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首页> 外文期刊>The journal of clinical psychiatry >Risperidone long-acting therapy prescribing patterns and their impact on early discontinuation of treatment in a large Medicaid population.
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Risperidone long-acting therapy prescribing patterns and their impact on early discontinuation of treatment in a large Medicaid population.

机译：利培酮长效治疗的处方模式及其对大量医疗补助人群中早期停药的影响。

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OBJECTIVE: Medicaid claims were examined to determine whether utilization of risperidone long-acting therapy (LAT) was consistent with manufacturer's prescribing information recommendations and what factors were associated with early discontinuation. METHOD: Florida Medicaid claims between July 1, 2003, and June 30, 2007, were used. Recipient demographics and diagnoses, provision of oral antipsychotic supplementation during the first 21 days, number of injections received, medication possession ratio, and augmentation/polypharmacy after the first 21 days were assessed. Logistic regression was used to identify factors associated with early discontinuation of risperidone LAT. RESULTS: There were 3,364 individuals who received 4,546 episodes of risperidone LAT. Most recipients were between 18 and 64 years and had schizophrenia or schizoaffective disorder. Median episode length was 106 days. Median number of injections was 5. Supplementation with oral antipsychotic during the first 21 days was provided in 48% of episodes. Mean dosages were 25 mg or less for 28% of episodes and greater than 75 mg for 7% of episodes. Augmentation/polypharmacy after the first 21 days occurred in 43% of episodes. Early risperidone LAT discontinuation was associated with absence of oral supplementation during the first 21 days (P < .001), low (P = .045) or high (P < .001) initial doses of risperidone LAT, prior inpatient treatment (P < .001), having a substance use disorder (P = .001), and being male (P = .036). CONCLUSIONS: Prescribing practices for risperidone LAT were compared with the recommended protocol. Risperidone LAT was typically used with recommended age and diagnostic groups. However, important discrepancies were identified that could have reduced perceived effectiveness and tolerability of risperidone LAT. Early discontinuation was less likely when the recommendations in the manufacturer's prescribing information regarding dosage and supplementation with oral antipsychotics were followed.
机译：目的：检查医疗补助要求，以确定利培酮长效疗法（LAT）的使用是否与制造商的处方信息建议相符，以及哪些因素与早期停药有关。方法：使用了2003年7月1日至2007年6月30日之间的佛罗里达医疗补助索赔。评估了接受者的人口统计学和诊断，在前21天提供口服抗精神病药，接受注射的次数，药物拥有率以及在前21天进行了增药/多药治疗。 Logistic回归用于确定与利培酮LAT早期停用相关的因素。结果：有3,364个人接受了4,546次利培酮LAT发作。大多数接受者年龄在18至64岁之间，患有精神分裂症或精神分裂症。平均发作时间为106天。注射的中位数为5。在最初的21天中，有48％的患者补充了口服抗精神病药。 28％的发作平均剂量为25 mg或更少，7％的发作大于75 mg。前21天后，有43％的病例发生了增强/多药治疗。早期停用利培酮LAT与最初21天（P <.001），利培酮LAT初始剂量低（P = .045）或高（P <.001）口服治疗前未口服补给相关（P < .001），患有物质使用障碍（P = .001），并且是男性（P = .036）。结论：利培酮LAT的处方实践与推荐方案进行了比较。利培酮LAT通常用于推荐的年龄和诊断组。但是，发现了重要的差异，这些差异可能降低了利培酮LAT的感知效力和耐受性。当遵循制造商的处方信息中有关口服抗精神病药剂量和补充的建议时，早期停药的可能性较小。

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