Satisfaction of immediate or delayed switch to paliperidone palmitate in patients unsatisfied with current oral atypical antipsychotics

Abstract

Patient satisfaction with treatment is an important clinical index associated with the efficacy and adherence of treatment in schizophrenia. Although switching from oral antipsychotics to the long-acting injectable formulation may improve convenience, patient satisfaction has not been studied extensively. We carried out a 21-week, multicenter, randomized, open-label comparative study. A total of 154 patients with schizophrenia unsatisfied with current oral atypical antipsychotics were assigned randomly to either immediate or delayed switching to paliperidone palmitate, the long-acting injectable formulation of paliperidone. The Medication Satisfaction Questionnaire (MSQ) and the Treatment Satisfaction Questionnaire for Medication (TSQM) were used to evaluate patient satisfaction with treatment, whereas the Positive and Negative Syndrome Scale (PANSS) and the Personal and Social Performance (PSP) scale were used to evaluate efficacy. From baseline to the final assessment, the MSQ score increased significantly in both groups, and the increase was greatest after the first administration of paliperidone palmitate in the immediate switch group. The scores of TSQM effectiveness, convenience, and global satisfaction as well as the PSP total score increased significantly, whereas the PANSS total score decreased significantly in both groups. The immediate switch group showed a significant improvement in the TSQM convenience score compared with the delayed switch group on oral antipsychotics during the comparison period. Most adverse events were minor and tolerable. In short, switching from oral atypical antipsychotics to paliperidone palmitate because of poor satisfaction significantly improved patient satisfaction, with comparable efficacy and tolerability.

The utility of novel outcome measures in a naturalistic evaluation of schizophrenia treatment

“…A review of the literature regarding patients’ satisfaction with antipsychotic medication for schizophrenia highlighted that as well as the more obvious negative effects upon satisfaction of drug side-effects, the lack of involvement in treatment planning or decision making was a major influence on satisfaction ratings. 23 The improvement we found in the mean MSQ scores at 12 months (compared to baseline scores) was 1.5 points, which is slightly higher than that reported in other studies: 0.88 points at 21 weeks 19 and 0.8 points at 12 months. 11 The improvement though, as well as the significant reduction found in the HoNOS-derived Severe Disturbance factor, described below, over the 12-month treatment period suggests that medication satisfaction with PP treatment is aligned to a reduction in the severity of psychotic symptoms.…”

“…Finally, patient-reported outcomes, including treatment satisfaction, are considered to be important in the assessment of therapeutic interventions, and a link has been shown between treatment satisfaction and an improvement in symptoms and adherence rates in schizophrenia. 18 Thus, in line with other studies measuring patient satisfaction with PP, 11 , 19 the medication satisfaction questionnaire (MSQ) was employed as the secondary outcome measure in this study.…”

Efficacy and safety profile of paliperidone palmitate injections in the management of patients with schizophrenia: an evidence-based review

“…Medication satisfaction improved significantly in both groups, with comparable efficacy and tolerability ( Table 2 ). 40 …”

“I live, I don't work, but I live a very normal life”—A qualitative interview study of Scandinavian user experiences of schizophrenia, antipsychotic medication, and personal recovery processes

“…Knowledge of service user perspectives on the antipsychotic treatment of schizophrenia is limited . A number of studies have compared oral treatment with long‐acting injections (LAIs) . This previous research has primarily been based on surveys of user satisfaction and measures of quality of life.…”