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The Impact of INVEGA SUSTENNA® on All-Cause, 30-Day Hospital Readmissions vs Oral Antipsychotics
In a retrospective claims analysis, INVEGA SUSTENNA® reduced the risk of all-cause, 30-day rehospitalization vs oral atypical antipsychotics
*Patients were required to have at least one schizophrenia-related index hospitalization during the study period defined using ICD-9 code 295.xx and ICD-10 codes F20.xx, F21.xx, or F25.xx. Coding selection included populations outside of the 2 approved indications of INVEGA SUSTENNA®. About 40% of the population had schizoaffective disorder, 33% had schizophrenia, and 3% had other diagnoses.
During the study period, “schizophrenia-related index hospitalizations” were defined as hospitalization with:
- A primary or admission diagnosis of schizophrenia
- A primary or admission diagnosis of mental disorder and a secondary diagnosis of schizophrenia
- 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=8 578) or oral atypical antipsychotics (n=305 252) 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).
Results of retrospective studies can be affected by coding-entry errors, missing data, and residual confounding. The DSM-V criteria used in the clinical setting to diagnose patients with schizophrenia and schizoaffective disorders are not identical to the ICD-9 and ICD-10 codes used in this study to identify patients with schizophrenia and schizoaffective disorders. Since the date of the first schizophrenia diagnoses 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?
"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
†All-cause 30-day readmissions were seen in 19.3% of patients 18-44 years old and 19.7% of patients 45-64 years old.
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. In: Healthcare Cost and Utilization Project (HCUP). Agency for Healthcare Research and Quality (US). Published May 2015. Accessed March 16, 2022. https://www.ncbi.nlm.nih.gov/books/NBK305353/pdf/Bookshelf_NBK305353.pdf 3. The American Psychiatric Association. Practice Guideline for the Treatment of Patients With Schizophrenia. 3rd ed. Accessed September 20, 2022. https://psychiatryonline.org/doi/pdf/10.1176/appi.books.9780890424841