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Antipsychotic treatment and risk of discontinuation and hospitalization in first-episode schizophrenia: a nationwide population-based study

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Abstract
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2021 Apr 15;1-8.
doi: 10.1017/S0033291721001379. Online ahead of print.

Background: Current evidence on antipsychotic treatment and risk of psychiatric hospitalization in first-episode schizophrenia (FES) is largely based on the findings from randomized clinical trials (RCTs). However, the generalization of the findings to real-world patients is limited due to inherent caveats of the RCT. We aimed to investigate the treatment discontinuation and risk of psychiatric hospitalization using a nationwide population database.

Methods: The Health Insurance Review Agency database in South Korea was obtained, and the observation period started from 1 January 2009 to 31 December 2016. We defined the maintenance period as the period from 6-month after the diagnosis of schizophrenia, which is utilized for the main results. For a total of 44 396 patients with FES, a within-individual Cox regression model was used to compare the risk of the treatment discontinuation and psychiatric hospitalization.

Results: In group comparison, a long-acting injectable (LAI) antipsychotic group was associated with the lowest risk of the treatment discontinuation (0.64, 0.55-0.75) and psychiatric hospitalization (0.29, 0.22-0.38) in comparison with a typical antipsychotic group and no use, respectively. Among individual antipsychotics, the lowest risk of the treatment discontinuation was observed in LAI paliperidone (0.46, 0.37-0.66) compared to olanzapine. Clozapine was found to be the most effective antipsychotic in lowering the risk of psychiatric hospitalization as monotherapy compared to no use (0.23, 0.18-0.31).

Conclusions: In real-world patients with FES, LAI paliperidone and clozapine were associated with low treatment discontinuation and better effectiveness in lowering the risk of psychiatric hospitalization.

Keywords: Antipsychotic; discontinuation; hospitalization; nationwide population.
Author(s)
김하린안수진이중선조영탁주성우최영재
Issued Date
2021
Type
Article
Keyword
Antipsychoticdiscontinuationhospitalizationnationwide population
DOI
10.1017/S0033291721001379
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8617
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2513242655&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Antipsychotic%20treatment%20and%20risk%20of%20discontinuation%20and%20hospitalization%20in%20first-episode%20schizophrenia:%20a%20nationwide%20population-based%20study&offset=0&pcAvailability=true
Publisher
PSYCHOLOGICAL MEDICINE
Location
영국
Language
한국어
ISSN
0033-2917
Citation Volume
0
Citation Number
0
Citation Start Page
1469
Citation End Page
8978
Appears in Collections:
Medicine > Medicine
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