title: Comparative effectiveness of injectable paliperidone palmitate versus oral atypical antipsychotics: early postmarketing evidence.
abstract: OBJECTIVE
  To provide comparative effectiveness evidence for long-acting injectable paliperidone palmitate versus oral atypical antipsychotics.
  
  
  METHODS
  We performed a retrospective, observational cohort study using patient claims data from Missouri Medicaid to compare the likelihood of emergency department (ED) visits and hospitalizations in the year following drug initiation using multivariable logistic regression.
  
  
  RESULTS
  Adjusted odds ratios (AOR) for ED visits (AOR: 0.63; 95% CI: 0.47-0.85) and hospitalizations (AOR: 0.85; 95% CI: 0.64-1.13) were lower in paliperidone palmitate patients, although hospitalizations did not achieve statistical significance. Sensitivity analyses examining mental health-related outcomes and using different analytic strategies for patient selection bias showed directionally similar beneficial effects but were not statistically significant.
  
  
  CONCLUSIONS
  Early evidence for paliperidone palmitate under real-world conditions is encouraging. However, caution should be taken until additional research substantiates the findings with greater certainty.
authors.affiliation: Colorado School of Public Health, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Elaine H
authors.initials: EH
authors.lastname: Morrato
authors.forename: Joe
authors.initials: J
authors.lastname: Parks
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Campagna
authors.forename: Erik
authors.initials: E
authors.lastname: Muser
authors.forename: Deborah S K
authors.initials: DS
authors.lastname: Thomas
authors.forename: Hai
authors.initials: H
authors.lastname: Fang
authors.forename: Dilesh
authors.initials: D
authors.lastname: Doshi
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage*; D057186:Comparative Effectiveness Research; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007267:Injections; D016015:Logistic Models; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D000068882:Paliperidone Palmitate / Q000008:administration & dosage*; D012189:Retrospective Studies; D012307:Risk Factors; D012559:Schizophrenia / Q000188:drug therapy*; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D000068882:Paliperidone Palmitate
keywords: Medicaid; atypical antipsychotics; comparative effectiveness; emergency department visits; hospitalization; paliperidone palmitate