title: Paliperidone palmitate: factors predicting continuation with treatment at 2 years.
abstract: Our aim was to determine factors relating to continuation with treatment with paliperidone palmitate long-acting injection (PP) in a 2 year, non-interventional, observational study of the use of PP in consecutive patients treated in a secondary care environment. We followed-up 300 consecutive patients; 24 (8%) were lost to follow-up (7 deceased and 17 left the care of the trust). Overall, 107 patients of the remaining 276 who were not lost to follow-up (38.7%) completed 2 years' continuous treatment. A further 21 (7.6%) patients discontinued PP but restarted it after >2 months, 11 (4.0%) of whom were still receiving PP at 2 years. Median treatment time for PP was 465 days (95% CI 333, 583 days). Prior treatment with risperidone reduced the risk of discontinuation by 39% (RR 0.61 (95% CI -0.44, 0.86, p=0.004)); being initiated as an out-patient by 49% (RR 0.51 (95% CI 0.36, 0.73 p=0.001)). Risk of discontinuation was increased by 63% when the reason for prescribing PP was poor tolerability of prior treatment (RR 1.63 (95% CI 1.05, 2.51 p=0.028)). The rate of continuation with PP at 2 years was higher than that seen with other long acting depot formulations. Likelihood of continuation can be vastly improved by targeting PP for those most likely to benefit.
authors.affiliation: Maudsley Hospital, Pharmacy Department, Denmark Hill, London SE5 8AZ, UK; Institute of Pharmaceutical Science, King׳s College, London, 5th Floor, Franklin-Wilkins Building 150 Stamford Street, London SE1 9NH, UK. Electronic address: david.taylor@slam.nhs.uk.
authors.forename: David M
authors.initials: DM
authors.lastname: Taylor
authors.affiliation: Maudsley Hospital, Pharmacy Department, Denmark Hill, London SE5 8AZ, UK.
authors.forename: Anna
authors.initials: A
authors.lastname: Sparshatt
authors.affiliation: Maudsley Hospital, Pharmacy Department, Denmark Hill, London SE5 8AZ, UK.
authors.forename: Maria
authors.initials: M
authors.lastname: O'Hagan
authors.affiliation: Maudsley Hospital, Pharmacy Department, Denmark Hill, London SE5 8AZ, UK.
authors.forename: Olubanke
authors.initials: O
authors.lastname: Dzahini
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003692:Delayed-Action Preparations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D000068882:Paliperidone Palmitate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011618:Psychotic Disorders / Q000188:drug therapy; D012008:Recurrence; D018570:Risk Assessment; D018967:Risperidone / Q000627:therapeutic use; D012559:Schizophrenia / Q000188:drug therapy; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations; D018967:Risperidone; D000068882:Paliperidone Palmitate
keywords: Antipsychotic; Effectiveness; Paliperidone; Relapse; Schizophrenia