Assessing the impact of long-acting injectable compared to oral antipsychotic medications on readmission to a state psychiatric hospital

IF 2.6 4区医学 Q1 NURSING

Journal of Psychiatric and Mental Health Nursing Pub Date : 2024-06-22 DOI:10.1111/jpm.13075

Chizimuzo T. C. Okoli, Bassema Abufarsakh, Tianyi Wang, Andrew Makowski, Andrew Cooley

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引用次数: 0

Abstract

What is known on the subject

People living with schizophrenia spectrum disorder (SSD) have a higher death rate which is caused, in part, by poorer adherence to treatment as compared to those with other mental illnesses.
Using long-acting injectable antipsychotic (LAI) medications can improve medication adherence and reduce hospitalizations for people living with SSD but are often underutilized.

What the paper adds to existing knowledge

As compared to oral antipsychotic medications provided to patients with SSD at discharge from a psychiatric hospitalization, being provided with an LAI antipsychotic medication may reduce subsequent rehospitalization.
Specifically, patients discharged on an atypical or second-generation LAI medication are less likely to be readmitted to the hospital when compared to those discharged on a typical first-generation oral medication.

What are the implications for practice

Because LAI antipsychotic medications are often underutilized as treatment options, the study findings suggest that this modality may be considered for patients with SSD when being discharged from a psychiatric hospitalization.
Ideally, psychiatric-mental health nurses can educate patients about indications, benefits, and risks of using atypical or second-generation LAI antipsychotic medications during hospitalization and at discharge prevent the risk for future rehospitalizations.

Introduction

People living with schizophrenia spectrum disorder (SSD) have poorer medication adherence compared to those with other mental illnesses. Long-acting injectable antipsychotic (LAI) medication use is associated with greater adherence, reduced re-hospitalizations, and improved recovery outcomes when compared to oral formulations.

Aim

To compare LAI antipsychotic medication use versus oral formulations on readmission to an inpatient hospital.

Method

Medical records (N = 707) from a state psychiatric hospital in the southern region of the United States were reviewed. Controlling for demographic variables, logistic regression analyses were used to examine LAI compared to oral formulations on readmission.

Results

Compared to patients discharged with oral antipsychotic medications, those with LAIs had a lower proportion of readmission rates in 6-month and 1-year periods, but not 30-day or 2-year periods. When controlling for demographic variables, those discharged with an atypical LAI had significantly lower odds of being readmitted within the 24-year period compared to those discharged on a typical oral antipsychotic.

Discussion

Compared to orals, LAIs do not increase and may mitigate readmissions to psychiatric hospitalization.

Implications for Practice

Psychiatric-mental health nurses and other professionals may recommend LAIs when indicated for those with SSD.

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评估长效注射抗精神病药物与口服抗精神病药物相比，对再次入住州立精神病院的影响。

相关知识精神分裂症谱系障碍（SSD）患者的死亡率较高，部分原因是与其他精神疾病患者相比，他们的治疗依从性较差。使用长效注射抗精神病药物（LAI）可以提高精神分裂症谱系障碍患者的服药依从性并减少住院次数，但这种药物往往未得到充分利用：与精神科住院患者出院时接受口服抗精神病药物治疗相比，接受LAI抗精神病药物治疗可减少随后的再次住院。具体来说，与使用典型的第一代口服药物出院的患者相比，使用非典型或第二代LAI药物出院的患者再次入院的可能性更低：由于LAI抗精神病药物作为治疗选择往往未得到充分利用，研究结果表明，患有SSD的患者在从精神病院出院时可以考虑使用这种治疗方式。理想情况下，精神科-心理健康护士可以在住院期间和出院时向患者讲解使用非典型或第二代LAI抗精神病药物的适应症、益处和风险，以防止未来再次住院的风险。摘要：引言：与其他精神疾病患者相比，精神分裂症谱系障碍（SSD）患者的服药依从性较差。与口服制剂相比，长效注射型抗精神病药物（LAI）的使用与更高的依从性、减少再入院次数和改善康复效果有关。目的：比较LAI抗精神病药物与口服制剂在住院患者再入院时的使用情况：方法：对美国南部地区一家州立精神病院的医疗记录（N = 707）进行了审查。在控制人口统计学变量的前提下，采用逻辑回归分析法研究了LAI与口服制剂在再入院时的对比情况：结果：与使用口服抗精神病药物出院的患者相比，使用 LAI 的患者在 6 个月和 1 年内的再入院率较低，但在 30 天或 2 年内的再入院率较低。在控制人口统计学变量后，与服用典型口服抗精神病药物的患者相比，服用非典型LAI的患者在24年内再次入院的几率明显较低：讨论：与口服药物相比，非典型抗精神病药物不会增加并可能减轻精神病院的再入院率：实践启示：精神心理健康护士和其他专业人员可根据 SSD 患者的病情推荐 LAIs。

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来源期刊

Journal of Psychiatric and Mental Health Nursing 医学-护理

CiteScore

4.70

自引率

3.70%

发文量

审稿时长

4-8 weeks

期刊介绍： The Journal of Psychiatric and Mental Health Nursing is an international journal which publishes research and scholarly papers that advance the development of policy, practice, research and education in all aspects of mental health nursing. We publish rigorously conducted research, literature reviews, essays and debates, and consumer practitioner narratives; all of which add new knowledge and advance practice globally. All papers must have clear implications for mental health nursing either solely or part of multidisciplinary practice. Papers are welcomed which draw on single or multiple research and academic disciplines. We give space to practitioner and consumer perspectives and ensure research published in the journal can be understood by a wide audience. We encourage critical debate and exchange of ideas and therefore welcome letters to the editor and essays and debates in mental health.