TY - JOUR
T1 - Efectividad Del Palmitato de Paliperidona en la Adherencia al Tratamiento y Las Recaídas en la Población Adulta Con Esquizofrenia
T2 - Un estudio en Imagen Especular de un Año en un Centro de salud Mental en Colombia
AU - Ribero, Oscar
AU - Castilloux, Anne Marie
AU - Agudelo, Lina Maria
AU - Machnicki, Gerardo
AU - Morales, Vanesa
AU - Perocco, Sergio
AU - Castillon, Genaro
AU - Moride, Yola
N1 - Funding Information:
This study was funded by McNeill Panama. The funding source was involved in the study design and in the decision to submit the article for publication. The funder had no role in the conduct of the study, i.e., patient selection, data collection, management, analyses, and interpretation of findings.
Publisher Copyright:
© 2022 Asociación Colombiana de Psiquiatría
PY - 2022
Y1 - 2022
N2 - Introduction: The benefits of long-acting injectable antipsychotics have been documented in several observational studies, but data remain scarce in Latin America. This study aimed at evaluating the effectiveness of paliperidone palmitate once monthly (PP1M) on treatment adherence and relapse in the schizophrenia population followed in a government-funded mental health care facility in Colombia. Methods: A mirror-image study was conducted. Adult schizophrenia patients treated with oral antipsychotics who subsequently received ≥2 PP1M injections between Jan. 1st, 2015 and Oct. 31st, 2018 were included. The study consisted of two retrospective phases: 12 months before and after the first PP1M injection. Outcomes were treatment adherence (proportion of days covered ≥80%), hospitalized relapse, hospital length of stay, and non-hospitalised relapse. Effect of PP1M on outcomes was assessed through multivariable conditional Poisson regression. Results: 123 patients were eligible (mean age, 30.3 years; 79.7% males). Adherence was 23.6% in the pre-phase and 89.4% in the post-phase (RR = 3.77; 95%CI, 2.75-5.17). The proportion of patients with hospitalised relapse decreased from 46.3% to 35.0% (RR = 0.76; 95%CI, 0.59-0.99). In the 75 (61.0%) patients who continued PP1M throughout post-phase, beneficial effect on hospitalised relapse was stronger (RR = 0.64; 95%CI, 0.42-0.98). The proportion of patients with non-hospitalised relapse symptoms increased from 6.5% to 18.7% (RR = 2.27; 95%CI, 1.11-4.64). Conclusions: PP1M initiation led to a dramatic improvement in treatment adherence and a decrease in hospitalised relapse. Observed increase in non-hospitalised relapse may be explained by a decrease in severity. Limitations are absence of a parallel comparison group and a generalisability limited to the population treated at this facility. Study provides data for the Latin America region and strength is the assessment of non-hospitalised relapse symptoms.
AB - Introduction: The benefits of long-acting injectable antipsychotics have been documented in several observational studies, but data remain scarce in Latin America. This study aimed at evaluating the effectiveness of paliperidone palmitate once monthly (PP1M) on treatment adherence and relapse in the schizophrenia population followed in a government-funded mental health care facility in Colombia. Methods: A mirror-image study was conducted. Adult schizophrenia patients treated with oral antipsychotics who subsequently received ≥2 PP1M injections between Jan. 1st, 2015 and Oct. 31st, 2018 were included. The study consisted of two retrospective phases: 12 months before and after the first PP1M injection. Outcomes were treatment adherence (proportion of days covered ≥80%), hospitalized relapse, hospital length of stay, and non-hospitalised relapse. Effect of PP1M on outcomes was assessed through multivariable conditional Poisson regression. Results: 123 patients were eligible (mean age, 30.3 years; 79.7% males). Adherence was 23.6% in the pre-phase and 89.4% in the post-phase (RR = 3.77; 95%CI, 2.75-5.17). The proportion of patients with hospitalised relapse decreased from 46.3% to 35.0% (RR = 0.76; 95%CI, 0.59-0.99). In the 75 (61.0%) patients who continued PP1M throughout post-phase, beneficial effect on hospitalised relapse was stronger (RR = 0.64; 95%CI, 0.42-0.98). The proportion of patients with non-hospitalised relapse symptoms increased from 6.5% to 18.7% (RR = 2.27; 95%CI, 1.11-4.64). Conclusions: PP1M initiation led to a dramatic improvement in treatment adherence and a decrease in hospitalised relapse. Observed increase in non-hospitalised relapse may be explained by a decrease in severity. Limitations are absence of a parallel comparison group and a generalisability limited to the population treated at this facility. Study provides data for the Latin America region and strength is the assessment of non-hospitalised relapse symptoms.
KW - Adherence
KW - Antipsychotics
KW - Paliperidone palmitate
KW - Relapse
KW - Schizophrenia
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U2 - 10.1016/j.rcp.2022.06.001
DO - 10.1016/j.rcp.2022.06.001
M3 - Article
AN - SCOPUS:85135355862
SN - 0034-7450
JO - Revista Colombiana de Psiquiatria
JF - Revista Colombiana de Psiquiatria
ER -