Health resource utilization and cost before versus after initiation of second-generation long-acting injectable antipsychotics among adults with schizophrenia in Alberta, Canada: a retrospective, observational single-arm study

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dc.contributor.authorWong, Kai O.
dc.contributor.authorKlarenbach, Scott W.
dc.contributor.authorMartins, Karen J. B.
dc.contributor.authorChue, Pierre
dc.contributor.authorDursun, Serdar M.
dc.contributor.authorSnaterse, Mark
dc.contributor.authorGuigue, Alexis
dc.contributor.authorSo, Helen
dc.contributor.authorLuu, Huong
dc.contributor.authorVu, Khanh
dc.contributor.authorRicher, Lawrence
dc.date.accessioned2022-07-03T00:02:44Z
dc.date.available2022-07-03T00:02:44Z
dc.date.issued2022-07-02
dc.date.updated2022-07-03T00:02:44Z
dc.description.abstractAbstract Background Long-acting injectable (LAI) antipsychotics, along with community treatment orders (CTOs), are used to improve treatment effectiveness through adherence among individuals with schizophrenia. Understanding real-world medication adherence, and healthcare resource utilization (HRU) and costs in individuals with schizophrenia overall and by CTO status before and after second generation antipsychotic (SGA)-LAI initiation may guide strategies to optimize treatment among those with schizophrenia. Methods This retrospective observational single-arm study utilized administrative health data from Alberta, Canada. Adults (≥ 18 years) with schizophrenia who initiated a SGA-LAI (no use in the previous 2-years) between April 1, 2014 and March 31, 2016, and had ≥ 1 additional dispensation of a SGA-LAI were included; index date was the date of SGA-LAI initiation. Medication possession ratio (MPR) was determined, and paired t-tests were used to examine mean differences in all-cause and mental health-related HRU and costs (Canadian dollars), comprised of hospitalizations, physician visits, emergency department visits, and total visits, over the 2-year post-index and 2-year pre-index periods. Analyses were stratified by presence or absence of an active CTO during the pre-index and/or post-index periods. Results Among 1,211 adults with schizophrenia who initiated SGA-LAIs, 64% were males with a mean age of 38 (standard deviation [SD] 14) years. The mean overall antipsychotic MPR was 0.39 (95% confidence interval [CI] 0.36, 0.41) greater during the 2-year post-index period (0.84 [SD 0.26]) compared with the 2-year pre-index period (0.45 [SD 0.40]). All-cause and mental health-related HRU and costs were lower post-index versus pre-index (p < 0.001) for hospitalizations, physician visits, emergency department visits, and total visits; mean total all-cause HRU costs were $33,788 (95% CI -$38,993, -$28,583) lower post- versus pre-index ($40,343 [SD $68,887] versus $74,131 [SD $75,941]), and total mental health-related HRU costs were $34,198 (95%CI -$39,098, -$29,297) lower post- versus pre-index ($34,205 [SD $63,428] versus $68,403 [SD $72,088]) per-patient. Forty-three percent had ≥ 1 active CTO during the study period; HRU and costs varied according to CTO status. Conclusions SGA-LAIs are associated with greater medication adherence, and lower HRU and costs however the latter vary according to CTO status.
dc.identifier.citationBMC Psychiatry. 2022 Jul 02;22(1):444
dc.identifier.doihttps://doi.org/10.1186/s12888-022-04075-y
dc.identifier.urihttp://hdl.handle.net/1880/114790
dc.language.rfc3066en
dc.rights.holderThe Author(s)
dc.titleHealth resource utilization and cost before versus after initiation of second-generation long-acting injectable antipsychotics among adults with schizophrenia in Alberta, Canada: a retrospective, observational single-arm study
dc.typeJournal Article
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