Treatment adherence and efectiveness of extended-release antipsychotics in a hospital setting

Abstract

Schizophrenia is a chronic mental disorder that affects young patients in which antipsychotic treatment is essential for symptomatic control and preventing progression. The high rate of relapse in these patients (10%) is mainly due to the abandonment of the medication. It is necessary to find tools to increase adherence. The long acting injectable antipsychotics (depot antipsychotics) represent a useful alternative in the recent years, since there is great evidence that they improve therapeutic compliance. Objective: To evaluate the effectiveness and adherence to pharmacological treatment with depot antipsychotics in patients with psychotic disorders. Methodology: A retrospective longitudinal observational study was performed on a population of 89 subjects from Hospital Universitario Fundación Alcorcón (HUFA) with psychotic disorders, who received depot antipsychotics since September 2015 until June 2017. The incidences of new symptomatic episodes (assessed as visits to Emergency Department, general hospital admissions and psychiatric admissions) were compared at 6, 12, 24 months before and 6, 12, 14 months after the start of the depot treatment. Results: There is a significant reduction in the relative risk of general and psychiatric admissions with all depot antipsychotics. Paliperidone Palmitate is superior to the others, being the only one that reduces the number of visits to general Emergencies. Aripiprazole only decreased the relative risk of psychiatric admissions. The depot antipsychotics used had a high adherence (73%). Among the causes of non-adherence to treatment (23%), the most important is non-compliance with the prescribed regimen. Conclusion: Depot antipsychotics are an effective alternative to improve therapeutic adherence in patients with psychotic disorders, which means a lower incidence of symptoms and lower hospital requirements.