title: Treatment persistence and hospitalization rates among patients with schizophrenia: a quasi-experiment to evaluate a patient information program.
abstract: The effective treatment of schizophrenia requires continuous antipsychotic maintenance therapy. However, poor persistence with treatment is common among patients with schizophrenia. The objective of this study was to compare persistence and hospitalization rates among patients with schizophrenia treated with long-acting injectable (LAI) antipsychotics (i.e. paliperidone palmitate and risperidone) and enrolled in a patient information program (program cohort) with patients treated with oral antipsychotics (OAs) who were not enrolled in a patient information program (nonprogram cohort).
  
  
  
  Using a quasi-experimental design, data from chart reviews (for program patients) and Medicaid claims (for nonprogram patients) was analyzed. Patients were eligible if they had ≥12 months of pre-index data, ≥6 months of post-index data, and no hospitalization at index.
  
  
  
  Persistence and hospitalization rates were assessed at 6 months post-index. Propensity score matching was used to control for observed differences in demographics and baseline clinical characteristics. Odds ratios (ORs) were calculated using generalized estimating equation models and adjusted for matched pairs and propensity score.
  
  
  
  A total of 102 program patients were matched to 408 nonprogram patients with similar baseline characteristics. Adjusted ORs indicated that the persistence rate at 6 months was significantly higher for the program cohort (88.2%) versus the nonprogram cohort (43.9%; OR: 9.70; P < .0001). The 6 month post-index hospitalization rate for the program cohort (14.7%) was significantly lower versus the nonprogram cohort after adjustments (22.5%; OR: 0.55; P = 0.0321).
  
  
  
  The data for the program and nonprogram patients were from two different and independent data sources (healthcare claims and chart reviews, respectively). Results were based on a relatively small number of program LAI patients.
  
  
  
  Program patients treated with LAI antipsychotics had higher persistence rates and significantly lower adjusted hospitalization rates compared with nonprogram patients treated with OAs.
authors.affiliation: a Groupe d'analyse Ltée , Montréal , QC , Canada.
authors.forename: Dominic
authors.initials: D
authors.lastname: Pilon
authors.affiliation: b Janssen Scientific Affairs LLC , Titusville , NJ , USA.
authors.forename: Tony B
authors.initials: TB
authors.lastname: Amos
authors.affiliation: a Groupe d'analyse Ltée , Montréal , QC , Canada.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Germain
authors.affiliation: a Groupe d'analyse Ltée , Montréal , QC , Canada.
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Lafeuille
authors.affiliation: a Groupe d'analyse Ltée , Montréal , QC , Canada.
authors.forename: Patrick
authors.initials: P
authors.lastname: Lefebvre
authors.affiliation: b Janssen Scientific Affairs LLC , Titusville , NJ , USA.
authors.forename: Carmela J
authors.initials: CJ
authors.lastname: Benson
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000145:classification; D003692:Delayed-Action Preparations / Q000008:administration & dosage / Q000009:adverse effects; D004333:Drug Administration Routes; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data; D008501:Medical Records, Problem-Oriented / Q000706:statistics & numerical data; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D057216:Propensity Score; D012189:Retrospective Studies; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D055502:Secondary Prevention / Q000379:methods; D014481:United States / Q000453:epidemiology; D016903:Drug Monitoring
chemical_list: D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations
keywords: Antipsychotics; hospitalization; long-acting injectable; patient assistance program; persistence; schizophrenia