Impact on length of stay and readmission rates when converting oral to long-acting injectable antipsychotics in schizophrenia or schizoaffective disorder

INTRODUCTION: Nonadherence with oral antipsychotics in patients with schizophrenia has been associated with symptom relapse and rehospitalizations, resulting in increased morbidity and health care costs. Long-acting injectable antipsychotics (LAIAs) are an alternative to enhance adherence and decrease relapse requiring hospitalization. The objectives of this study are to determine the impact of LAIAs on reducing length of stay, the rate of annual readmissions, and the number of failed annual discharges (defined as a readmission in less than 30 days) in patients with schizophrenia or schizoaffective disorder admitted to an acute inpatient psychiatric unit. METHODS: Using the hospital database, 52 patients receiving a diagnosis of schizophrenia or schizoaffective disorders treated with oral antipsychotics and later transitioned to LAIAs were evaluated retrospectively. RESULTS: Patients treated with LAIAs did not show a statistically significant reduction in length of stay compared with their length of stay on oral antipsychotics. Patients treated with LAIAs experienced a statistically significant reduction in the rate of annual readmissions and a reduction in the number of failed annual discharges, although the latter was not statistically significant (P = .076 when compared to treatment with oral antipsychotics). DISCUSSION: These findings suggest a potential role for maintaining patients with a diagnosis of schizophrenia or schizoaffective disorder on LAIAs to prevent relapse and rehospitalizations. The reduction in the number of failed annual discharges between the oral versus LAIA group, although not statistically significant, warrants further investigation to determine the impact of LAIAs on readmission within 30 days.