Continuity of Care Among Patients Newly Initiated on Second-Generation Oral or Long-Acting Injectable Antipsychotics During a Schizophrenia-Related Inpatient Stay

Abstract: BACKGROUND: Quality measures were compared between patients initiated on second-generation long-acting injectable antipsychotics (SGLAIs) and oral atypical antipsychotics (OAAs). METHODS: Adults newly initiated on an SGLAI or OAA during a schizophrenia-related inpatient stay were identified in HealthVerity® databases (01/2015-12/2020); the index date was the discharge date. Patients had continuous eligibility 6 months pre-admission and post-discharge from the inpatient stay; antipsychotic utilization and adherence, and schizophrenia-related readmissions and outpatient visits were compared during the 6-month period post-discharge. Characteristics between cohorts were balanced using inverse probability weights. RESULTS: Post-discharge, only 36.9% and 40.7% of weighted SGLAI (Nf466) and OAA (Nf517) patients had ≥1 claim for the antipsychotic initiated during the inpatient stay, among whom SGLAI patients were 4.4 times more likely to be adherent to that antipsychotic compared to OAA patients (P=0.001). Additionally, SGLAI patients were 2.3 and 3.0 times more likely to have a claim for and to be adherent to any antipsychotic relative to OAA patients (including index antipsychotic; all P=0.001). Within 7 and 30 days post-discharge, 1.7% and 13.0% of SGLAI patients and 4.1% and 12.6% of OAA patients had a readmission. Further, SGLAI patients were 51% more likely to have an outpatient visit compared to OAA patients (P=0.044). CONCLUSIONS: Less than half of patients initiated on antipsychotics during a schizophrenia-related inpatient stay continued the same treatment post-discharge. However, SGLAI patients were more likely to be adherent to the initiated antipsychotic and to have an outpatient visit, which may suggest improved continuity of care post-discharge relative to OAA patients.Short Description: Patients may be lost to follow-up after a schizophrenia-related inpatient stay; post-discharge care may differ between patients initiated on second-generation long-acting injectable antipsychotics (SGLAIs) or oral atypical antipsychotics (OAAs). Less than half of patients continued the initiated antipsychotic post-discharge, among whom SGLAI patients were more likely to be adherent to that antipsychotic relative to OAA patients. Within 30 days post-discharge, SGLAI patients were more likely to have a schizophrenia-related outpatient visit compared to OAA patients.Name of Sponsoring Organization(s): Janssen Scientific Affairs, LLC