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186 Hospital Utilization Rates Following Antipsychotic Dose Reductions Among Patients With Schizophrenia

Published online by Cambridge University Press:  15 June 2018

Stanley N. Caroff ,
Fan Mu ,
Rajeev Ayyagari ,
Traci Schilling ,
Victor Abler  and
Benjamin Carroll
Stanley N. Caroff
Affiliation:
Department of Psychiatry, Corporal Michael J. Crescenz VA Medical Center and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
Fan Mu
Affiliation:
Analysis Group, Inc., Boston, Massachusetts, USA
Rajeev Ayyagari
Affiliation:
Analysis Group, Inc., Boston, Massachusetts, USA
Traci Schilling
Affiliation:
Teva Pharmaceutical Industries, Frazer, Pennsylvania, USA
Victor Abler
Affiliation:
Teva Pharmaceutical Industries, Frazer, Pennsylvania, USA
Benjamin Carroll
Affiliation:
Teva Pharmaceutical Industries, Frazer, Pennsylvania, USA
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Abstract

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Introduction

Tardive dyskinesia (TD), an often-irreversible movement disorder, develops in patients treated withantipsychotics. Although antipsychotic dose reduction has been utilized in the management of TD, the benefits and risks of lowering doses have not been well studied and could cause additional burden to patients.

Objective

To analyze the healthcare burden of antipsychotic dose reduction in patients with schizophrenia.

Methods

Medical claims from six US states spanning 6 years are retrospectively analyzed for ≥10% or ≥30% antipsychotic dosereductions and compared with those from patients receiving stable doses. Outcomes measured include inpatient admissions and emergency room (ER) visits for schizophrenia, all psychiatric disorders, and all causes.

Results

Baseline analysis revealed 17,984 patients with ≥10% and 14,029 patients with ≥30% dose reduction. Patients with≥10% dose reduction and matched controls were similar in age (mean 45.5 years), gender (51% male) and healthcare plan type. Preliminary analyses indicate that ≥10% dose reduction is associated with increased risk of admission or ER visit for schizophrenia (hazard ratio [HR] 1.26; 95% confidence interval [CI] 1.18, 1.35; P<0.001) and all psychiatric disorders (HR 1.18; 95% CI 1.11, 1.25; P<0.001) versus controls, which may be even greater with ≥30% dose reduction. Final updated results of ongoing analyses will be presented at the meeting.

Conclusions

Patients with antipsychotic dose reductions may be at risk for significant increases in hospital utilization rates. This suggests that dose reductions may increase overall healthcare burden in some schizophrenia patients, and highlights the need for alternative strategies in the management of TD.

Presented at: Psych Congress; September 16–19, 2017; New Orleans, Louisiana, USA.

Funding Acknowledgements

This study was funded by Teva Pharmaceutical Industries, Petach Tikva, Israel.

Type
Abstracts
Information
CNS Spectrums , Volume 23 , Issue 1 , February 2018 , pp. 106 - 107
Copyright
© Cambridge University Press 2018