Impact of risperidone long acting injection on resource utilization in psychiatric secondary care

Abstract

Risperidone long acting injection (RLAI) is the only long acting atypical antipsychotic available in the UK. Its impact on NHS resource use has not been widely studied. This review of medical records was conducted to quantify the impact of RLAI on NHS psychiatric secondary care resource use, primarily in terms of episodes of inpatient hospital care 12 months before and 12 months after RLAI initiation. Data on number of hospitalizations and hospital bed days were collected retrospectively, from patient notes and hospital databases in four acute psychiatric units in the UK for all individuals with a diagnosis of schizophrenia or schizoaffective disorder who were prescribed RLAI more than 12 months previously. Data were collected on 100 individuals (58 male) with a mean age 40.8 years (range 19-70). The median duration of illness before RLAI initiation was 12 years (range six months to 43 years). There were 62 admissions in the 12 months pre-RLAI, falling to 22 admissions in the 12 months post-RLAI. Number of admissions, we argue, offer a more reliable indicator of the impact of treatment than total hospital bed days in this type of study. In this study there were 40 fewer admissions in the 12 months after RLAI was initiated compared with the previous 12 months. This is important as readmission is a good proxy measure of relapse, and adherence to medication is known to be a key factor in relapse prevention.

Long‐term safety and efficacy of long‐acting risperidone in elderly psychotic patients

“…In addition, there were a few re-hospitalizations in the study period, which is considered a good proxy measure of relapse. A retrospective review of medical records showed that there were 64.5% reductions in hospital admissions in the 12 months following RLAI treatment compared with the 12 months pre-RLAI treatment (Taylor et al, 2006). Finally, medication adjustments in the current study were individually determined by treating clinicians, using personal criteria, which likely were not consistent across practitioners.…”

The impact on schizophrenia-related hospital utilization and costs of switching to long-acting risperidone injections in Sweden

“…This may have removed the confounding effects of differences in disease severity, but more importantly, artificial allocation rules for hospital stays overlapping the index switch data did not apply to patients in whom Risperdal Consta was initiated on an outpatient basis [9]. Second, we complemented our base case estimate of the change in hospital bed-days per year with an alternative analytical approach inspired from modelling.…”

Adherence to risperidone long‐acting injection dosing recommendations

“…Mirrorimage studies in the UK of patients prescribed RLAI and followed-up for up to 35 months showed a reduction in the number of admissions post-treatment initiation. [11][12][13] It is suggested that number of admissions offer a more reliable indicator of treatment outcomes than total hospital bed days in this type of study as there are fewer confounding factors af fecting admissions than continued hospital stay. 12 Hospitalisation rates observed over 12 months in a long-term clinical trial of RLAI were considered to compare favourably with studies of conventional long-acting antipsychotics.…”

“…[11][12][13] It is suggested that number of admissions offer a more reliable indicator of treatment outcomes than total hospital bed days in this type of study as there are fewer confounding factors af fecting admissions than continued hospital stay. 12 Hospitalisation rates observed over 12 months in a long-term clinical trial of RLAI were considered to compare favourably with studies of conventional long-acting antipsychotics. 1 Additionally, the majority of previous inpatients who were now outpatients and still on RLAI at the time of audit were on monotherapy, implying that RLAI alone might provide good symptom control.…”