30-Day Hospital Readmissions with INVEGA SUSTENNA® (paliperidone palmitate) vs Oral Atypical Antipsychotics

In a Retrospective Study, INVEGA SUSTENNA® Reduced the Risk of 30-Day Readmissions vs Oral Atypical Antipsychotics

Study Design

During the Study Period, “Schizophrenia-related Index Hospitalizations” Were Defined as Hospitalization With:

  1. A primary or admission diagnosis of schizophrenia
  2. A primary or admission diagnosis of mental disorder and a secondary diagnosis of schizophrenia
  3. A primary or admission diagnosis of injury or poisoning and a secondary diagnosis of schizophrenia

The Premier Perspective Comparative Hospital database, which encompasses inpatient services from over 700 hospitals in the US, was used to retrospectively compare rehospitalizations of adults with schizophrenia treated with paliperidone palmitate (n=8578) or oral atypical antipsychotics (n=306,252) from January 2009 to December 2016.

Odds ratios were presented as a measure of effect, along with 95% confidence intervals and P values. A multivariate generalized estimating equation model, adjusted for a variety of demographic and clinical factors, was used to estimate the odds of rehospitalization for patients on paliperidone palmitate and oral atypical antipsychotics.

This study was not designed to measure the efficacy of INVEGA SUSTENNA® (paliperidone palmitate).

Limitations:

Results of retrospective studies can be affected by coding-entry errors, missing data, and residual confounding. Since the date of first schizophrenia diagnosis was not available, age was used as a surrogate for time from diagnosis. Patients could only be traced for hospitalizations occurring at the same facility, which could lead to underestimation of rehospitalization rates.

How Can You Help Patients Stay on Treatment During Their Transition From the Inpatient to Outpatient Setting?

Approximately 1 in 5 patients

with a principal diagnosis of schizophrenia at initial stay experience an all-cause readmission within 30 days.2*

"An LAI formulation of an antipsychotic may also be considered when patients are transitioning between settings (e.g., at inpatient discharge, on release from a correctional facility), when future adherence is uncertain and the risk of reduced adherence may be increased."

Excerpt From the American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia3

A few simple adjustments in communication and integration between treatment teams may also help your adult patients with schizophrenia make a successful transition to the outpatient setting. Download these actionable best practices to address 6 common challenges associated with the continuity of care.

*All-cause, 30-day readmissions were seen in 19.3% of patients 18-44 years old and in 19.7% of patients 45-64 years old.

The study did not disclose what medication was received at initial discharge.

References: 1. Pilon D, Amos TB, Kamstra R, et al. Short-term rehospitalizations in young adults with schizophrenia treated with once-monthly paliperidone palmitate or oral atypical antipsychotics: a retrospective analysis. Curr Med Res Opin. 2019;35(1):41-49. 2. Heslin KC, Weiss AJ. Hospital Readmissions Involving Psychiatric Disorders, 2012: Statistical Brief #189. 2015 May. In: Healthcare Cost and Utilization Project (HCUP) Statistical Briefs [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US). 3. The American Psychiatric Association. Practice Guideline for the Treatment of Patients With Schizophrenia. 3rd ed. Accessed July 21, 2021. https://psychiatryonline.org/doi/pdf/10.1176/appi.books.9780890424841.