title: Medication discontinuation with depot and oral antipsychotics in outpatients with schizophrenia: comparison of matched cohorts from a 12-month observational study.
abstract: OBJECTIVE
  This study compared all-cause medication discontinuation (any switch, augmentation or medication discontinuation) in matched cohorts of patients with schizophrenia who were initiated on depot or oral antipsychotics. Other objectives included between-group comparisons of resource use, and clinical and functional outcomes.
  
  
  METHODS
  This post hoc analysis of a one-year, multicentre, prospective, observational study included outpatients with schizophrenia who required a change in their antipsychotic medication because of a physician-perceived risk of medication non-adherence. Patients were matched 1 : 1 using an optimal algorithm with rank-based Mahalanobis distances. All-cause medication discontinuation was compared using the Klein and Moeschberger test for survival and hazard ratios (HR) with 95% confidence intervals (CI) were calculated using a Cox proportional hazards model, stratifying on matched pairs.
  
  
  RESULTS
  Forty patients who initiated a depot antipsychotic could be matched to patients who initiated an oral antipsychotic. Fewer depot-treated patients discontinued their antipsychotic medication at least once compared with oral-treated patients [20% (8/40) vs. 40% (16/40)]. Depot-treated patients discontinued their medication later (Klein and Moeschberger test p = 0.025) and were less likely to discontinue their initial antipsychotic medication [HR = 0.33 (95% CI, 0.12-0.92), p = 0.033] than oral-treated patients. There were few differences in resource use and no differences in clinical and functional outcomes between cohorts.
  
  
  CONCLUSIONS
  In this matched-cohort analysis, patients with schizophrenia who were considered to be non-adherent with their prior oral antipsychotics were less likely to discontinue their medication for any cause if they were initiated on depot compared with oral antipsychotics.
authors.affiliation: Intercontinental Information Sciences, Eli Lilly Australia Pty Ltd, Macquarie Park, NSW, Australia. alan_brnabic@lilly.com
authors.forename: A J M
authors.initials: AJ
authors.lastname: Brnabic
authors.forename: K
authors.initials: K
authors.lastname: Kelin
authors.forename: H
authors.initials: H
authors.lastname: Ascher-Svanum
authors.forename: W
authors.initials: W
authors.lastname: Montgomery
authors.forename: Z
authors.initials: Z
authors.lastname: Kadziola
authors.forename: J
authors.initials: J
authors.lastname: Karagianis
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D003692:Delayed-Action Preparations; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012559:Schizophrenia / Q000188:drug therapy*; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations