Good, moderate, and poor functioning of adult patients with schizophrenia treated with aripiprazole once-monthly or paliperidone palmitate once-monthly in the Qualify study

Introduction
QUALIFY was a 28-week, randomized, open-label, rater-blinded, head-to-head study (NCT01795547) evaluating effectiveness of aripiprazole once-monthly (AOM 400) vs paliperidone palmitate once-monthly (PP1M) in adult schizophrenia patients. 

Aim
To evaluate changes in Heinrichs-Carpenter Quality-of-Life Scale (QLS) scores from baseline to week 28 in Qualify, when translated into categories of “good”, “moderate” and “poor” functioning. 

Methods
QLS is a 21-item scale of patients’ social, occupational, and psychological functioning. The possible total score is 0-126, higher scores indicate better functioning.
Functioning was “good” when the QLS total score was > 84.5, “moderate” and “poor” were separated by a cutoff score of 15.5 on the QLS intrapsychic foundation domain in patients with QLS total score  < 84.5. 
Functioning was evaluated in a shift analysis. Statistical significance was tested using Fishers exact test.

Results
At baseline, distribution of patients in functioning categories was similar in the AOM 400 (n=144) and PP1M (n=137) groups. 
Of the AOM 400 and PP1M patients who had good functioning at baseline, 96% (21/22) and 54% (7/13) maintained that, respectively. Of the patients who had moderate functioning at baseline, 30% (19/64) and 23% (13/57) improved to good functioning, 67% (43/64) and 74% (42/57) maintained moderate functioning, respectively. Of the patients who had poor functioning at baseline, 6% (1/18) and 6% (1/16) improved to good and 56% (10/18) and 31% (5/16) to moderate functioning, respectively. The remaining worsened or had “poor” functioning.