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首页> 外文期刊>Therapeutic advances in psychopharmacology. >Real-world effectiveness of long-acting antipsychotic treatments in a nationwide cohort of 3957 patients with schizophrenia, schizoaffective disorder and other diagnoses in Quebec
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Real-world effectiveness of long-acting antipsychotic treatments in a nationwide cohort of 3957 patients with schizophrenia, schizoaffective disorder and other diagnoses in Quebec

机译：长效抗精神病药物治疗在魁北克全国3957名精神分裂症，精神分裂症和其他诊断患者中的实际疗效

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Long-acting injectable antipsychotics (LAI-AP) for patients with schizophrenia (SCZ) have saved significant healthcare costs. However, the cost effectiveness of LAI-AP for patients with other mental disorders has yet to be established. The goal of this study was to evaluate the impact of early initiation of LAI-AP medications on healthcare resource utilization (HRU). Drawing on the Quebecois universal healthcare program (RAMQ), we conducted a nationwide prospective cohort study of LAI-AP under real-world conditions. This study was performed using a representative sample of patients newly treated with LAI-AP (n = 3957) who were covered by the Québec Health Insurance Plan. The index date was defined as the date of the first prescription for LAI-AP between 1 January 2008 and 31 March 2012. We collected (a) the demographics and patient characteristics; (b) the treatment characteristics index drug, speciality of the principal prescriber, prescriptions of LAI-AP; and (c) HRU and costs. Two comparisons were made between (a) non-SCZ users of LAI-AP and SCZ users of LAI-AP; and (b) patients with SCZ using first-generation antipsychotic LAI-AP (FGA-LAI) and second-generation antipsychotic LAI-AP (SGA-LAI). In the people with SCZ group, 976 patients were on an SGA-LAI, and 1020 patients were on an FGA-LAI; 41.9% of all users were on risperidone LAI-AP during this period and 17.9% were on zuclopenthixol decanoate. The number of hospitalizations was reduced by half. Durations were also significantly reduced. The total healthcare cost savings for all users were C$29,876 per patient/per year. Younger patients tended to receive more SGA-LAI than FGA-LAI: 29% versus 13%. The percentage of general practitioners who prescribe LAI-AP is higher in the FGA-LAI group than in the SGA-LAI group: 19% versus 13%. For psychiatrist prescribers, it is the opposite: 86% (SGA-LAI) versus 79% (FGA-LAI). The concomitant use of oral antipsychotics (OAP) in the year following index date is higher in the FGA-LAI group: 75% versus 43%. The number of hospitalization days was reduced by 31.5 days in the FGA-LAI group and 38.8 days in the SGA-LAI group. Cost savings were of C$31,924 in the FGA-LAI group and of C$39,100 in the SGA-LAI group. The initiation of LAI-AP saved significant costs to the province of Québec compared with the previous year. Initiation of a LAI-AP resulted in lower resource use. Higher medication costs were offset by lower inpatient and outpatient costs.
机译：精神分裂症（SCZ）患者的长效注射抗精神病药（LAI-AP）节省了可观的医​​疗费用。但是，LAI-AP在其他精神疾病患者中的成本效益尚未确定。这项研究的目的是评估早期使用LAI-AP药物对医疗资源利用（HRU）的影响。利用魁北克全民医疗保健计划（RAMQ），我们在现实条件下对LAI-AP进行了全国性前瞻性队列研究。这项研究使用的是魁北克健康保险计划所涵盖的接受LAI-AP新治疗的患者（n = 3957）的代表性样本。索引日期定义为2008年1月1日至2012年3月31日期间首次接受LAI-AP处方的日期。我们收集（a）人口统计学和患者特征; （b）治疗特征指数药物，主要处方者的专业，LAI-AP的处方; （c）HRU和费用。 （a）LAI-AP的非SCZ用户和LAI-AP的SCZ用户之间进行了两个比较; （b）使用第一代抗精神病LAI-AP（FGA-LAI）和第二代抗精神病LAI-AP（SGA-LAI）的SCZ患者。在SCZ组中，有976例患者接受SGA-LAI，有1020例患者接受FGA-LAI。在此期间，所有用户中有41.9％的患者使用利培酮LAI-AP，而癸酸戊哌噻吨癸酸酯的使用率为17.9％。住院数量减少了一半。持续时间也大大减少。每位患者/每年为所有用户节省的总医疗成本为29,876加元。年轻的患者往往比FGA-LAI接受更多的SGA-LAI：29％比13％。处方LAI-AP的全科医生百分比在FGA-LAI组中高于SGA-LAI组：19％对13％。对于精神科医生，则相反：86％（SGA-LAI）对79％（FGA-LAI）。 FGA-LAI组在索引日期后的一年中同时使用口服抗精神病药（OAP）的比例更高：分别为75％和43％。 FGA-LAI组的住院天数减少了31.5天，SGA-LAI组的住院天数减少了38.8天。 FGA-LAI组的成本节省为31,924加元，SGA-LAI组的成本节省为39,100加元。与上一年相比，LAI-AP的启动为魁北克省节省了大量成本。 LAI-AP的启动导致资源使用减少。较高的药物费用被较低的住院和门诊费用所抵消。

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