RLAI as in-patients had the index admission attributed to previous treatment.


RESULTS
Patients prescribed RLAI had significantly higher baseline rates of drug misuse, alcohol misuse, unemployment and forensic markers than control patients prescribed oral antipsychotics. Most patients started RLAI because of poor compliance with oral antipsychotics. Inefficacy accounted for more discontinuations than intolerability. Fifty-eight percent (39/67) of patients were continuing RLAI 12 months after initiation. Mirror-image analysis (n = 74) showed that RLAI was associated with a reduction in the number of admissions (65 vs. 33, P < 0.005) and in total in-patient days (4550 vs. 2188 days, P < 0.005). The mean reduction in in-patient care was 29 days per patient-year of treatment, equivalent to a net financial saving over the acquisition and administration costs of RLAI of pound1172.


CONCLUSIONS
Risperidone long-acting injection was associated with reduced in-patient care and was cost-effective.
Niaz
O S
OS
Sheffield Care Trust, Sheffield.
Haddad
P M
PM
D000293:Adolescent; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D003692:Delayed-Action Preparations / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008605:Mental Health Services / Q000191:economics; D008875:Middle Aged; D012008:Recurrence; D018967:Risperidone / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D012559:Schizophrenia / Q000188:drug therapy* / Q000191:economics / Q000534:rehabilitation*; D013997:Time Factors; D006113:United Kingdom
D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations; D018967:Risperidone