Comparison of long-acting injectable antipsychotics with oral antipsychotics and hospital readmission rates in pediatric patients.

Danial Chowdhury, Daniel Greer, Mei T Liu, Caitlin McCarthy, Megan Maroney
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Abstract

Introduction: Studies indicate that long-acting injectable antipsychotics (LAIAs) reduce the risk of relapse and hospitalization compared with oral antipsychotics (APs) in adults. Oral formulations of APs are well-studied in the pediatric population, but little is known regarding the off-label use of LAIAs in this population.

Methods: This retrospective chart review evaluated readmission rates for pediatric patients admitted to a psychiatric ward in a large academic hospital between January 1, 2015, and December 1, 2022, requiring AP therapy. The experimental group included patients initiated on LAIA therapy, and the control group included patients initiated on a new oral AP. Patients were matched by several clinical factors.

Results: Each group consisted of 38 patients. For the primary outcome, hospital readmission rates at 3 months, the LAIA group had a 13.2% readmission rate compared with 26.3% in the comparator group (p = .153). In months 4 through 6, there was a 5.3% versus 15.8% readmission rate, respectively (p = .139). In months 7 through 12, it was 7.9% versus 18.4% (p = .179). There were significantly fewer cumulative readmissions at the 1-year mark in the LAIA group (N = 9, 23.7%) compared with the oral AP group (N = 18, 47.4%) (p = .031). No statistically significant differences were seen in hospital length of stay although results numerically favored LAIA.

Discussion: In a pediatric population, the administration of an LAIA when compared with the oral equivalent resulted in numerically fewer hospital readmissions, decreased length of stay, and fewer adverse effects, but these effects were not statistically significant except for cumulative readmissions at 1 year.

长效注射抗精神病药与口服抗精神病药及儿科患者再入院率的比较。
导言:研究表明,与成人口服抗精神病药物(APs)相比,长效注射抗精神病药物(LAIAs)可降低复发和住院风险。在儿科人群中,口服抗精神病药物的研究较多,但对LAIAs在儿科人群中的标示外使用却知之甚少:这项回顾性病历审查评估了一家大型学术医院精神科病房在 2015 年 1 月 1 日至 2022 年 12 月 1 日期间收治的需要接受 AP 治疗的儿科患者的再入院率。实验组包括开始接受LAIA治疗的患者,对照组包括开始接受新型口服AP治疗的患者。两组患者根据多项临床因素进行配对:结果:每组有 38 名患者。就主要结果(3 个月时的再入院率)而言,LAIA 组的再入院率为 13.2%,而对照组为 26.3%(P = .153)。在第 4 到第 6 个月,再入院率分别为 5.3% 和 15.8% (P = .139)。在第 7 至 12 个月,再入院率分别为 7.9% 和 18.4%(p = .179)。与口服 AP 组(18 人,47.4%)相比,LAIA 组(9 人,23.7%)的 1 年累计再入院率明显较低(p = .031)。虽然从数字上看,LAIA 组更受青睐,但在住院时间上没有明显的统计学差异:讨论:在儿科人群中,使用 LAIA 与口服 AP 相比,再入院次数更少、住院时间更短、不良反应更少,但除了 1 年的累积再入院次数外,这些影响在统计学上并不显著。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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