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Evaluation of oral antipsychotic supplementation of select second-generation long-acting injectable antipsychotics in an acute-care psychiatric setting
INTRODUCTION: Long-acting injectable (LAI) antipsychotics were developed to increase medication adherence in patients with schizophrenia. The US Food and Drug Administration (FDA)-approved LAI dosing provides guidance regarding oral antipsychotic supplementation. Previous studies have concluded conc...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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College of Psychiatric & Neurologic Pharmacists
2019
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322819/ https://www.ncbi.nlm.nih.gov/pubmed/30627499 http://dx.doi.org/10.9740/mhc.2019.01.018 |
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author | Alastanos, Jennifer N. Paxos, Chris Emshoff, Jessica |
author_facet | Alastanos, Jennifer N. Paxos, Chris Emshoff, Jessica |
author_sort | Alastanos, Jennifer N. |
collection | PubMed |
description | INTRODUCTION: Long-acting injectable (LAI) antipsychotics were developed to increase medication adherence in patients with schizophrenia. The US Food and Drug Administration (FDA)-approved LAI dosing provides guidance regarding oral antipsychotic supplementation. Previous studies have concluded concomitant use of oral and LAI antipsychotics requires further investigation. The aim of this study was to examine oral antipsychotic supplementation among patients receiving select second-generation LAIs. METHODS: Patients were included if they were admitted to an inpatient psychiatric unit and received a second-generation LAI. The primary outcome was to determine the percentage of patients receiving oral antipsychotic supplementation prescribed in accordance with FDA recommendations. Secondary outcomes described oral supplementation prescribed in an inconsistent manner with FDA recommendations and identified patient-specific predictors associated with oral supplementation prescribed consistent with FDA recommendations. RESULTS: Of the 422 patients evaluated, 376 patients met inclusion criteria. Oral supplementation was prescribed in a manner consistent with FDA recommendations in 30% of patients. The following predictors were associated with oral supplementation prescribed in accordance with FDA recommendations: LAI initiation (odds ratio 1.868, 95% confidence interval 1.120-3.125) and the use of the once-monthly paliperidone LAI (odds ratio 20.278, 95% confidence interval 10.472-39.873). DISCUSSION: In the patient population evaluated, oral supplementation of LAI antipsychotics were prescribed in 30% of patients in a manner consistent with FDA recommendations. Of the patients who were prescribed oral antipsychotic supplementation inconsistent with FDA labeling, 223 patients were prescribed oral supplementation longer than the recommended duration and 8 patients received oral supplementation for a shorter duration than recommended. |
format | Online Article Text |
id | pubmed-6322819 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | College of Psychiatric & Neurologic Pharmacists |
record_format | MEDLINE/PubMed |
spelling | pubmed-63228192019-01-09 Evaluation of oral antipsychotic supplementation of select second-generation long-acting injectable antipsychotics in an acute-care psychiatric setting Alastanos, Jennifer N. Paxos, Chris Emshoff, Jessica Ment Health Clin Original Research INTRODUCTION: Long-acting injectable (LAI) antipsychotics were developed to increase medication adherence in patients with schizophrenia. The US Food and Drug Administration (FDA)-approved LAI dosing provides guidance regarding oral antipsychotic supplementation. Previous studies have concluded concomitant use of oral and LAI antipsychotics requires further investigation. The aim of this study was to examine oral antipsychotic supplementation among patients receiving select second-generation LAIs. METHODS: Patients were included if they were admitted to an inpatient psychiatric unit and received a second-generation LAI. The primary outcome was to determine the percentage of patients receiving oral antipsychotic supplementation prescribed in accordance with FDA recommendations. Secondary outcomes described oral supplementation prescribed in an inconsistent manner with FDA recommendations and identified patient-specific predictors associated with oral supplementation prescribed consistent with FDA recommendations. RESULTS: Of the 422 patients evaluated, 376 patients met inclusion criteria. Oral supplementation was prescribed in a manner consistent with FDA recommendations in 30% of patients. The following predictors were associated with oral supplementation prescribed in accordance with FDA recommendations: LAI initiation (odds ratio 1.868, 95% confidence interval 1.120-3.125) and the use of the once-monthly paliperidone LAI (odds ratio 20.278, 95% confidence interval 10.472-39.873). DISCUSSION: In the patient population evaluated, oral supplementation of LAI antipsychotics were prescribed in 30% of patients in a manner consistent with FDA recommendations. Of the patients who were prescribed oral antipsychotic supplementation inconsistent with FDA labeling, 223 patients were prescribed oral supplementation longer than the recommended duration and 8 patients received oral supplementation for a shorter duration than recommended. College of Psychiatric & Neurologic Pharmacists 2019-01-04 /pmc/articles/PMC6322819/ /pubmed/30627499 http://dx.doi.org/10.9740/mhc.2019.01.018 Text en © 2019 CPNP. The Mental Health Clinician is a publication of the College of Psychiatric and Neurologic Pharmacists. http://creativecommons.org/licenses/by-nc/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License, which permits non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Research Alastanos, Jennifer N. Paxos, Chris Emshoff, Jessica Evaluation of oral antipsychotic supplementation of select second-generation long-acting injectable antipsychotics in an acute-care psychiatric setting |
title | Evaluation of oral antipsychotic supplementation of select second-generation long-acting injectable antipsychotics in an acute-care psychiatric setting |
title_full | Evaluation of oral antipsychotic supplementation of select second-generation long-acting injectable antipsychotics in an acute-care psychiatric setting |
title_fullStr | Evaluation of oral antipsychotic supplementation of select second-generation long-acting injectable antipsychotics in an acute-care psychiatric setting |
title_full_unstemmed | Evaluation of oral antipsychotic supplementation of select second-generation long-acting injectable antipsychotics in an acute-care psychiatric setting |
title_short | Evaluation of oral antipsychotic supplementation of select second-generation long-acting injectable antipsychotics in an acute-care psychiatric setting |
title_sort | evaluation of oral antipsychotic supplementation of select second-generation long-acting injectable antipsychotics in an acute-care psychiatric setting |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322819/ https://www.ncbi.nlm.nih.gov/pubmed/30627499 http://dx.doi.org/10.9740/mhc.2019.01.018 |
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