Home Mind & Brain Study Finds Long-Acting Injectable Antipsychotics Reduce Hospital Readmissions for Psychosis and Bipolar Disorder

Study Finds Long-Acting Injectable Antipsychotics Reduce Hospital Readmissions for Psychosis and Bipolar Disorder

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A new study published in Psychiatry Research has found that long-acting injectable (LAI) antipsychotic medications significantly reduce hospital readmissions among patients with psychosis and bipolar disorder. The research provides compelling evidence for the effectiveness of LAIs over traditional oral medications in managing these chronic mental health conditions.

The study involved a community sample of 193 patients diagnosed with psychosis and bipolar disorder. The participants were treated at the Department of Psychiatry, University of Crete General Hospital, and the affiliated Mobile Mental Health Unit. The sample consisted of 164 patients with psychosis and 29 with bipolar disorder, with a mean follow-up period of 5.6 years.

The primary aim was to compare the effectiveness of LAI treatments against oral medications in reducing hospital readmissions. The study also examined the impact of pre-treatment hospitalisation type (voluntary vs. involuntary) and compared the effectiveness of first-generation versus second-generation LAIs.

The study revealed a significant 45.2% reduction in total hospital readmissions after patients switched to LAI treatment. This reduction was consistent regardless of whether patients had a history of voluntary or involuntary hospitalisations before the LAI treatment.

Both first-generation and second-generation LAIs were found to be equally effective in reducing hospital readmissions. This finding suggests that the choice between first-generation and second-generation LAIs can be tailored to individual patient needs without compromising effectiveness.

Psychosis and bipolar disorder are severe, chronic mental illnesses that require long-term treatment. The lifetime prevalence of these conditions is about 1%, but they contribute significantly to the global burden of disease due to their chronic nature and the high costs associated with treatment and care​​.

Adherence to medication is a critical factor in managing these disorders. Unfortunately, adherence rates are often low, with studies showing rates of around 42% for schizophrenia and 41% for bipolar disorder​​. Poor adherence is associated with higher relapse rates and worse long-term outcomes, making effective and manageable treatment options vital.

LAIs have been developed to address some of the challenges associated with oral medications, such as the need for daily dosing and the potential for patients to forget to take their medication. LAIs are administered via injection every few weeks or months, providing a more stable and continuous delivery of medication​​.

The researchers utilised a mirror-image study design, comparing hospital readmission rates during an equal-length period of oral treatment before switching to LAIs. Patients included in the study had a history of poor adherence to oral medications and had experienced at least one hospital admission before starting LAI treatment.

Patients were divided into subgroups based on their pre-treatment hospitalisation history (voluntary vs. involuntary) and the type of LAI used (first-generation vs. second-generation). Statistical analyses were conducted to determine the effectiveness of LAIs in reducing hospital readmissions across these different groups.

The findings from this study have significant implications for the clinical management of psychosis and bipolar disorder. The substantial reduction in hospital readmissions highlights the potential of LAIs to improve treatment outcomes and reduce the burden on healthcare systems.

Clinicians may consider prescribing LAIs more frequently, especially for patients with a history of poor adherence to oral medications. The equal effectiveness of first-generation and second-generation LAIs provides flexibility in choosing the most appropriate treatment based on individual patient characteristics and preferences.

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