Antipsychotic treatment patterns and hospitalizations among adults with schizophrenia.
OBJECTIVE
To characterize the longitudinal patterns of antipsychotic treatment and to investigate the relationship between antipsychotic treatment patterns and acute hospitalizations among adults with schizophrenia. We hypothesized that continuous antipsychotic treatment would be associated with fewer hospitalizations and shorter lengths of stay.


METHODS
Seven years of retrospective Maryland Medicaid administrative data were used to examine inpatient medical encounters and outpatient psychotropic treatment in community-based settings from 1993 through 2000. The sample consisted of 1727 adults continuously enrolled in the Maryland Medicaid program from July 1992 through June 1994, and diagnosed with schizophrenia. The main outcome measures were a) any schizophrenia hospitalization; b) number of schizophrenia hospitalizations; and c) inpatient days associated with a primary diagnosis of schizophrenia.


RESULTS
The average duration of antipsychotic use was six months in any single year and four and one-half years across the entire study period. Compared to individuals with a more continuous pattern of antipsychotic treatment, individuals with moderate or light use had odds of hospitalization for schizophrenia that were 52 or 72% greater (95%CI: 30-75% greater, 49-100% greater respectively). Light users of antipsychotics have an average length of stay per hospitalization that is approximately 20% longer than the average for continuous users (95%CI: 2-39% longer).


CONCLUSIONS
Findings emphasize the benefit of continuous antipsychotic treatment for individuals with schizophrenia.
dosReis
Susan
S
Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA. sdosrei1@jhmi.edu
Johnson
Elizabeth
E
Steinwachs
Donald
D
Rohde
Charles
C
Skinner
Elizabeth A
EA
Fahey
Maureen
M
Lehman
Anthony F
AF
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D017723:Drug Utilization Review; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008396:Maryland; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales; D012111:Residence Characteristics; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology*
D014150:Antipsychotic Agents