Effectiveness of Paliperidone Palmitate on Treatment Adherence and Relapse in the Adult Schizophrenia Population: A One-Year Mirror-Image Study in a Colombian Mental Health Care Facility

Q3 Medicine

Revista Colombiana de Psiquiatria Pub Date : 2024-10-01 DOI:10.1016/j.rcp.2022.06.001

Oscar Ribero , Anne-Marie Castilloux , Lina Maria Agudelo , Gerardo Machnicki , Vanesa Morales , Sergio Perocco , Genaro Castillon , Yola Moride

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Abstract

Introduction

The benefits of long-acting injectable antipsychotics have been documented in several observational studies, but data remain scarce in Latin America. This study aimed at evaluating the effectiveness of paliperidone palmitate once monthly (PP1M) on treatment adherence and relapse in the schizophrenia population followed in a government-funded mental health care facility in Colombia.

Methods

A mirror-image study was conducted. Adult schizophrenia patients treated with oral antipsychotics who subsequently received ≥2 PP1M injections between Jan. 1^st, 2015 and Oct. 31^st, 2018 were included. The study consisted of two retrospective phases: 12 months before and after the first PP1M injection. Outcomes were treatment adherence (proportion of days covered ≥80%), hospitalized relapse, hospital length of stay, and non-hospitalised relapse. Effect of PP1M on outcomes was assessed through multivariable conditional Poisson regression.

Results

123 patients were eligible (mean age, 30.3 years; 79.7% males). Adherence was 23.6% in the pre-phase and 89.4% in the post-phase (RR = 3.77; 95%CI, 2.75-5.17). The proportion of patients with hospitalised relapse decreased from 46.3% to 35.0% (RR = 0.76; 95%CI, 0.59-0.99). In the 75 (61.0%) patients who continued PP1M throughout post-phase, beneficial effect on hospitalised relapse was stronger (RR = 0.64; 95%CI, 0.42-0.98). The proportion of patients with non-hospitalised relapse symptoms increased from 6.5% to 18.7% (RR = 2.27; 95%CI, 1.11-4.64).

Conclusions

PP1M initiation led to a dramatic improvement in treatment adherence and a decrease in hospitalised relapse. Observed increase in non-hospitalised relapse may be explained by a decrease in severity. Limitations are absence of a parallel comparison group and a generalisability limited to the population treated at this facility. Study provides data for the Latin America region and strength is the assessment of non-hospitalised relapse symptoms.

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棕榈酸帕利哌酮对成年精神分裂症患者治疗依从性和复发的有效性：哥伦比亚精神卫生保健机构的一年镜像研究

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来源期刊

Revista Colombiana de Psiquiatria Medicine-Psychiatry and Mental Health

CiteScore

2.50

自引率

0.00%

发文量

期刊介绍： Revista Colombiana de Psiquiatría (RCP) is a quarterly official publication of Colombian Psychiatry Association (March, June, September and December) and its purpose is to spread different the knowledge models that currently constitute the theoretical and practical body of our specialty. Psychiatrists, psychiatric residents, non psychiatric physicians, psychologists, philosophers or other health professionals or persons interested in this area can take part in the magazine. This journal publishes original works, revision or updating articles, case reports of all psychiatry and mental health areas, epistemology, mind philosophy, bioethics and also articles about methodology of investigation and critical reading.