title: An evaluation of inpatient treatment continuation and hospital readmission rates in patients with bipolar disorder treated with aripiprazole or quetiapine.
abstract: OBJECTIVE
  The primary objective of this study was to assess patient and treatment variables that have an impact on inpatient antipsychotic treatment continuation and 30-day hospital readmission rates in patients with bipolar disorder treated with aripiprazole or quetiapine.
  
  
  METHODS
  This was a retrospective cohort study of adult patients with bipolar disorder admitted to a psychiatric hospital. Patients who were initiated on aripiprazole or quetiapine during hospitalization were included in the analysis. The two groups were compared with regards to antipsychotic treatment continuation to discharge and 30-day hospital readmission rates using logistic regression analysis.
  
  
  RESULTS
  A total of 336 patients were included in the study. No difference in inpatient antipsychotic treatment continuation rates to discharge were observed, with 85.3% and 84.9% of patients in the aripiprazole and quetiapine cohorts, respectively, continuing treatment with the index antipsychotic to discharge (p = 0.92). Logistic regression analysis revealed that patients were more likely to be prescribed their index antipsychotic at discharge if they were younger than 40 years of age (OR = 2.05, 95% CI =1.08-3.89) and/or diagnosed with a bipolar depressed (OR = 3.05, 95% CI = 1.05-8.85) or mixed episode (OR = 4.14, 95% CI = 1.24-13.87) compared with a manic episode. Patients treated with divalproex (OR = 0.49, 95% CI = 0.25-0.94) or a benzodiazepine (OR = 0.37, 95% CI = 0.18-0.75) at discharge were less likely to be prescribed the index antipsychotic at discharge. Continuation of the index antipsychotic to discharge did not have an impact on readmission rates; admissions during the year before the index hospitalization were the only predictor of 30-day readmission rates (OR = 2.44, 95% CI = 1.08-5.48).
  
  
  CONCLUSIONS
  No difference was observed in inpatient antipsychotic treatment continuation and 30-day hospital readmission rates in patients treated with either aripiprazole or quetiapine.
authors.affiliation: University of Incarnate Word, Feik School of Pharmacy, San Antonio, TX 78209, USA. kreys@uiwtx.edu
authors.forename: Tiffany-Jade M
authors.initials: TJ
authors.lastname: Kreys
authors.forename: Tanya J
authors.initials: TJ
authors.lastname: Fabian
authors.forename: Melissa I
authors.initials: MI
authors.lastname: Saul
authors.forename: Roger
authors.initials: R
authors.lastname: Haskett
authors.forename: Kim C
authors.initials: KC
authors.lastname: Coley
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D018692:Antimanic Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000068180:Aripiprazole; D001569:Benzodiazepines / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy*; D015331:Cohort Studies; D003987:Dibenzothiazepines / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006778:Hospitals, Psychiatric; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010359:Patient Readmission / Q000706:statistics & numerical data*; D010879:Piperazines / Q000008:administration & dosage / Q000627:therapeutic use*; D000069348:Quetiapine Fumarate; D015363:Quinolones / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D014635:Valproic Acid; D055815:Young Adult
chemical_list: D018692:Antimanic Agents; D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D010879:Piperazines; D015363:Quinolones; D001569:Benzodiazepines; D000069348:Quetiapine Fumarate; D014635:Valproic Acid; D000068180:Aripiprazole