Patients with serious mental illnesses such as schizophrenia often struggle with medication adherence, due to lack of insight into their disease, medication side effects, forgetfulness, and a variety of other factors. One solution to this problem is to use long-acting injectables or LAIs. Whereas most antipsychotics are oral medications, LAIs are typically injectables that you need to get only about once per month.
Can using LAIs improve outcomes and decrease cost? According to a study by MacEwan et al., (2016), the answer is yes.
LAIs were associated with significantly lower probability of rehospitalization compared with oral antipsychotics at 60 days for schizophrenia-only patients (adjusted odds ratio [AOR]=.60, 95% confidence interval [CI]=.41–.90) and for all patients (AOR=.70, CI=.52–.95). The absolute difference in probability of rehospitalization for all patients was significantly lower by 5.0% at 60 days in the LAI group compared with the oral antipsychotics group.
Patients that receive LAIs likely have more severe form of the disease on average than patients using oral antipsychotics so the authors–which include some of my colleagues at PHE–used multivariate logistic regression and propensity score matching (PSM) methods.
- MacEwan, Joanna P., Siddhesh A. Kamat, Ruth A. Duffy, Seth Seabury, Jacquelyn W. Chou, Susan N. Legacy, Ann Hartry, Anna Eramo, and Craig Karson. “Hospital Readmission Rates Among Patients With Schizophrenia Treated With Long-Acting Injectables or Oral Antipsychotics.” Psychiatric Services (2016): appi-ps.