CPNP 2020 Annual Meeting Poster Abstracts

Type: Work in Progress. Background: Schizophrenia spectrum disorders are a set of chronic and severe mental disorders that affect how a person thinks, feels, and behaves. These disorders affect approximately 4% of patients treated at the Veterans Affairs (VA) Healthcare System. Optimal treatment includes use of an antipsychotic medication. Paliperidone palmitate once-monthly injection (PP1M) is an antipsychotic FDA-approved to treat schizophrenia and schizoaffective disorder. Several studies have raised concerns regarding variable PP1M distribution in obese patients and the potential impact body mass index (BMI) may have on medication effectiveness. This is especially important as patients with schizophrenia are twice as likely to be obese. The purpose of this study is to assess the effectiveness of PP1M in obese compared to non-obese patients. Objectives: (1) Determine the difference in effectiveness, defined as treatment failure, among obese (BMI 30 kg/m) compared to non-obese (BMI 18.5-29.9 kg/m) patients treated at the VA Northeast Ohio Healthcare System (VANEOHS) with PP1M for schizophrenia spectrum disorders. (2) Evaluate treatment failure based on area of injection. Methods: This is a retrospective chart review of patients with a diagnosis of schizophrenia or schizoaffective disorder from January 1, 2014 through January 1, 2019 who received at least one maintenance dose of PP1M at the VANEOHS. The patient list was obtained using the electronic medical record and data will be obtained by chart review. Patients with BMI , 18.5 kg/ m and those who previously trialed PP1M will be excluded. In short, treatment failure is defined as: (1) all cause discontinuation (2) hospital admission for schizophrenia spectrum disorders (3) completed or attempted suicide (4) increased scheduled antipsychotic therapy. Bivariate group comparisons will be completed using ChiSquare test for categorical dependent-outcome variables and t-test for continuous dependent-outcome variables. Logistic regression will be used with obese vs non-obese as the main predictor of interest controlling for covariates of age, race, renal function, and gender predicting treatment failure vs success. The project is approved by local IRB and data analysis will be concluded by February 29, 2020. Outcomes: We will report the number and percent of patients with treatment failure based on BMI categorization and area of injection overall and based on co-variates of interest.